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Committee approves bill to allow certified nurse midwives full practice authority
Summary
The committee passed House Bill 1215 to grant certified nurse midwives independent practice authority in Arkansas, with medical experts, midwives and March of Dimes testimony arguing it would expand access, especially in "maternity deserts," and sponsors saying credentialing safeguards remain.
The Public Health, Welfare and Labor Committee voted to advance House Bill 1215, a measure to allow certified nurse midwives (CNMs) to practice to the full extent of their training without Arkansas's current interpartum/collaborative agreement requirement.
Representative Bentley, sponsor of HB1215, opened by citing Arkansas's high infant and maternal mortality rates and argued states with broader midwifery practice have better outcomes. Dr. Steven Todd Bashwick, an OB-GYN who practices in Northwest Arkansas, told the committee that after reviewing data he supports independent CNM practice in hospitals and birth centers and said midwifery is associated with lower cesarean rates and broader access to care in areas with few OB-GYNs.
Certified nurse midwives and professional groups described barriers CNMs face in Arkansas, including the state's unique interpartum agreement requirement. Laurel O'Neil and Joni Arnall, both CNMs, explained that national education, certification and written-practice-guideline requirements would remain in place and that hospital credentialing and privileging processes continue to provide checks on scope and patient safety. Erin Gildner of March of Dimes said that 37 of 75 Arkansas counties lack a delivering hospital or maternity provider and that expanding CNM authority could improve access and outcomes.
Committee members asked whether CNMs would move to rural 'maternity deserts'; sponsors said they could not guarantee relocations but expected more CNMs to remain in or return to Arkansas if practice barriers were removed. The committee voted in favor of HB1215 on a voice vote; sponsors said credentialing and hospital privileging would still apply and that the bill aims to expand access and reduce interventions that contribute to maternal morbidity.
