An Act To License Certified Professional Midwives
Maine Legislature, Session 123, LD 2253
Committee Amendment CA_A_H935 (House)
Amends: 32 MRSA §12501, 32 MRSA §12502, 32 MRSA §12503, 32 MRSA §13811, 32 MRSA §13812

COMMITTEE AMENDMENT ':A " 
to H.P. 1616, L.D. 2253, Bill, "An Act To 
License Certified Professional Midwives" 
Amend the bill by striking out everything after the enacting clause and before the 
summary and inserting the following: 
'Sec. 1. 32 MRSA §12501, sub-§6-A is enacted to read: 
6-A. Licensed midwife. "Licensed midwife" means a person who is licensed by the 
board to practice midwifery under this chapter. 
Sec. 2. 32 MRSA §12501, sub-§6-B is enacted to read: 
6-B. Midwifery. "Midwifery" means a system of health care for the provision of 
care, support and education consistent with a midwife's training, education and 
experience to women and their newborns throughout the prenatal and postpartum period. 
Sec. 3. 32 MRSA §12502, sub-§l, as amended by PL 2007, c. 402, Pt. AA, §1, is 
further amended to read: 
1. 
Membership. 
The Board of Complementary Health Care Providers, as 
established in Title 5, section 12004-A, subsection 8-A, shall regulate the professions of 
midwifery, acupuncture and naturopathic medicine according to the provisions of this 
chapter. The board consists of:;' 2. members appointed by the Governor. The Governor 
shall make the initial appointments to the board no later than 60 days after the effective 
date of this section and shall infonn the Commissioner of Professional and Financial 
Regulation of these appointments. The commissioner shall call the first meeting of the 
board on a date no later than 30 days following notification of appointments by the 
Governor. All members of the board must be residents of this State. Two members of 
the board must be acupuncturists licensed in this State. Two members of the board must 
be practitioners of naturopathic medicine who are eligible for licensure under, or are 
licensed pursuant to, the requirements of subchapter 3. Two members of the board must 
be licensed midwives. One member must be a public member as defined in Title 5, 
COMMITTEE AMENDMENT 
COMMITTEE AMENDMENT .. Pr, to H.P. 1616, L.D. 2253 
section 12004-A. One member must be an allopathic or osteopathic physician who is 
licensed in this State. One member must be a pharmacist who is licensed in this State. 
Sec. 4. 32 MRSA §12502, sub-§6, as amended by PL 2007, c. 402, Pt. AA, §1, is 
further amended to read: 
6. Meetings; chair; quorum. The board shall meet at least once a year to conduct 
its business and elect a chair. Additional meetings must be held as necessary to conduct 
the business ofthe board and may be convened at the call of the chair or a majority of the 
board members. Few: Six members of the board constitute a quorum. 
Sec. 5. 32 MRSA §12503, sub-§l, as amended by PL 2007, c. 402, Pt. AA, §2, is 
further amended to read: 
1. Duties. The board shall: 
A. Adopt rules necessary to administer this chapter; 
B. Set standards of practice for acupuncturists aRd~ naturopathic doctors and licensed 
midwives; 
D. 
Ensure that acupuncturists and naturopathic doctors serving the public meet 
minimum standards of proficiency and competency to protect the health, safety and 
welfare of the public; aREl 
E. Administer and enforce the provisions of this chapter and any rules adopted by the 
board under that authority granted in this chapter7 ; and 
L. Adopt the standards of care and scope of practice standards published by an 
international certification agency for certified professional midwives or other 
credentialing authority acceptable to the board. 
Sec. 6. 32 MRSA c. 113-B, sub-c. 4 is enacted to read: 
SUBCHAPTER 4 
LICENSED MIDWIVES 
§12531. Licensing; licensee title 
1. License required. A person may not profess to be a licensed midwife in this 
State unless that person holds a current, valid license to practice midwifery from the 
board. 
2. Title. 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. 
3. Exception. This subchapter does not apply to student midwives working under 
the supervision of a licensed midwife, under protocols defined by the board. 
COMMITTEE AMENDMENT 
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COMMITTEE AMENDMENT A" to H.P. 1616, L.D. 2253 
Nothing in this subchapter may be construed to require any person who practices the 
same techniques as or techniques similar to those of licensed midwives to obtain a license 
as a licensed midwife under this subchapter. 
Certified nurse midwives who become licensed midwives remain subject to the 
jurisdiction of the State Board of Nursing and are subject to this subchapter. 
§12532. Qualifications for licensed midwives 
I. EIiKibility. To be eligible to apply for a license under this subchapter, an 
applicant must meet requirements regarding education and experience as established by 
the board. 
The requirements must include certification as a certified professional 
midwife from a national certification agency whose mission is to establish and administer 
certification for the credential of certified professional midwife or other credentialing 
authority acceptable to the board. 
