[{"_1":2,"_100":-5,"_101":-5},"loaderData",{"_3":4,"_26":27},"root",{"_5":6,"_17":10,"_18":19,"_20":21,"_22":10,"_23":-5,"_24":-5,"_25":10},"user",{"_7":8,"_9":10,"_11":10,"_12":-5,"_13":-5,"_14":15,"_16":-5},"roles",[],"isAuthenticated",false,"isPremium","planName","subscriptionStatus","featureFlags",{},"insightsBudget","isDevelopmentHost","userPreferences",{},"recaptchaSiteKey","6LcvOJcUAAAAAHsB-gPGfGktcRlKpH7OTIU_dMTD","isImpersonating","impersonation","affiliateStatus","isFreedomPortal","routes/v2/article/layout",{"_28":29,"_30":31},"notFound",true,"relatedArticles",[32,76,88],{"_33":34,"_35":36,"_37":38,"_39":40,"_41":42,"_43":44,"_45":46,"_47":48,"_49":50,"_51":52,"_53":54,"_55":56,"_57":58,"_59":60,"_61":62,"_63":64,"_65":66,"_67":68,"_69":70,"_71":72,"_73":74,"_75":74},"mediaId",6454849,"mediaKeyId","5857865-3d5406c519d89d2469dfae8445549c5e","parentId",5857865,"title","UCSF study: California nurse midwife workforce older, unevenly distributed and largely nationally certified","audioSeconds",743,"startMs",604000,"endMs",1347000,"viewUrl","/Search/View?dp=1&key=5857865-3d5406c519d89d2469dfae8445549c5e&start=604&end=1347","thumbnailUrl","https://assets.pipeline.soar.com/5857865-3d5406c519d89d2469dfae8445549c5e/thumbnail_604000.jpg","articleUrl","/articles/6454849/California/UCSF-study-California-nurse-midwife-workforce-older-unevenly-distributed-and-largely-nationally-certified","mediaUrl","https://secure.pipeline.soar.com/6454849-20c9ef5b970b77d757a2858c956b4aad/orig.mp4?Expires=1770450647&Signature=ntwqAu1Do0C3BkJyjE8-l8K4IgeWUhreno4iMcQe4K52gn1BVPbQSZa1Ew33rC-k3fiYiVZLfEo4BMvjv-ttGsJwYeaDUQ5pTqNqdScHFcgFsYDaUkazgoj8VGl3BNoc6jpeYal5bB4tHJPughFAJO36dIbwvJM-55B9mRxWEZmcFfw3yuD0vC9UNeWj727KkuL5b9~QpyP0pGzgwL76aZEqM1gHyqpsTM~lcwGCi5cwLwjZEDj5wa4UaH~NuIacVgycd945LxnRlC1IlQkCk54tbu6qGvhnWNrKvOvCF4AzalaRFSRfO5BuCPkWiRKE8dB7c7I~qT-AiQL0Ft1NBg__&Key-Pair-Id=KUT5TJCACFTXG","author","Respiratory Care Board of California","date","2025-09-30T16:57:19Z","article","Kim Do, a certified nurse midwife and member of the research team, presented results from a 2022'23 workforce survey of California nurse midwives to the Nurse Midwifery Advisory Committee of the Board of Registered Nursing. The study was conducted by researchers at the University of California, San Francisco and funded by the California HealthCare Foundation.

The study surveyed 700 California-licensed nurse midwives and \"received a 39.5% response rate,\" Do said. Respondents were weighted to be representative of the statewide licensed population. The research team reported that the average age of respondent nurse midwives was 50.4 years and that the workforce is distributed unevenly across the state, with the Greater Bay Area accounting for the largest share.

The survey found 76% of respondents were practicing midwifery and, among those, eight in 10 reported attending births. The presenters reported that around 76.1% of nurse midwives identified as white and that only 26.5% reported speaking Spanish as an additional language; the team noted this does not reflect the racial and linguistic diversity of California women of reproductive age.

On services, presenters said 82.8% of practicing nurse midwives provide prenatal care and 89.6% provide postpartum care; 78.2% provide preventive sexual and reproductive health services. The team reported roughly 30% of practicing nurse midwives provide medication abortion and about 4.8% provide aspiration abortion. The presenters also said 57.4% of respondents reported \"always or almost always\" practicing to the fullest extent of their legal scope, down from 72.4% in the BRN's 2017 workforce study.

Joanne Spetz, professor and director of the Philip R. Lee Institute for Health Policy Studies at UCSF, who served as principal investigator, joined Do for questions. Committee members and public commenters asked whether the reduced percentage reporting practice to full scope could be linked to continued institutional supervision despite legal changes that removed physician supervision in 2020. Do said the team did not have a definitive explanation in the survey data and suggested further study.

Members discussed barriers to expanding the midwifery workforce. Presenters and several committee members highlighted clinical preceptor shortages and geographic concentration of educational programs as likely contributors. Do and others said clinical precepting is time-consuming and often conflicts with productivity expectations in hospitals. Committee members noted only two California schools currently operating midwifery education programs, and that existing accreditation and clinical-site policies can limit where students can do required clinical experiences.

