As a two time client of CPM midwives I must insist you correct the discrepancy in this regulation that prevents Virginia's Licensed Midwives from using the skills for which they are trained. I needed rhogam after my first birth and it was incredibly difficult with how much jumping through hoops I had to do to get this standard medicine for A-negative blood type moms. Not because my care providers aren't trained to, just that the regulation fails to reflect that. 

The medicines that midwives are trained to carry prevent emergencies. Subjecting women and care providers to stress and uncertainty surrounding such important resources is senseless. Some of the medicines are even required by the state to be offered. Why overburden our healthcare system with moms and infants who could easily get that care at home? 

Virginia should be reaping the full benefits of our licensed midwives. 

A flaw in our regulations prevents Virginia midwives from serving the public health and safety of Virginians to the best of their training, skills, and abilities. Training at a national level for Certified Professional Midwives includes the carrying and administering of certain medications, which are often required or requested at the time of birth. Furthermore, state laws require that a newborn be administered certain drugs within 24 hours of birth. Every Licensed Midwife is certified at the national level to carry and administer these medications, but the current midwifery laws prevent them from carrying or administering them.

Situations that are low risk and manageable within the home or community are, as a result, made into ordeals that at best inconvenience and at worst endanger the wellbeing of mothers and babies. Unnecessary exposure of infants to the public, and further overburdening of our healthcare systems, means that this inconsistency negatively affects the entire community.

However, if the barrier to the resources for which they are trained is removed, midwives could relieve the maternity care desert status affecting nearly half of Virginians, who live outside a reasonable driving distance from a well stocked medical facility.

Prioritizing public safety means allowing trained health professionals to use all of their resources and skills. The demand for midwifery care will increase as uncertainty rises. Strong, self reliant communities are built on skilled individuals like our midwives. To reiterate, our LMs are already trained and certified to administer these medications; only the law prevents their acting on it.

A flaw in our regulations prevents Virginia midwives from serving the public health and safety of Virginians to the best of their training, skills, and abilities. Training at a national level for Certified Professional Midwives includes the carrying and administering of certain medications, which are often required or requested at the time of birth. Furthermore, state laws require that a newborn be administered certain drugs within 24 hours of birth. Every Licensed Midwife is certified at the national level to carry and administer these medications, but the current midwifery laws prevent them from carrying or administering them.

Situations that are low risk and manageable within the home or community are, as a result, made into ordeals that at best inconvenience and at worst endanger the wellbeing of mothers and babies. Unnecessary exposure of infants to the public, and further overburdening of our healthcare systems, means that this inconsistency negatively affects the entire community. However, if the barrier to the resources for which they are trained is removed, midwives could relieve the maternity care desert status affecting nearly half of Virginians, who live outside a reasonable driving distance from a well stocked medical facility.

Prioritizing public safety means allowing trained health professionals to use all of their resources and skills. The demand for midwifery care will increase as uncertainty rises. Strong, self reliant communities are built on skilled individuals like our midwives.  To reiterate, our LMs are already trained and certified to administer these medications; only the law prevents their acting on it. 

I am a Birth Doula and I support Certified Professional Midwife/Licensed Midwife. I wanted to make the analysts and reviewers aware of an inconsistency in the regulations that impacts midwifery practice and public health. State law requires that a newborn be administered certain drugs within 24 hours of birth but the midwifery laws prevent us/them from carrying or administering these drugs. Furthermore, there are low risk procedures occasionally required during or after a birth that requires the administration of certain medications that the current law prohibits us/them from carrying and administering. Midwives are trained and competent to administer these drugs but current law is preventing them form administering these drugs creating an unnecessary burden for clients. 

Home Birth is safe and our community needs our midwives to have all tools possible to care for low-risk birthers. 

A flaw in our regulations prevents Virginia midwives from serving the public health and safety of Virginians to the best of their training, skills, and abilities. Training at a national level for Certified Professional Midwives includes the carrying and administering of certain medications, which are often required or requested at the time of birth. Furthermore, state laws require that a newborn be administered certain drugs within 24 hours of birth. Every Licensed Midwife is certified at the national level to carry and administer these medications, but the current midwifery laws prevent them from carrying or administering them.

