An Act To License Certified Professional Midwives
Maine Legislature, Session 123, LD 2253
Committee: Business, Research and Economic Development
Amends: 5 MRSA §12004-A

Legislative Document 
No. 2253 
H.P.1616 
House of Representatives, March 10,2008 
An Act To License Certified Professional Midwives 
Reported by Representative SMITH of Monmouth for the Joint Standing Committee on 
Business, Research and Economic Development pursuant to Resolve 2007, chapter 115. 
Reference to the Committee on Business, Research and Economic Development suggested 
and ordered printed under Joint Rule 218. 
Printed on rec.:ydeu paper 
'!r/~ 
1?1.11!dC;1~~~l 
MILLICENT M. MacFARLAND 
Clerk 
Be it enacted by the People of the State of Maine as follows: 
Sec. 1. 5 MRSA §12004-A, sub-§49 is enacted to read: 
49. 
Board of Licensed Midwives 
Expenses Only 
MRSA § 17402 
Sec. 2. 32 MRSA c. 139 is enacted to read: 
CHAPTER 139 
MIDWIVES 
§ 17401. Definitions 
As used in this chapter, unless the context otherwise indicates, the following terms 
have the following meanings. 
1. Board. "Board" means the Board of Licensed Midwives under section 17402. 
2. 
Certified professional midwife. 
"Certified professional midwife" means a 
person who has knowledge of and experience providing midwifery in out-of-hospital 
settings and has met the standards for certification set by the North American Registry of 
Midwives. 
3. Informed choice. 
"Informed choice" means a written disclosure of specific 
information to any person to whom midwifery is provided. This disclosure includes, but 
is not limited to, the certified professional midwife's education, experience and 
credentials, the midwifery model of care, a notice of the certified professional midwife's 
professional liability insurance coverage status and the board's contact information. 
4. Licensed midwife. "Licensed midwife" means a person who meets the certified 
professional midwife requirements of the North American Registry of Midwives and who 
meets the eligibility criteria and standard of care for a certified professional midwife 
established by the board. 
5. Midwife. "Midwife" means a person who is trained to give care and advice to 
women during pregnancy, labor, birth and the post-birth period on the midwife's own 
responsibility and to care for the newly born infant. 
6. Midwifery. "Midwifery" means the provision of care, support and education 
consistent with a midwife's training, education and experience to women and their 
newborns throughout the childbearing cycle. Care provided by a midwife may occur in 
any setting, including in a home, freestanding birthing center, office or medical facility. 
Such care, support and education may relate to: 
A. Measures that promote and maintain the health of the mother and baby; 
B. The detection of abnormal conditions; 
C. The procurement of appropriate medical assistance; 
D. The execution of emergency measures; 
E. The provision of newborn care; 
F. The provision of well-woman health care; and 
G. The principles of informed choice. 
7. 
North American Registry of Midwives. 
"North American Registry of 
Midwives" means the international certification agency whose mission is to establish and 
administer certification for the credential of "certified professional midwife" or its 
successor organization. 
8. 
National Association of Certified Professional Midwives. 
"National 
Association of Certified Professional Midwives" 
means a national professional 
organization of certified professional midwives or its successor organization. 
§ 17402. Board of Licensed Midwives 
1. Establishment and membership. There is established within the Department of 
Professional and Financial Regulation, in accordance with Title 5, section 12004-A, 
subsection 49, the Board of Licensed Midwives. 
The board consists of 7 members 
appointed by the Governor: 
A. Four certified professional midwives; 
B. One consumer; 
C. One certified nurse midwife; and 
D. One physician who works with midwives. 
2. Terms of appointment. Members are appointed for 3-year terms. A member of 
the board may be removed from office for cause by the Governor. 
3. Meetings. The board shall meet each January to select a chair and for other 
purposes. At least one additional meeting must be held before the end of each calendar 
year. Other meetings may be convened at the call of the chair or the written request of 
any 2 board members. A majority of the members of the board constitutes a quorum for 
all purposes. 
4. 
Vacancy. 
Any vacancy in the board must be filled by appointment by the 
Governor of a person of the same category as the board member being replaced to hold 
office for the unexpired term. 
§17403. Powers and duties of the board 
The board has the powers and duties set forth in this section in addition to all other 
powers and duties set forth in this chapter. 
1. Duties. The board shall: 
A. Make and adopt rules necessary to administer this chapter; 
B. Define a protocol and formulary for drug use by licensed midwives, including but 
not limited to antihemorrhagic medications and oxygen; 
C. Adopt the National Association of Certified Professional Midwives standards of 
care and specific rules defining scope and practice standards; 
D. Determine fees for application for licensure, for initial licensure and for renewal 
within fee caps established by section 17409; 
E. Ensure that licensed midwives serving the public meet minimum standards of 
proficiency and competency to protect the health, safety and welfare of the public; 
F. Administer and enforce the provisions of this chapter and any rules adopted by the 
board under that authority granted in this chapter; 
G. Maintain a record of its acts and proceedings, including the issuance, refusal, 
renewal, suspension and revocation oflicenses; 
H. 
Maintain a roster of all licensed midwives licensed under this chapter that 
indicates: 
(1) The name of the licensee; 
(2) The licensee's current professional office address; 
(3) The date of issuance and the number of the licensee's liee1lJse; and 
(4) Whether the licensee is in good standing with the board, including: 
Ca) Any restrictions or limitations on an individual's license; 
(b) A record of any revocations or suspensions; and 
(c) Any information that the board directs must be included in a member's 
record; 
1. Keep all applications for licensure as a permanent record; and 
J. Keep the records ofthe board open to public inspection at all reasonable times. 
2. 
Complaints. 
The board shall investigate, or cause to be investigated, all 
complaints made to it and all cases of noncompliance with this chapter. 
3. 
Hearings. The board may conduct hearings to assist with investigations, to 
determine whether grounds exist for suspension, revocation or denial of a license or to 
fulfill its responsibilities under this chapter as the board otherwise determines necessary. 
The board may not refuse to renew a license for any reason other than failure to pay the 
required fee, unless it has afforded the licensee an opportunity for an adjudicatory 
hearing. The board shall hold an adjudicatory hearing upon the written request of any 
person who is denied a license without hearing for any reason other than failure to pay a 
required fee. The written request for a hearing must be received by the board within 30 
days of the applicant's receipt of written notice of the denial of the application. The 
written notice of denial must set forth the reasons for the denial and the applicant's right 
to request a hearing. The board shall conduct hearings in conformity with the Maine 
Administrative Procedure Act to the extent applicable. 
4. Subpoena power; administration of oaths; power to compel production of 
documents. The board may subpoena witnesses, administer oaths in any hearing or 
disciplinary proceedings and compel, by subpoena duces tecum, the production of papers 
and records. 
5. Witness fees. A witness summoned before the board must be paid the same fee as 
a witness summoned to appear before the Superior Court and that summons has the same 
effect as though issued for appearance before the Superior Court. 
6, Suspension and revocation. The board may suspend or revoke a license pursuant 
to Title 5, section 10004. The following are grounds for an action to refuse to issue, 
modify, suspend, revoke or refuse to renew the license of an individual licensed under 
this chapter: 
A. The practice of fraud or deceit in obtaining a license under this chapter or in 
connection with services rendered as a licensed midwife; 
B. A legal finding of mental incompetence; 
C. 
Any gross negligence, incompetence or misconduct In the performance of 
midwifery; 
D. Failing to obtain informed consent; 
E. 
Disregarding a client's dignity or right to privacy as to person, condition, 
possessions or medical record; 
F. 
Failing to file or record any medical report as required by law, impeding or 
obstructing the filing or recording of the report or inducing another to fail to file or 
record the report; 
G. 
Breaching a statutory, common law, regulatory or ethical requirement of 
confidentiality with respect to a person who is a client, unless ordered by the court; 
H. Inappropriately delegating midwifery duties; 
I. 
Using advertising or an identification statement that is false, misleading or 
deceptive; 
J. Using any letters, words or insignia indicating or implying that the person is a 
licensed midwife, unless the person is licensed in accordance with this chapter, 
except that a person may use any designation issued by a state or nationally 
recognized organization, as long as the name of that organization is clearly used with 
the designation; or 
K. Submitting a birth certificate known by the person to be false or fraudulent. 
§ 17404. Civil violations; penalties 
A person who violates any provision of this chapter for which a penalty is not 
prescribed commits a civil violation for which a fine of not more than $1,000 may be 
adjudged. 
§17405. Criminal violations; penalties 
1. Violation. A person, including a corporation, association or individual, may not: 
A. Use in connection with the person's name a designation tending to imply that the 
person is a licensed midwife unless so licensed under this chapter; or 
B. Use prescriptive medications, except oxygen, while engaged in the practice of 
midwifery when not licensed under this chapter. 