Public commenters representing clinical preceptors and the California Nurse Midwives Association supported the report's recommendations and urged state support for new programs and funding mechanisms such as Song-Brown to expand training capacity.

The committee received the presentation as information and opened the item for public comment; no formal board action was taken on the survey itself.

Ending: The presenters and committee flagged the need for additional research on regional differences, preceptor incentives and the causes of reported reductions in practicing to full scope; staff said those topics could inform future committee work and legislative or regulatory recommendations.","mediaType","Video","parentTitle","Board of Registered Nursing Nurse Midwifery Advisory Committee Meeting September 23, 2025","oneSentenceSummary","Kim Do, a certified nurse midwife and member of the UCSF research team, presented a 2022'23 workforce survey showing California nurse midwives have an average age of 50.4, are unevenly distributed across the state and are largely nationally certified.","taxTitle","Respiratory Care Board of California, Boards and Commissions, Executive, California","taxId",76751,"location","California","headline","","shortSummary",{"_33":77,"_35":36,"_37":38,"_39":78,"_41":79,"_43":80,"_45":81,"_47":82,"_49":83,"_51":84,"_53":85,"_55":56,"_57":58,"_59":86,"_61":62,"_63":64,"_65":87,"_67":68,"_69":70,"_71":72,"_73":74,"_75":74},6454839,"NMAC backs drafting regulations to tie California midwifery licensure to national accreditation and certification",982,5354000,6336000,"/Search/View?dp=1&key=5857865-3d5406c519d89d2469dfae8445549c5e&start=5354&end=6336","https://assets.pipeline.soar.com/5857865-3d5406c519d89d2469dfae8445549c5e/thumbnail_5354000.jpg","/articles/6454839/California/NMAC-backs-drafting-regulations-to-tie-California-midwifery-licensure-to-national-accreditation-and-certification","https://secure.pipeline.soar.com/6454839-910547eaa94e018a94dbe866c7c35454/orig.mp4?Expires=1770450647&Signature=OAH9Kbtaljdm4ZB~WksayEaZN3yYmB-Yb22Kg1JxwlYIYSf9h84GTazmOi-Zw9J4f8pE3DNDYHRNkVDyj3q1NcuK09wm2xY6Pgmc7AadTA0dyCZFzGLE1l0IfWbROvjfj-hyKzKDlbUdBt24AkL0S-sRPIKZXD4o~VVGZsE0n1OgZeHhYHg~CbDwxJZrFSTev~I~3v~GP3gobZiD6JlQ5BrUTM5sBo4kvufLj7c0DDn87kXon0xWLlLkgXTyHdnmUquZZ4p5~Q0HcqnZwS9Az3jttfjwVmmTFIFbXYdA~KAayC3mH7oFHzxnG5Qj8qY1GBihqB8L6YlZwcxyH3RGww__&Key-Pair-Id=KUT5TJCACFTXG","Kim Do, presenting as a member of the NMAC education subcommittee, asked the committee to consider updating California Code of Regulations, title 16, sections 1460 and 1462, which set board educational standards for nurse midwives. Do told the committee the regulations were last amended in 1985 and that statutory scope-of-practice changes and national accreditation standards argue for a fresh review.

Do outlined three existing regulatory pathways currently in CCR 14 60: (1) completion of a program that meets BRN standards (pathway most commonly used by California-based programs), (2) an equivalency pathway under which the board reviews an applicant's program and may request remediation, and (3) demonstration of certification by an equivalent national organization. Do explained that in practice many programs and applicants already meet national standards, because Accreditation Commission for Midwifery Education (ACME) accreditation and American Midwifery Certification Board (AMCB) certification are widely used.

Do proposed that the committee consider regulations that would require as the minimum for licensure a nationally accredited program (ACME) and national certification (AMCB), with a temporary license option (analogous to RN temporary licensure) to bridge the gap between program completion and receipt of national certification. Do said the ACME accreditation process covers program administration, policies for student support, curriculum aligned with ACNM core competencies, clinical resources and quality monitoring; AMCB provides standardized national certification.

Committee members asked procedural questions about precedent and process. Staff and counsel explained that the committee may draft regulatory text for the board's consideration, but the full board ultimately determines whether to initiate formal rulemaking. Committee members also discussed whether California's current permissive pathway (licensure without national certification) provides equity or creates differences with other professions. Public comment from Anya Rapoport (California Nurse Midwives Association) supported the proposed move to require ACME accreditation and AMCB certification and asked for a six-month temporary license window parallel to the RN temporary license.

The committee voted to direct the education subcommittee to draft proposed regulatory language requiring applicants to demonstrate completion of a nationally accredited midwifery education program and AMCB certification; the subcommittee will present draft text at a future NMAC meeting and the BRN will be apprised of the committee's direction.