Situations that are low risk and manageable within the home or community are, as a result, made into ordeals that at best inconvenience and at worst endanger the wellbeing of mothers and babies. Unnecessary exposure of infants to the public, and further overburdening of our healthcare systems, means that this inconsistency negatively affects the entire community. However, if the barrier to the resources for which they are trained is removed, midwives could relieve the maternity care desert status affecting nearly half of Virginians, who live outside a reasonable driving distance from a well stocked medical facility.

Prioritizing public safety means allowing trained health professionals to use all of their resources and skills. The demand for midwifery care will increase as uncertainty rises. Strong, self reliant communities are built on skilled individuals like our midwives. To reiterate, our LMs are already trained and certified to administer these medications; only the law prevents their acting on it.

We should be allowed to utilize the medications recommended by the World Health Organization.  Please let us practice to the full extent of our scope.  This makes homebirth which already has amazing outcomes, even safer.

I am a student midwife who seeks to serve on the Northern Neck, an area that currently has no hospital that will deliver babies and very limited access to prenatal or postpartum care. Families on the Neck deserve safe birth options. Continuing to restrict CPMs from practicing the full scope of our training forces these families to birth in a low resource setting. Situations that may arise and be easily managed with certain medications become inconvenient or even dangerous because of these restrictions. Families must endanger newly delivered mothers and their brand new babies by venturing out to a clinic or hospital for medications, such as Rhogam or vitamin K, when they should be at home recovering from pregnancy and birth. Ambulances must be called in to transport birthing parents to a hospital just to administer antihemorrhagics. Travel time is blood lost in these situations and that increases the risk of morbidity and mortality when pitocin or misoprostol could have remedied the situation. Giving CPMs the ability to carry medications will ensure safer births for many families who choose home births for religious reasons, inability to travel long distances while in labor, or personal choice. 

I am a birth doula, lactation consultant and a breech home birth after cesarean (all a variation of normal and not a high risk emergency) mom myself. It is imperative that midwives be allowed to use the full scope of practice that they are trained including administration of medications. Birth is inherently safe and therefore home birth is inherently safe. CPMs are fully trained in normal physiological birth but they are also fully trained and capable of handling an emergency if it we're to arise much more so than most of the EMS department that would respond in an emergency situation. The health of our community and the health of moms and babies depends on CPMs being able to use all of their skills often times saving lives. It's completely unethical to tie their hands behind their back and disallow them to use skills that they are fully trained in.

I am a registered nurse in L&D. I have been doing birth work for 15 years and I have ever understood the absurdity in the regulations on midwifery practice and public health in this state. State law requires that a newborn be administered certain drugs within 24 hours of birth but midwifery laws prevent midwives from carrying or administering these drugs. This is a public health issue.  These meds are simple to administer and have a nonexistent potential for abuse. Not having the legal ability to administer these med puts the burden on the new family to take their baby out in public before most are ready for this.

There are other low risk procedures occasionally required during or after a birth that require the administration of certain (sometimes life saving) medications that the current law prohibits midwives from carrying and administering. Midwives are trained and competent to administer these drugs but current law is preventing them from administering them. A hospital trip for a postpartum perineal repair that could have been done at home in a few minutes is just absurd! 

Since midwifery is legal, let’s also let it be as safe as possible for Virginians who choose this route for bringing their children to the world! 

For more information please feel free to contact the Virginia Midwives' Alliance at info@virginiamidwives.org or by visiting our website at [www.virginiamidwives.org](http://www.virginiamidwives.org/).

I am a Certified Professional Midwife here in Virginia and want to alert the analysts and reviewers of an inconsistency in our regulations that impacts public health. State law requires newborns to be administered certain drugs within 24 hours of birth but current laws prevent us from carrying or administering these drugs. Additionally, optimal midwifery care occasionally requires the administration of certain low-risk medications during or after birth that current legislation prohibits us from carrying and administering. We are trained to administer these drugs but are prevented from doing so, creating an unnecessary burden for our clients and the maternity care system in Virginia as they struggle to find these resources elsewhere. For more information please feel free to contact the Virginia Midwives' Alliance at info@virginiamidwives.org or by visiting our website at www.virginiamidwives.org.

Allowing midwives to be licensed to perform a skill they are already are trained for, improves healthcare for all of Virginia.  Virginians deserve the health freedom bestowed on them by God.  As a nurse, I support safe standards of care for each citizen this includes providing licensure to trained & qualified midwives to provide any skill improving the health of the mother & child which they are appropriately trained to do.  