2. Class E crime. A person who violates subsection 1 commits a Class E crime. 
The State may bring an action in Superior Court to enjoin a person from violating this 
chapter regardless of whether proceedings have been or may be instituted in District 
Court or whether criminal proceedings have been or may be instituted. 
§17406. Immunity 
A health care provider, as defined in Title 24, section 2502, subsection 2, is immune 
from civil liability for any injuries resulting from the acts or omissions of a licensed 
midwife. 
Licensed physicians are immune from civil liability when consulting or 
collaborating with a licensed midwife or accepting transfer of care of clients who are 
outside of the scope of practice of a licensed midwife. 
§17407. Rulemaking 
Rules adopted by the board pursuant to this chapter are routine technical rules as 
defined in Title 5, chapter 375, subchapter 2-A. 
§17408. Licensure 
1. Licensure reguired. A person may not practice or profess to practice as a 
licensed midwife unless that person holds a current and valid license from the board. 
2. Eligibility. To be eligible to apply for a license to practice as a licensed midwife, 
an applicant must meet requirements regarding education and experience as established 
by the board. These requirements must include: 
A. Certification as a certified professional midwife; and 
B. An agreement to practice according to the scope and standards of practice as 
required by rules. 
3. Exceptions. This chapter does not apply to: 
A. Certified nurse midwives licensed as advanced practice registered nurses under 
I 
Title 32, chapter 31; 
B. Certified midwives authorized under the State Board of Nursing to practice in the 
State, unless they are licensed midwives; 
C. Licensed physicians or other licensed health care providers authorized to provide 
midwifery; and 
D. Student midwives working under supervision of a licensed midwife. 
Notwithstanding this subsection, certified nurse midwives who become licensed 
midwives remain subject to the jurisdiction of the State Board of Nursing as well as to the 
provisions of this chapter. 
§17409. Fees 
The Director of the Office of Licensing and Registration within the Department of 
Professional and Financial Regulation may establish by rule fees for purposes authorized 
under this chapter in amounts that are reasonable and necessary for their respective 
purposes, except that the fee for any application may not exceed $200 and the fee for 
initial and renewal licensure may not exceed $675 annually. Rules adopted pursuant to 
II 
this section are routine technical rules pursuant to Title 5, chapter 375, subchapter 2-A. 
§17410. Application for renewal 
1. 
Requirements. 
Every 3 years the Director of the Office of Licensing and 
Registration within the Department of Professional and Financial Regulation or board 
shall forward a renewal form to each licensed midwife. 
The completed form must 
include verification that, during the preceding 3 years, the licensed midwife has 
maintained current certification with the North American Registry of Midwives. Upon 
receipt of the completed form and of the renewal fee, the board shall issue renewal 
licenses to applicants who qualify under this section. 
2. Late renewal. The board shall renew a license that has lapsed for a period of 3 
years or less upon receipt of the late renewal penalty, a reinstatement fee and an 
application for renewal that shows that the person meets the eligibility requirements of 
this chapter and that all requirements for renewal, including continuing education, have 
been satisfied. A person may not be required to pay renewal fees for lapsed years. The 
board may adopt rules to ensure that an applicant whose license has lapsed for a period 
greater than 3 years may be eligible for licensing, but such rules may not establish 
requirements greater than the eligibility requirements of this chapter. 
§17411. Title and abbreviation 
An individual who holds a current license to practice midwifery in this State has the 
right to use the title "licensed midwife" and the abbreviation "L.M." No other individual 
may assume the title or use the abbreviation or other words, letters, signs or devices to 
indicate that the individual using the same is a licensed midwife. 
§17412. Administration of medication 
A licensed midwife who, in the exercise of care, is authorized by the board to 
perform selected activities in the administration of medications may administer certain 
medications as defined by protocols established by the board, including, but not limited 
to, antihemorrhagic medications and oxygen. 
Sec. 3. Initial appointments to the Board of Licensed Midwives. 
The 
Governor, within 60 days following the effective date of this Act, shall appoint 2 board 
members for a term of one year, 2 for a term of 2 years and 3 for a term of 3 years to the 
Board of Licensed Midwives pursuant to the Maine Revised Statutes, Title 32, section 
17402. 
SUMMARY 
This bill establishes a license for certified professional midwives and creates the 
Board of Licensed Midwives within the Department of Professional and Financial 
Regulation.