Ending: NMAC will draft proposed regulations and return with text for review; staff warned regulatory change is a multistep process and may take many months to complete, and the full BRN must approve initiation of formal rulemaking.","The Nurse Midwifery Advisory Committee voted to ask the education subcommittee to draft regulatory language that would require applicants for nurse-midwife licensure to show completion of an ACME-accredited education program and proof of AMCB national certification; committee members requested staff and the full BRN be briefed as drafts progress.",{"_33":89,"_35":36,"_37":38,"_39":90,"_41":91,"_43":92,"_45":93,"_47":94,"_49":95,"_51":96,"_53":97,"_55":56,"_57":58,"_59":98,"_61":62,"_63":64,"_65":99,"_67":68,"_69":70,"_71":72,"_73":74,"_75":74},6454844,"BRN draft FAQs tightened; committee votes to adopt with abortion-services language removed pending legal review",2335,2743000,5078000,"/Search/View?dp=1&key=5857865-3d5406c519d89d2469dfae8445549c5e&start=2743&end=5078","https://assets.pipeline.soar.com/5857865-3d5406c519d89d2469dfae8445549c5e/thumbnail_2743000.jpg","/articles/6454844/California/BRN-draft-FAQs-tightened-committee-votes-to-adopt-with-abortion-services-language-removed-pending-legal-review","https://secure.pipeline.soar.com/6454844-ebe783ee2ae3a131e160fed34473841d/orig.mp4?Expires=1770450647&Signature=emyIteggGF9GT6S4oD4tKDq~bNpsNcCo5uKop4L92bm0qLsJzdS0UiGW~nhKhch97H4RcILzNXMQgMcSdsixs9qoBGSFqafcsGxiAVHgxwjOR4BFfSTDHbzL4cgwMKY0GfZgHAc~lAvaswJ3S26Kq-J4GQ5g9s-krjSR~mJFgEajcpG~EfqidGwa-TDrBHGp5153Tom9E52cAxVN0qg4hcopap3uo38iXnLzlRNzXLceObt5gvOYoEX3eSy9Gajx~j50v0kY-jXbID4g8sU4j8RpUnyFBbxx89ZMvbagxmeiNjNzLe9W4TBlFOB506xUql-MvIyVLII7AhiRUYdRCg__&Key-Pair-Id=KUT5TJCACFTXG","Loretta Melby, executive officer of the Board of Registered Nursing, presented proposed revisions to the board's nurse-midwife frequently asked questions and asked the committee for feedback. The revisions reflect changes to state law and aim to clarify practice issues such as low-risk definitions, mutual policies and protocols with physicians, furnishing controlled substances and lab-director provisions.

Melby and board legal counsel Reza Pejuez repeatedly emphasized the limits on the board's authority to interpret statute, noting FAQ language must stay tied to statutory text. The draft FAQ clarified that nurse midwives may provide care defined as \"low risk\" without mutually agreed-upon policies and protocols, but that care falling outside that low-risk definition generally requires signed, mutually agreed-upon policies and protocols with a physician. The draft also removed a prior requirement for standardized procedures and reiterated that furnishing certain controlled substances requires specific coursework, DEA and CURES registration.

The most contested portion concerned one FAQ asking whether a nurse midwife may provide abortion services. The draft stated nurse midwives may provide first-trimester abortion via medication or aspiration without physician supervision but noted additional clinical and didactic competency is statutorily required and, because of that additional training requirement, the practice would fall under the subdivision that requires mutually agreed-upon policies and protocols.

Public commenter Holly Smith and committee member commenters objected to that framing. Smith and others argued the statutory language (including the midwifery scope-of-practice and the dedicated abortion-by-aspiration statute) and national core competencies do not support adding an administrative requirement beyond the competency statutory language; they warned such an interpretation could create unauthorised barriers to care. Counsel Reza Pejuez and EO Melby responded that the statute specific to abortion-by-aspiration (cited in the meeting) requires additional competency and thus presents a legal question about whether FAQs should state the practice requires mutually agreed-upon policies and protocols.

After public comment and committee discussion, a motion passed to adopt the revised FAQ with two modifications: (1) edit the scope-of-practice opening language to mirror statutory phrasing including \"care for common gynecologic conditions,\" and (2) remove the FAQ question and answer on abortion services from the posted FAQ pending further legal review. Committee members asked staff to add an approval date to the published FAQ and to return with legal analysis and proposed language for any future publication on that topic.

Ending: The FAQ package was adopted with the two changes; staff will add a posting date and bring a legal review of the contested abortion section back to the committee before republication.","The Nurse Midwifery Advisory Committee reviewed a substantially revised FAQ for nurse-midwife practice on the BRN website; the committee voted to adopt the updated FAQs with two changes: (1) edit scope language to match statute and (2) remove the FAQ on abortion services pending further legal review and clarification.","actionData","errors"]

Article not found

UCSF study: California nurse midwife workforce older, unevenly distributed and largely nationally certified

NMAC backs drafting regulations to tie California midwifery licensure to national accreditation and certification

BRN draft FAQs tightened; committee votes to adopt with abortion-services language removed pending legal review