I am a Certified Professional Midwife and wanted to make the analysts and reviewers aware of an inconsistency in our regulations that impacts midwifery practice and public health. State law requires that a newborn be administered certain drugs within 24 hours of birth but the midwifery laws prevent us from carrying or administering these drugs. Furthermore, there are low risk procedures occasionally required during or after a birth that requires the administration of certain medications that the current law prohibits us from carrying and administering. We are trained and competent to administer these drugs but current law is preventing us form administering these drugs creating an unnecessary burden for our clients. For more information please feel free to contact the Virginia Midwives' Alliance at info@... or by visiting our website at www.virginiamidwives.org.

Our goal is for all women and babies in our care to be safe and healthy and and the current legislation limits our ability to ensure that . 

Thank you for reviewing the licensing and regulation of certified professional midwives! I have given birth at home twice myself, and am also a doula who has attended births at home, in birth centers, and in twenty different hospitals across the country. With this broad experience I can attest that home birth with CPMs is a safe option, validated by many studies and reviews to-date. 

I've worked in Virginia for seven years, but previously worked in California and Utah where CPM midwives can carry and administer standard medications such as anti-hemorrhagic drugs, IV saline, and oxygen. Birth emergencies are extremely rare for women who are healthy when they go into labor, but when an emergency such as hemorrhage occurs, there are mere minutes to treat it for optimal outcomes. CPMs have many non-pharmaceutical tools to prevent and manage hemorrhage, and some studies have shown hemorrhage rates to be lower at home than in hospital due to the lower rates of interventions such as epidural anesthesia and induction/augmentation with Pitocin. But when serious hemorrhage occurs, the Virginia laws currently in the books could cost a woman her life -- when a CPM could have saved it with the right tools (that she is already trained to administer).

Aside from emergencies, it should not be necessary for a woman to transfer mid-birth for dehydration (which IV fluids could easily solve at home) or for antibiotics should she wish to receive them for Group B Strep infection. Similarly, if she wishes to accept Vitamin K or erythromycin ointment for her baby, she should be able to receive them shortly after birth within the standard timeframe, and without having to leave her home. ANY disruption during the first few hours/days after birth can impact breastfeeding, bonding, infant health, and maternal mental health longterm --- hospital transfer is not only disruptive but potentially traumatic. Having these medications available to her chosen home care provider allows the mother-baby dyad to be as undisturbed during birth and postpartum as possible. 

There is nothing to lose in expanding the legal scope of Virginia midwifes to match their professional scope and training.

As a medical provider (CPM), licensed in the state of Virginia, due to the law, I am unable to carry or administer life saving medications including antihemorrhagics, that I am trained to use in community birth (out of hospital birth).  This is an inconsistency in our regulations that impacts midwifery care and public health.  Move us forward Virginia! 

I am a birth doula, birth assistant to a CPM, and an aspiring midwife. I have experienced and witnesses many births attended by amazing CPMs and how they are changing the health and well-being of mothers and their families. Please consider the below comment and change the regulation to allow these trained professionals to fully practice in the scope they are trained for. This is especially helpful when many of the mothers we serve are at least an hour drive from the nearest hospital with a labor and delivery unit. I have witnessed a hospital transfer that would have otherwise been unnecessary if the midwife would have been permitted to administer the medications the mother needed in the moment. Due to the transfer, the mother and father needed to worry about what would happen with their baby, the EMS staff was rude to everyone, and their peaceful birth was interrupted with a 30-minute ambulance ride, delaying being with their new family. 

The medications these midwives are trained and nationally certified to use includes:

Allowing to administer:

-antihemorrhagics

-local anesthetic

-newborn eye ointment

-rhogam

-IV fluids and antibiotics

-oxygen

-Vitamin K

A flaw in our regulations prevents Virginia midwives from serving the public health and safety of Virginians to the best of their training, skills, and abilities. Training at a national level for the Certified Professional Midwives includes the carrying and administering of certain medications, which are often needed or requested at the time of birth. Furthermore, state laws require that a newborn be administered certain drugs within 24 hours of birth. Every Licensed Midwife is certified at the national level to carry and administer these medications, but the current midwifery laws prevent them from carrying or administering them.

