Kansas Midwives Alliance briefs nursing committee on certified professional midwives, licensure debate and collaborative transfer practices

Deidra Dovrado of the Kansas Midwives Alliance briefed the Kansas Board of Nursing Practice Committee on the role, training and clinical practice of certified professional midwives (CPMs) and discussed how midwifery operates in Kansas without a statutory license.

Dovrado described CPM scope and training, including prenatal, intrapartum and postpartum care, newborn screening and follow‑up visits, and said CPMs in other states may have limited prescriptive authority for medications such as oxytocics, vitamin K and antibiotics depending on state law. "We are certified professional midwives," she said, describing certification through the North American Registry of Midwives and apprenticeship‑based clinical training routes.

Dovrado reviewed Kansas’s legal landscape for midwifery: she said a 1993 court case commonly referenced in Kansas — named in the presentation as "Rupi versus Board of Nursing" and action against the Board of Healing Arts — led to a judicial interpretation that childbirth "standing alone in and of itself is not a medical condition" and that midwifery practice in Kansas is governed by that judicial precedent rather than a specific licensure statute. She told the committee CPMs are licensed in 36 states, but Kansas relies on voluntary association oversight and collaborative local relationships.

Board members asked about safety, oversight and practice variation. A committee member said licensure “provides consistency” and disciplinary processes, and expressed concern that without state licensure there can be unregulated practitioners who call themselves midwives. Dovrado acknowledged that concern and described local solutions in Wichita: established transfer protocols, direct phone lines to hospital labor units, periodic meetings with hospital directors of nursing and formalized collaborative arrangements that allow timely transfer and NICU admission when needed.

Dovrado cited performance metrics from her practice and the alliance: she said her group’s out‑of‑hospital transfer rate is "approximately 10 percent," a cesarean rate of about "2 percent" and a NICU transfer rate this year around "5 percent," and she said her practice had delivered "just short of 1,100 babies." She and board members also described variations across the state and the potential for uneven training and oversight when licensure is not required.

Committee members asked practical questions about CPMs’ pharmaceutical access and emergency response. Dovrado said midwives commonly arrange prescriptions through collaborating physicians or telehealth prescribers, maintain relationships with local physicians for consultations and transfer care when needed, and that some physicians in their communities will call in or prescribe medications when required.

The presentation was educational; the committee took no regulatory action. Members said the briefing helped them understand why the issue of credentialing and oversight is complex and why local collaborative relationships matter to patient safety. The committee did not vote to pursue a statutory change at the session, and Dovrado encouraged ongoing communication if the committee pursues licensure discussions or other policy options.

The committee will consider the information as background if and when it deliberates regulatory or statutory recommendations concerning midwifery practice in Kansas.