Health and Fitness : New law makes Iowa 38th state to regulate midwives

On June 1, Governor Kim Reynolds announced the signing of HF 265 to license certified professional midwives in Iowa. Thirty-seven other states and the District of Columbia currently regulate the practice of midwifery, making Iowa the 38th state.The bill provides licensure for Certified Professional Midwives (CPM), also referred to as direct-entry midwives, which are certified by the North American Registry of Midwives (NARM).

CPM training focuses on providing the midwifery model of care in homes and freestanding birth centers. Unlike Certified Nurse Midwives (CNMs), which are already licensed by the state and practice primarily in hospital settings, CPMs are not required to have a nursing degree. Iowa has approximately 12 CPMs currently practicing and several CPM students. According to the National Association of Certified Professional Midwives (NACPM), as of 2021 approximately one in five midwives in the United States is a CPM.

The bill had significant bi-partisan support with passage in the Senate by a vote of 46-2 and passage in the House 91-2. The bill was sponsored and floor managed by Rep. Bobby Kaufmann of Wilton and floor managed by Senator Scott Webster of Bettendorf. "This bill has been decades in the making, thanks to a diverse coalition of individuals past and present," says Megan Day, advocacy lead for Friends of Iowa Midwives. "This bill ensures more Iowa families can afford to access the midwifery model of care, which is associated with improved maternal health outcomes."

"Licensure opens the doors for Certified Professional Midwives from neighboring states to practice in Iowa and invites CPMs to move here," says Bethany Gates, a CPM practicing in Vinton. "Increasing the number of CPMs practicing in Iowa will improve access to desperately needed maternity care providers, especially in more rural areas."

"Licensing midwives will improve access to culturally congruent care options, reduce preventable medical interventions, and lower healthcare costs," says Rachel Bruns, a chapter leader for the International Cesarean Awareness Network of Central Iowa.

The new licensure will be managed by the Iowa Board of Nursing, which will establish a midwifery advisory council to advise on education requirements, standards of practice, professional ethics, disciplinary actions, medications, and other relevant issues. The bill provides for health insurance coverage with licensure beginning July 1, 2024.