Situations that are low risk and manageable within the home or community are, as a result, made into ordeals that at best inconvenience and at the worst endanger the wellbeing of mothers and babies. Unnecessary exposure of infants to the public and further overburdening of our healthcare systems, means that this inconsistency negatively affects the entire community. However, if the barrier to the resources for which they are trained is removed, midwives could relieve the maternity care desert status affecting nearly half of Virginians, who live outside a reasonable driving distance from a well-stocked medical facility. 

Prioritizing public safety means allowing trained health professionals to use all their resources and skills. The demand for midwifery care will increase as uncertainty rises. Strong, self-reliant communities are built on skilled individuals like our midwives. To reiterate, our LMs are already trained and certified to administer these medications, only the law prevents their acting on it. 

I personally agree with the message included below; please allow us the tools they need to provide the great care these families deserve. 

The medications these midwives are trained and nationally certified to use includes:

Allowing to administer:

-Vitamin K

-antihemorrhagics in case of excessive bleeding

-IV fluids

-local anesthetic for perineal repair

-newborn eye ointment

-Rhogam for our Rh-positive birthing families

-oxygen- for neonatal resuscitation

A flaw in our regulations prevents Virginia midwives from serving the public health and safety of Virginians to the best of their training, skills, and abilities. Training at a national level for the Certified Professional Midwives includes the carrying and administering of certain medications, which are often needed or requested at the time of birth. Furthermore, state laws require that a newborn be administered certain drugs within 24 hours of birth. Every Licensed Midwife is certified at the national level to carry and administer these medications, but the current midwifery laws prevent them from carrying or administering them.

Situations that are low risk and manageable within the home or community are, as a result, made into ordeals that, at best inconvenience and at the worst endanger the wellbeing of mothers and babies. Unnecessary exposure of infants to the public and further overburdening of our healthcare systems, means that this inconsistency negatively affects the entire community. However, if the barrier to the resources for which they are trained is removed, midwives could relieve the maternity care desert status affecting nearly half of Virginians, who live outside a reasonable driving distance from a well-stocked medical facility. 

Prioritizing public safety means allowing trained health professionals to use all their resources and skills. The demand for midwifery care will increase as uncertainty rises. Strong, self-reliant communities are built on skilled individuals like our midwives. To reiterate, our LMs are already trained and certified to administer these medications, only the law prevents their acting on it.

I am a Certified Professional Midwife in Maryland and wanted to make the analysts and reviewers aware of an inconsistency in the regulations that impacts midwifery practice and public health. State law requires that a newborn be administered certain drugs within 24 hours of birth but the midwifery laws prevent Virginia midwives from carrying or administering these drugs. Furthermore, there are low risk procedures occasionally required during or after a birth that require the administration of certain medications that the current law prohibits them from carrying and administering. This is unique to Virginia as other nearby states such as DC, Maryland, Delaware, and Pennsylvania allow midwives to carry these common-sense medications. VA CPMs are trained and competent to administer these drugs but current law is preventing them from administering them, creating an unnecessary burden for clients. 

Situations that are low risk and manageable within the home or community are, as a result, made into ordeals that at best inconvenience and at worst endanger the wellbeing of mothers and babies. Unnecessary exposure of infants to the public, and further overburdening of our healthcare systems, means that this inconsistency negatively affects the entire community. However, if the barrier to the resources for which they are trained is removed, midwives could relieve the maternity care desert status affecting nearly half of Virginians, who live outside a reasonable driving distance from a well stocked medical facility.

Prioritizing public safety means allowing trained health professionals to use all of their resources and skills. The demand for midwifery care will increase as uncertainty rises. Strong, self reliant communities are built on skilled individuals like our midwives.  To reiterate, our LMs are already trained and certified to administer these medications; only the law prevents their acting on it

The statistics for midwifery care outcomes from Washington state clearly prove that the greater the legal scope of home birth midwives, the better the outcomes for the public, which has prompted WA to continue to expand the list of drugs and devices approved for midwives.  Public health and safety is served best by empowering midwives to carry and use everything that may be needed at a birth, not by deliberately restricting the prompt use of anything that could improve care or save a life if needed.  I am more than happy to discuss this in person with any legislator who genuinely desires an improvement in maternity care outcomes.

