Protect NJ Homebirth

Dear NJ Home Birth community:

Dear NJ Homebirth Community,

You may have heard that there has been a midwifery bill introduced recently (June 27, 2023) in both the NJ House of Representatives (Britnee N. Timberlake – District 34 – Essex and Passaic – Assembly, No. 5674) and the NJ Senate (Joseph Vitale – District 19 – Middlesex – Senate, No. 4042).

Advantages of this bill include:

  • The creation of an independent Board of Midwifery under the Division of Consumer affairs, rather than the current structure which is a Midwifery Liaison Committee reporting to the Board of Medical Examiners.

  • Term limits in the newly formed Board of Midwifery.

  • The Certified Professional Midwife (CPM) can work in birth centers. We are currently permitted to work in birth centers because there was a waiver issued by the Department of Health at the end of 2020 initiated by the CPM community. This bill solidifies this.

  • CPM will be permitted to provide gynecological and primary preventative reproductive care for people with female reproductive systems.

  • Certified Nurse Midwives (CNM) and Certified Midwives (CM) will have completely autonomous practice and will be able to prescribe and practice to the full extent of their scope of practice.

    Disadvantages of this bill include:

  • The newly created Board of Midwifery will have only 7 midwives in the group of 13 people that will be appointed to the Board. The remaining Board members are obstetricians (2), family practice doctor (1), pediatrician (1), a public member (1), and an appointed member from the Executive Branch of the NJ Judiciary (1). We believe that a Board of Midwifery should have a larger majority of midwives. We prefer one obstetrician/family practice doctor, which would then open two more seats for midwives, ensuring midwifery presence from all credentials.

  • Liability insurance will be required for all licensed midwives. There is only one malpractice insurance provider in the country that will cover the CPM in NJ. This will severely limit the ability to acquire insurance. Only four states in the country require malpractice insurance for CPMs to practice.

  • CPMs will be required to have written practice guidelines established with a physician practicing obstetrics, a midwife (CNM/CM), an advanced practice nurse, or a physician assistant. A total of three states have supervisory requirements for CPMs.

  • CPMs will be required to have “standing orders” with one of the above-named licensees to be able to obtain and dispense medications.

  • This bill creates in law a hierarchical structure of midwives with the CPM at the bottom of the hierarchy.

  • This bill has the VERY REAL possibility of creating a situation where the CPM (who provides the vast majority of licensed home birth care in the state) will be unable to practice.

    CNMs and CMs are trained for birth in the hospital setting and most have hospital privileges, while the CPM is trained for Community Birth (out-of-hospital). This new bill allows CNMs and CMs to provide prescriptions and carry life-saving medications without a signature/back up doctor. The CPM on the other hand is required to get permission to practice, as well as standing orders from a doctor, CNM, or PA to carry and administer the meds needed to provide the safest care to their clients.

    Because there is no requirement that a physician (or others permitted) provide the CPM with what they need to practice, it is nearly impossible for the CPM to create a relationship with a physician (or others permitted) to get the standing orders needed, quite possibly practically eliminating home birth as an option in NJ. CPMs currently provide the vast majority of homebirth care in NJ.

    While we want the current midwifery law to change, we want to see the change benefit all midwives, (hence all midwifery clients) not just a select few pathways to midwifery.

    We ask you, our clients, friends of our clients, family of our clients to reach out to your local legislators, both Senators and Representatives, and beg, bother, and repeat until they require the legislators writing this law to allow ALL midwives to practice autonomously and to their full scope. Find your legislators here.

    We need you now! We have seen you step up as activists in times when big decisions in NJ had to be made, and we ask that you enlist the power that the people of NJ have. Assure that this bill is correctly amended and returns choice back to the families of NJ.

    Please see attached for a letter/script that can be presented to your legislator either by mail or preferably by phone.

    Please call many times to assure you are heard.

    Documents & Links: