I am a mother in Virginia and I agree with the statement below. I recently gave birth at a highly reputable birth center facility under the excellent care of fully certified CPMa and Doulas and was prescribed all precautionary medications through a nurse midwife who has an independent practice and partners with my CpM. One of the prescriptions was rhoGAM (not needed unless baby’s blood type requires after it is tested after birth and only available in a OB office or hospital unless it’s ordered by a specialty pharmacy). My daughter was born 10 days ago at the beginning of a weekend and her blood type came back late on a Friday revealing that I did in fact need the shot. This must be given within 72 hours after birth so it couldn’t wait until Monday when any specialty pharmacy would get it in as a special order. Because it was a weekend we were faced with either spending all day in an ER waiting for the shot (backing up actual emergencies and wasting precious hours with my newborn and recovery and risking infection in a hospital) or hoping and praying we found the medication in stock somewhere by some fluke. We spent my daughters first day home calling every pharmacy we and my midwives could think of hoping they might have one dose In stock. Within 200 miles, only ONE place happened to have one available and it was located two and a half hours away. My husband then left me home alone with my 2day old and toddler to pickup and pay CASH price for my shot. We are extremely lucky to have found that but had my birth center been authorized to prescribe and handle this medication (and honestly all other meds we ended up paying cash for just as a precaution) in house as the skilled well trained professionals they are, the whole situation could have been avoided and saved us much strain and expense as a family and for myself in recovery.

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.