There are various reasons someone might choose to birth at home, one being a pandemic. Having a traumatic birth at a hospital might drive a mother to birth in a calmer setting for the health of both her and the child. These mothers should be able to get the best care possible. Certified nurse midwives should be able to access the medications required to care for the mothers without need to contact the local hospital. They have done the work required to hold their certifications so why hold this back?

I am a Certified Professional Midwife and wanted to make the analysts and reviewers aware of an inconsistency in our regulations that impacts midwifery practice and public health. State law requires that a newborn be administered certain drugs within 24 hours of birth but the midwifery laws prevent us from carrying or administering these drugs. Furthermore, there are low risk procedures occasionally required during or after a birth that requires the administration of certain medications that the current law prohibits us from carrying and administering. We are trained and competent to administer these drugs but current law is preventing us form administering these drugs creating an unnecessary burden for our clients. For more information please feel free to contact the Virginia Midwives' Alliance at info@virginiamidwives.org or by visiting our website at www.virginiamidwives.org.

I am a home birth and birth center supporter and wanted to make the analysts and reviewers aware of an inconsistency in our regulations that impacts midwifery practice and public health. State law requires that a newborn be administered certain drugs within 24 hours of birth but the midwifery laws prevent us from carrying or administering these drugs. Furthermore, there are low risk procedures occasionally required during or after a birth that requires the administration of certain medications that the current law prohibits us from carrying and administering. We are trained and competent to administer these drugs but current law is preventing us from administering them, creating an unnecessary burden for our clients. For more information please feel free to contact the Virginia Midwives' Alliance at info@virginiamidwives.org or by visiting our website at www.virginiamidwives.org.

States across the country are making it so that homebirth and out of hospital midwives can carry and administer these important medications. Statistics prove that out of hospital birth is safe for healthy moms and healthy babies, while midwives are often scrutinized about having unsafe birthing practices that simply is not true. Nobody talks about the horrendous birth statistics in the hospitals throughout our state. As a family who has chosen homebirth, I think that it is absolutely ridiculous to allow out of hospital midwives to practice in our state but not give them the full rights of their training. Or to carry the essential tools that they need to keep women and babies safe.

I am a home birth and birth center support and wanted to make the analysts and reviewers aware of an inconsistency in our regulations that impacts midwifery practice and public health. State law requires that a newborn be administered certain drugs within 24 hours of birth but the midwifery laws prevent us from carrying or administering these drugs. Furthermore, there are low risk procedures occasionally required during or after a birth that requires the administration of certain medications that the current law prohibits us from carrying and administering. We are trained and competent to administer these drugs but current law is preventing us form administering these drugs creating an unnecessary burden for our clients. For more information please feel free to contact the Virginia Midwives' Alliance at info@virginiamidwives.org or by visiting our website at www.virginiamidwives.org.

I am a home birth and birth center support and wanted to make the analysts and reviewers aware of an inconsistency in our regulations that impacts midwifery practice and public health. State law requires that a newborn be administered certain drugs within 24 hours of birth but the midwifery laws prevent us from carrying or administering these drugs. Furthermore, there are low risk procedures occasionally required during or after a birth that requires the administration of certain medications that the current law prohibits us from carrying and administering. We are trained and competent to administer these drugs but current law is preventing us form administering these drugs creating an unnecessary burden for our clients. For more information please feel free to contact the Virginia Midwives' Alliance at info@virginiamidwives.org or by visiting our website at www.virginiamidwives.org.

I am a home birth and birth center support and wanted to make the analysts and reviewers aware of an inconsistency in our regulations that impacts midwifery practice and public health. State law requires that a newborn be administered certain drugs within 24 hours of birth but the midwifery laws prevent us from carrying or administering these drugs. Furthermore, there are low risk procedures occasionally required during or after a birth that requires the administration of certain medications that the current law prohibits us from carrying and administering. We are trained and competent to administer these drugs but current law is preventing us form administering these drugs creating an unnecessary burden for our clients. For more information please feel free to contact the Virginia Midwives' Alliance at info@virginiamidwives.org or by visiting our website at www.virginiamidwives.org.

