HOUSTON – Once you see the double blue line or the words “Pregnant,” expecting mothers have much running through their minds. From planning gender reveals, baby showers, doctor appointments, and choosing a color scheme for the baby’s room or bedding, selecting the best healthcare options can be overwhelming.
In a time when many mothers-to-be are seeking safer and more personal options for childbirth, the number of midwives has increased.
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READ: Step-by-step guide when choosing, vetting a midwife in Texas
If you’re thinking about using a midwife in Texas, there are specific regulations you should be aware of. Midwives in Texas have different legal scopes of practice compared to those in other states, and there is also a distinction between certified nurse midwives (CNMs) and certified professional midwives (CPMs).
What’s the difference?
According to the Texas Tribune, Texas recognizes two types of midwife certifications, each with distinct regulations:
- Certified Nurse Midwives (CNMs): These midwives must earn a graduate degree in nursing and are licensed to practice in medical settings like hospitals and clinics. CNMs have prescriptive authority, meaning they can administer medication and provide a broader range of care.
- Certified Professional Midwives (CPMs) or Licensed Midwives: These midwives do not need a nursing degree but must complete a midwifery program and meet Texas licensing requirements. They primarily assist with home births or work in birthing centers and generally have a more holistic approach to maternity care.
The shortage of certified nurse midwives
According to the Texas Health and Human Services’ 2024 report, most Texas counties have zero certified nurse midwives. This shortage has resulted in limited access to midwifery care for many women, particularly in rural areas where healthcare options are already scarce. As a result, home births and birthing centers staffed by CPMs have become a more viable option for expectant mothers in Texas.
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Texas midwifery regulations
The Texas Department of Licensing and Regulation (TDLR) oversees midwifery practice in the state.
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Here are some key regulations:
- Midwives must be licensed by the state and meet educational and practical training requirements.
- CPMs are not permitted to perform C-sections or administer epidurals.
- They must have a physician or hospital referral plan in place in case of emergencies.
- Texas law requires midwives to provide informed consent, including discussing the risks and benefits of home birth versus hospital birth.
- Midwives are required to maintain detailed medical records and adhere to infection control standards.
- Certain medical conditions or complications during pregnancy may require a midwife to transfer care to a physician.
- Abortion Regulations: Texas has some of the strictest abortion laws in the U.S. Under the current law, abortion is prohibited except in cases where the mother’s life is in danger. Midwives are not legally allowed to perform or assist in abortions. Any termination of pregnancy must be conducted by a licensed physician following state law.
Choosing a midwife in Texas
When selecting a midwife, it’s essential to consider the following:
- Credentials and experience.
- Whether they practice in a hospital, birth center, or home setting.
- Their emergency care protocols and referral plans.
- Reviews and testimonials from other mothers.
Midwifery care in Texas continues to evolve, offering expecting mothers more choices for their childbirth experience. Whether choosing a hospital setting with a CNM or a home birth with a CPM, understanding the regulations and available options is important for making an informed decision.