Scope of Practice:

CNMs independently manage women’s health care services relating to pregnancy, childbirth, the postpartum period, family planning, and routine gynecological needs. They may also provide normal newborn care and primary health care for women.

They consult, collaborate, or refer to other health professionals for patient care issues outside of their area of competency.

CNMs may have prescriptive authority delegated by a collaborating physician if the CNM meets the requirements of the BNE.

Education:

CNMs are registered nurses that have completed a graduate level program in nurse-midwifery.

CNM educational programs are accredited by the American College of Nurse Midwives (ACNM) and recognized by the U.S. Department of Education. These programs must also meet the standards of the Board of Nurse Examiners for the State of Texas (BNE).

There are two nurse midwifery educational programs in Texas:

• Parkland School of Nurse Midwifery, Dallas (affiliated with UT Southwestern Medical Center)
• The U.T. Collaborative Nurse Midwifery Education Program, U.T.M.B., Galveston.

The BNE also has continuing education requirements for advanced practice nurses.

Regulation:

Certified Nurse-Midwives are regulated by the BNE. CNMs are licensed as registered nurses authorized to practice as a category of advanced practice nurse (APN).

Approximately 350 CNMs are authorized by the BNE to practice in Texas.

Certification Documentation:

The BNE requires that nurse midwives be certified, and recognizes the ACNM Certification Council, Inc. (ACC) as the certification body for CNMs. The ACC develops the certification exam and sets the requirements for ongoing certification.

Standards of Practice:

The BNE requires CNMs to follow the Standards of Practice of Nurse-Midwifery created by the ACNM.

Practice Settings:

CNMs work in a wide variety of settings such as clinics, hospitals, medical offices, and their own private practices. The majority of CNM assisted births are in hospitals but they also deliver in birth centers and homes.

Medicaid Reimbursement

In Texas, Medicaid recognizes CNMs as primary care providers for women. Medicaid reimburses CNMs at 85% of the rate paid to a physician for the same service.