States across the country are making it so that homebirth and out of hospital midwives can carry these important medication‘s and administer these important mini medication‘s. Statistics prove that out of hospital birth is safe for healthy moms and healthy babies while midwives are often scrutinized about having unsafe birthing practices that simply is not true. Nobody talks about the horrendous Birth statistics in the hospitals throughout our state. As a family who has chosen homebirth I think that it is absolutely ridiculous to allow out of hospital midwives to practice in our state but not give them the full rights of their training. Or to carry the essential choose tools that they need to keep women and babies safe. Even though the demand of medication‘s administering of medication‘s for the low risk mom and baby are very very low.

I am a home birth and birth center support and wanted to make the analysts and reviewers aware of an inconsistency in our regulations that impacts midwifery practice and public health. State law requires that a newborn be administered certain drugs within 24 hours of birth but the midwifery laws prevent us from carrying or administering these drugs. Furthermore, there are low risk procedures occasionally required during or after a birth that requires the administration of certain medications that the current law prohibits us from carrying and administering. We are trained and competent to administer these drugs but current law is preventing us form administering these drugs creating an unnecessary burden for our clients. For more information please feel free to contact the Virginia Midwives' Alliance at info@virginiamidwives.org or by visiting our website at www.virginiamidwives.org.

I am a home birth and birth center support and wanted to make the analysts and reviewers aware of an inconsistency in our regulations that impacts midwifery practice and public health. State law requires that a newborn be administered certain drugs within 24 hours of birth but the midwifery laws prevent us from carrying or administering these drugs. Furthermore, there are low risk procedures occasionally required during or after a birth that requires the administration of certain medications that the current law prohibits us from carrying and administering. We are trained and competent to administer these drugs but current law is preventing us form administering these drugs creating an unnecessary burden for our clients. For more information please feel free to contact the Virginia Midwives' Alliance at info@virginiamidwives.org or by visiting our website at www.virginiamidwives.org.

States across the country are making it so that homebirth and out of hospital midwives can carry these important medication‘s and administer these important mini medication‘s. Statistics prove that out of hospital birth is safe for healthy moms and healthy babies while midwives are often scrutinized about having unsafe birthing practices that simply is not true. Nobody talks about the horrendous Birth statistics in the hospitals throughout our state. As a family who has chosen homebirth I think that it is absolutely ridiculous to allow out of hospital midwives to practice in our state but not give them the full rights of their training. Or to carry the essential choose tools that they need to keep women and babies safe. Even though the demand of medication‘s administering of medication‘s for the low risk mom and baby are very very low.

I am a home birth supporter and wanted to make the analysts and reviewers aware of an inconsistency in our regulations that impacts midwifery practice and public health. State law requires that a newborn be administered certain drugs within 24 hours of birth but the midwifery laws prevent us from carrying or administering these drugs. Furthermore, there are low risk procedures occasionally required during or after a birth that requires the administration of certain medications that the current law prohibits us from carrying and administering. We are trained and competent to administer these drugs but current law is preventing us form administering these drugs creating an unnecessary burden for our clients. For more information please feel free to contact the Virginia Midwives' Alliance at info@virginiamidwives.org or by visiting our website at www.virginiamidwives.org.

I am a home birth and birth center supporter and wanted to make the analysts and reviewers aware of an inconsistency in our regulations that impacts midwifery practice and public health. State law requires that a newborn be administered certain drugs within 24 hours of birth but the midwifery laws prevent midwives from carrying or administering these drugs. Furthermore, there are low risk procedures occasionally required during or after a birth that requires the administration of certain medications that the current law prohibits midwives  from carrying and administering. Midwives are trained and competent to administer these drugs but current law is preventing us form administering these drugs creating an unnecessary burden for their clients. For more information please feel free to contact the Virginia Midwives' Alliance at info@virginiamidwives.org or by visiting their website at www.virginiamidwives.org.

I am a home birth and birth center supporter and wanted to make the analysts and reviewers aware of an inconsistency in our regulations that impacts midwifery practice and public health. State law requires that a newborn be administered certain drugs within 24 hours of birth but the midwifery laws prevent us from carrying or administering these drugs. Furthermore, there are low risk procedures occasionally required during or after a birth that requires the administration of certain medications that the current law prohibits us from carrying and administering. We are trained and competent to administer these drugs but current law is preventing us form administering these drugs creating an unnecessary burden for our clients. For more information please feel free to contact the Virginia Midwives' Alliance at info@virginiamidwives.org or by visiting our website at www.virginiamidwives.org.

