Decision Maker Response
North Carolina Medical Board

Jun 5, 2012 — I'm afraid there is a great deal of misinformation circulating about the NC Medical Board’s interest in home birth and, more specifically, its role in physician supervision of certified nurse midwives (CNMs).

Here are the facts:

• The Medical Board does not have a position on home birth. It is neither for it nor against it.

• The Board does not license CNMs and has no direct authority to affect the ability of these practitioners to provide care to patients.

• To practice lawfully, CNMs must be supervised by a licensed physician in accordance with criteria set out in Article 10A of the NC General Statutes. Proper supervision includes having detailed written guidelines that describe the clinical roles of the CNM and the supervising physician, written guidelines that describe how and under what circumstances the CNM and the supervising physician will communicate, and a formal process for periodically reviewing care, among other things.

• The Board has no policy that would prohibit physicians from supervising CNMs and has no plans to adopt such a policy. Any physician who meets the requirements of state law and related administrative rules may supervise CNMs.

• As the regulatory agency that licenses physicians, the NCMB has a duty to investigate when it has information that a physician may not be in compliance with supervision laws/rules and, if warranted, take appropriate action against that physician's license.

I understand that the laws regarding supervision of CNMs are unpopular in the home birth community, but the Board does have a duty to uphold them.

Jean Fisher Brinkley