On September 30, 2025, the Board of Registered Nursing's Nurse Midwifery Advisory Committee convened to discuss the findings of a recent workforce survey conducted by the University of California, San Francisco. The survey, which gathered data from nurse midwives licensed in California, revealed significant trends and challenges within the profession that could impact maternity care across the state.

The survey, conducted between July 2022 and March 2023, achieved a response rate of 39.5% from 700 nurse midwives. Key findings highlighted a 50% increase in the number of births attended by nurse midwives in California, rising from 8.4% in 2012 to 12.8% in 2022. However, the distribution of nurse midwives remains uneven, with the Greater Bay Area housing the largest concentration, raising questions about accessibility in other regions.

The average age of nurse midwives surveyed was 50.4 years, indicating a potential future workforce shortage as many approach retirement. The survey also revealed a lack of diversity within the workforce, with 76.1% identifying as white, contrasting sharply with the racial diversity of the state's reproductive-age population. This disparity underscores the need for targeted recruitment and training initiatives to better reflect the communities served.

A notable concern raised during the meeting was the decline in the percentage of nurse midwives practicing to the fullest extent of their legal scope, dropping from 72.4% in 2017 to 57.4% in 2023. This decline may be linked to institutional barriers that persist despite legislative changes aimed at reducing physician supervision requirements.

The committee discussed the critical role of clinical precepting in nurse midwifery education, highlighting that 44.5% of practicing midwives had precepted students in the past year. However, challenges in finding qualified preceptors were noted, which could hinder the training of future midwives. The meeting emphasized the importance of creating supportive structures to incentivize clinical precepting, as many midwives face productivity pressures that limit their ability to mentor students.

In terms of employment, the survey indicated that 29% of nurse midwives work full-time, while 55% work part-time. Despite these challenges, 76% reported satisfaction with their work, suggesting a commitment to the profession. However, nearly 30% plan to reduce their hours or take a temporary leave within the next five years, raising concerns about future workforce stability.

The committee also discussed legislative efforts to support midwifery education, including two bills currently awaiting the governor's signature. These bills aim to establish funding for new nurse midwifery programs and to study the sustainability of existing programs, which could help address the workforce shortages and improve access to maternity care in underserved areas.

In conclusion, the discussions at the Nurse Midwifery Advisory Committee meeting highlighted both the progress and challenges facing nurse midwives in California. The findings from the workforce survey provide critical insights that could inform policy decisions and educational strategies aimed at enhancing the midwifery profession and ensuring quality maternity care for all Californians. As the committee moves forward, addressing the identified gaps in workforce diversity, clinical training, and legislative support will be essential for the future of midwifery in the state.