I hope this order will be repealed or amended to allow midwives to carry and administer medications and drugs for mothers and babies.  Their training and licensing allows it, and Virginia law reflecting that can only help give parents more options and alleviate strain on the hospital system.  

My daughter insisted on using midwives & I know I would feel much better if they could legally have the medications that prevent emergencies for her & my new grandchildren!

My daughter insisted on using midwives & I know I would feel much better if they could legally have the medications that prevent emergencies for her & my new grandchildren!

I am a home birth and birth center support and wanted to make the analysts and reviewers aware of an inconsistency in our regulations that impacts midwifery practice and public health. State law requires that a newborn be administered certain drugs within 24 hours of birth but the midwifery laws prevent us from carrying or administering these drugs. Furthermore, there are low risk procedures occasionally required during or after a birth that requires the administration of certain medications that the current law prohibits us from carrying and administering. We are trained and competent to administer these drugs but current law is preventing us form administering these drugs creating an unnecessary burden for our clients. For more information please feel free to contact the Virginia Midwives' Alliance at info@virginiamidwives.org or by visiting our website at www.virginiamidwives.org.

States across the country are making it so that homebirth and out of hospital midwives can carry these important medication‘s and administer these important mini medication‘s. Statistics prove that out of hospital birth is safe for healthy moms and healthy babies while midwives are often scrutinized about having unsafe birthing practices that simply is not true. Nobody talks about the horrendous Birth statistics in the hospitals throughout our state. As a family who has chosen homebirth I think that it is absolutely ridiculous to allow out of hospital midwives to practice in our state but not give them the full rights of their training. Or to carry the essential choose tools that they need to keep women and babies safe. Even though the demand of medication‘s administering of medication‘s for the low risk mom and baby are very very low.

I am a home birth and birth center support and wanted to make the analysts and reviewers aware of an inconsistency in our regulations that impacts midwifery practice and public health. State law requires that a newborn be administered certain drugs within 24 hours of birth but the midwifery laws prevent us from carrying or administering these drugs. Furthermore, there are low risk procedures occasionally required during or after a birth that requires the administration of certain medications that the current law prohibits us from carrying and administering. We are trained and competent to administer these drugs but current law is preventing us form administering these drugs creating an unnecessary burden for our clients. For more information please feel free to contact the Virginia Midwives' Alliance at info@virginiamidwives.org or by visiting our website at www.virginiamidwives.org.

As a mother I deserve full access to all the benefits of midwife care. As a client of CPM midwives I must insist you correct the discrepancy in this regulation that prevents Virginia's Licensed Midwives from using the skills for which they are trained. Should a mother need rhogam, pitocen for hemorrhage, or her newborn need oxygen she should have full access, through the care team she has chosen. Midwives should be able to practice as they have been trained. 

The medicines that midwives are trained to carry prevent emergencies. Subjecting women and care providers to stress and uncertainty surrounding such important resources is senseless. Some of the medicines are even required by the state to be offered. Why overburden our healthcare system with moms and infants who could easily get that care at home? 

Virginia should be reaping the full benefits of our licensed midwives. So let's stop restricting them from the care they can so wonderfully give. 

I am a home birth and birth center support and wanted to make the analysts and reviewers aware of an inconsistency in our regulations that impacts midwifery practice and public health. State law requires that a newborn be administered certain drugs within 24 hours of birth but the midwifery laws prevent us from carrying or administering these drugs. Furthermore, there are low risk procedures occasionally required during or after a birth that requires the administration of certain medications that the current law prohibits us from carrying and administering. We are trained and competent to administer these drugs but current law is preventing us form administering these drugs creating an unnecessary burden for our clients. For more information please feel free to contact the Virginia Midwives' Alliance at info@virginiamidwives.org or by visiting our website at www.virginiamidwives.org.

I am a home birth and birth center support and wanted to make the analysts and reviewers aware of an inconsistency in our regulations that impacts midwifery practice and public health. State law requires that a newborn be administered certain drugs within 24 hours of birth but the midwifery laws prevent us from carrying or administering these drugs. Furthermore, there are low risk procedures occasionally required during or after a birth that requires the administration of certain medications that the current law prohibits us from carrying and administering. We are trained and competent to administer these drugs but current law is preventing us form administering these drugs creating an unnecessary burden for our clients. For more information please feel free to contact the Virginia Midwives' Alliance at info@virginiamidwives.org or by visiting our website at www.virginiamidwives.org.

