North Carolina ranks 44th in the nation for infant mortality and 37th for maternal death.  North Carolina is also one of five states that requires obstetrician supervision over practicing Certified Nurse-Midwives.

That provision has become an obstacle to care, especially in rural areas that have no practicing obstetricians,” said Alex Miller, spokesman and lobbyist for the N.C. College of Nurse-Midwives.

About 30 rural counties in North Carolina have no local obstetricians, and 78 out of the 100 counties are considered medically underserved, according to the U.S. Department of Health and Human Services. 

Miller said about 300 CNMs are practicing in the state, and 80 others are licensed but not practicing. He said the regulation requiring a supervising physician sets no specific geographic limits, but certified nurse midwives have been stopped from practicing by the state medical board on grounds that their supervisor worked a county or two away. 

Both the national American Congress of OB-GYNs and the Institute of Medicine, a part of the National Academy of Sciences, have opposed restrictions on CNMs.  

Three bills in the General Assembly battle against NC Medical Society’s opposition to practicing nurse midwives.  The organization expresses concern on educational background and patient protection.

For more information on qualified nurse midwives, read here.