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There are two types of midwives who may legally practice in the state of Texas: Certified Nurse Midwives (CNM) and Licensed Midwives (LM). A third credential is the Certified Professional Midwife (CPM). Both CNMs and LMs may also be a CPM. A CPM must also have a Texas license or CNM credential to practice legally in Texas.
Lay midwifery is illegal in Texas.
CNMs are registered nurses that have completed a graduate level program in nurse-midwifery. CNM educational programs are accredited by the American College of Nurse Midwives (ACNM) and recognized by the U.S. Department of Education. These programs must also meet the standards of the Board of Nurse Examiners for the State of Texas (BNE).
There are two nurse midwifery educational programs in Texas:
Licensed midwives are direct-entry midwives. This means they are not required to be nurses. Their education in Texas is based on the Midwives Alliance of North America (MANA) Standards of Practice, MANA Core Competencies, the North American Registry of Midwives (NARM) test and skill specifications, and the Texas Midwifery Basic Information and Instructor Manual, which is created and approved by the Texas Department of Licensing and Regulation. In addition, all licensing candidates must meet minimum clinical education requirements, be certified in healthcare provider CPR, and neonatal resuscitation. Ongoing continuing education is requirement for re-licensure every two years.
There are currently two direct-entry midwifery programs approved by TDLR:
For more information on the ATM Midwifery Training Program visit the Education page.
• Certified Nurse-Midwives are regulated by the BNE. CNMs are licensed as registered nurses authorized to practice as a category of advanced practice nurse (APN).
Approximately 350 CNMs are authorized by the BNE to practice in Texas.
• Licensed Midwives in Texas are regulated by Texas Department of Licensing and Regulation
There are approximately 200 Licensed Midwives in Texas.
• The BNE requires that nurse midwives be certified, and recognizes the ACNM Certification Council, Inc. (ACC) as the certification body for CNMs. The ACC develops the certification exam and sets the requirements for ongoing certification.
• To become licensed in Texas, a midwife must:
1. Be Certified by the North American Registry of Midwives (Certified Professional Midwife or C.P.M.) and pass a course covering the Midwifery Basic Information and Instructor Manual
2. Complete a midwifery education program through a Texas TDLR-approved midwifery school and then pass the North American Registry of Midwives (NARM) exam (This process also qualifies her to become a CPM).
• The BNE requires CNMs to follow the Standards of Practice of Nurse-Midwifery created by the ACNM.
• Licensed Midwives must practice according to rules and standards of care as stated in the Texas Midwifery Rules, approved by the TDLR.
• CNMs work in a wide variety of settings such as clinics, hospitals, medical offices, and their own private practices. The majority of CNM assisted births are in hospitals but they also deliver in birth centers and homes. Licensed Midwives work in a variety of settings such as clinics, midwifery offices, and their own private practices.
• Licensed Midwife assisted births are in birth centers or homes.
• In Texas, Medicaid recognizes CNMs as primary care providers for women. Medicaid reimburses CNMs at 85% of the rate paid to a physician for the same service.
• In Texas, Medicaid only recognizes Licensed Midwives as providers if they work in licensed birth centers.
Consortium of Texas Certified Nurse Midwives (CTCNM)
4000 Sunflower Lane
Belton, TX 75613
American College of Nurse Midwives (ACNM)
8403 Colesville Rd, Suite 1550
Silver Spring, MD 20910
Phone 240-485-1800 Fax: 240-485-1818
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Association of Texas Midwives
P.O.Box 887 Elmendorf, TX 78112
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"To advance the quality and accessibility of midwifery in Texas."