I stand for expanding the scope of practice for Certified Professional Midwives/Licensed Midwives to include the administration of medications they are trained in. The Virginia Board of Medicine recognizes the North American Registry of Midwives standards of certification which includes requirements for training and education in the use of these interventions.

The World Health Organization states: “All midwives should be educated to high standards and enabled to practice to their full scope.” (emphasis added)

The WHO also states “It is now almost universally acknowledged that unless the traditional health practitioners (including traditional midwives) are properly recognized and articulated with the national health system, countries will never be able to achieve adequate health coverage for all their populations....The development of a policy favorable to traditional midwifery depends on the enlightened understanding of the nature of such care and the role and resources of its practitioners, many of whom possess a fund of wisdom, knowledge and experience that can only serve to improve the quality of care that countries provide for their populations.”

According the the March of Dimes 47% of counties in Virginia are without full access to maternity care. Arming midwives with the tools they need would quickly reduce this number. Midwives as individuals are typically more willing and able to establish themselves in rural communities quickly.

The Virginia Rural Health Plan states “pregnant women living in rural communities face unprecedented barriers to accessing adequate maternity care, often leading to disparate birth outcomes.” The VRHP also states “In order to begin to bridge the gaps between rural mothers, their babies, and adequate care, growing and retaining the maternity care workforce in rural communities should be made a top priority by health policy makers...” Midwives are essential pieces in quickly and efficiently reaching healthcare deserts.

Denying the value of midwives who are able to practice to the full extent of their training is denying mothers across Virginia completely safe birth. Many of these women are hour(s) from a hospital but minutes from a midwife.

Lastly, I would like to acknowledge the skill, knowledge and effectiveness at which midwives in Virginia have already been practicing despite the limited scope. The expansion of scope would only serve to make birth even safer in the state of Virginia. The benefit to families, hospitals, Emergency Medical Personnel and communities across the state would be astronomical.

I ask that these statements be considered in the decision to honor the training CPMs receive and expand the scope of practice.

Sources: https://www.vdh.virginia.gov/content/uploads/sites/76/2022/01/Virginia-Rural-Health-Plan_8-Healthy-Moms.pdf

https://www.who.int/

www.marchofdimes.org

Allow midwives to practice within the full scope of their expertise. Women in VA deserve to have this option for childbirth support. 

I am a midwife in Tennessee and am also licensed in VA.  As a CPM our scope of practice and training is underutilized in VA.  We can not even carry an O2 tank or administer Vitamin K to infants under the current guidelines in VA.  In most states we have the ability to carry life saving pharmaceuticals in case of postpartum hemorrhaging like Cytotec or Pitocin or administer an IV for shock or even dehydration in the first trimester.  

Virginia women should be allowed to have complete care from their midwives unhindered by laws that keep them from doing so.

Get updated with the times. Midwives are essential to the health of mom and baby. Why is America the only country that doesn’t have midwives as the standard of care? 

As stated in numerous comments previously we have an opportunity to serve our community with midwifery in places where access to healthcare is limited. It is an amazing alternative to birth your baby without all the unnecessary interventions that you would receive if you were to birth in a hospital. Additionally you are not exposed to all the germs that people carry into there from illness. Midwives are medical professionals and carry the skill to make judgement calls when the use of medications is necessary. It’s silly to withhold this from them. Open up the doors!

Being able to receive care from and birth at home with a midwifery team changed my life. My first baby was born in a hospital under duress with extreme pressure for unnecessary medical intervention by the staff. I was treated so poorly than many of their actions would be considered malpractice and unfortunately that is the case for too many women. Midwifery is a caring, empathetic and respect based experience. Midwifery care is essential for the ability of mothers to choose their birth and expanding what they are able to offer will make home birth safer and more available for every woman. 

I loved both my midwife experiences, during prenatal care and labor and even in the months afterwards. The care and attention midwives provide far surpasses any hospital experience I have ever had. I would never go back to mainstream hospital care, especially for giving birth and every chance I get I recommend home birth. In fact, I'd go so far as to say any environment is better and safer than the hospital for birthing. Does that sound crazy? Maybe, but it is the cold, hard truth.