§12533. Scope of practice 
1. Scope of practice. The scope of practice for licensed midwives includes the 
provision of care, support and education consistent with a midwife's training, education 
and experience to women and their newborns throughout the prenatal and postpartum 
period. Care provided by a licensed midwife may occur in any setting, including in a 
home, freestanding birthing center, office or medical facility, and may include care, 
support and education that is related 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, including written disclosure of specific 
information to any person to whom midwifery is provided. 
The written disclosure described in paragraph G must include such information 
determined necessary by the board, including, but not limited to, the licensed midwife's 
education, experience and credentials, the midwifery model of care, a notice of the 
licensed midwife's professional liability insurance coverage status and the board's contact 
information. 
2. Authority to possess and administer medication. Licensed midwives have 
limited authority to possess and administer noncontrolled prescription medication, as set 
out in this subsection. 
A. A licensed midwife may possess and administer, in the course of the practice of 
midwifery, only the following noncontrolled prescription drugs and substances: 
(1) Oxygen; 
COMMITTEE AMENDMENT 
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COMMITTEE AMENDMENT A " 
to H.P. 1616, L.D. 2253 
(2) Oxytocin, excluding the oxytocic drug methergine, for the sole purpose of 
postpartum control of maternal hemorrhage; 
(3) Vitamin K; 
(4) Eye prophylaxis; and 
(5) Local anesthetics or numbing agents for repair of lacerations. 
B. When administering oxytocin under paragraph A, a licensed midwife may not 
administer more than 20 units of oxytocin to a single patient. Oxytocin may be 
administered only for postpartum purposes in order to treat hemorrhaging and 
specifically may not be used to induce labor. 
§12534. 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 subchapter 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 of licensed midwives may not exceed $750 annually. Rules 
adopted pursuant to this section are routine technical rules pursuant to Title 5, chapter 
375, subchapter 2-A. 
§12535. Application for renewal 
1. Requirements. Prior to the expiration of a license, a licensed midwife may make 
an application for renewal upon payment of the renewal fee as set under section 12534 
and upon satisfactory demonstration of completion of any requirements adopted by the 
board as a condition of renewal. 
2. Late renewal. An application under subsection 1 made no more than 90 days past 
the date of expiration of a license must include a late fee in addition to the renewal fee as 
set under section 12534. An application received more than 90 days past the expiration 
date is subject to all requirements covering new applicants under this subchapter. 
Sec. 7. 32 MRSA §13811 is enacted to read: 
§13811. Drug administration by licensed midwives 
A licensed midwife who is licensed under section 12531 may: 
1. 
Possession. 
Possess, in the course of the practice of midwifery, only the 
noncontrolled prescription drugs and substances set out in this subsection: 
A. Oxygen; 
B. 
Oxytocin, excluding the oxytocic drug methergine, for the sole purpose of 
postpartum control of maternal hemorrhage; 
C. Vitamin K; 
D. Eye prophylaxis; and 
E. Local anesthetics or numbing agents for repair of lacerations; and 
COMMITTEE AMENDMENT 
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COMMITTEE AMENDMENT ·4 " 
to H.P. 1616, L.D. 2253 
2. Administration. Administer, in the course of the practice of midwifery, those 
drugs and substances that are listed in subsection 1. When administering oxytocin under 
this section, a licensed midwife may not administer more than 20 units of oxytocin to a 
single patient. Oxytocin may be administered only for postpartum purposes in order to 
treat hemorrhaging and specifically may not be used to induce labor. When a licensed 
midwife administers oxytocin in accordance with this section, the licensed midwife shall 
report that use to the maternal and child health division of the Department of Health and 
Human Services, Maine Center for Disease Control and Prevention within 7 days of the 
use of oxytocin. 
Sec.8. 32 MRSA §13812 is enacted to read: 
§13812. Dispensing of medication by pharmacist 
1. Dispensing of medication. A pharmacist may sell and dispense to a licensed 
midwife licensed under section 12531 the noncontrolled prescription drugs and 
substances identified in section 13 811. 
2. Good faith. A pharmacist, or person acting at the direction of a pharmacist, who: 
A. In good faith sells and dispenses noncontrolled prescription drugs and substances 
to a licensed midwife pursuant to this section is not liable for any adverse reactions 
caused by any method of use by the licensed midwife; and 
B. Makes a report relating to the dispensing of noncontrolled prescription drugs and 
substances to a licensed midwife pursuant to section 13811 to an enforcement agency 
is immune from any civil liability that may result from that action, including, but not 
limited to, any civil liability that might otherwise arise under state or local laws or 
rules regarding confidentiality of information. 
In a proceeding in which a pharmacist, or person acting at the direction of a pharmacist, 
invokes the immunity provided pursuant to this subsection, there is a rebuttable 
presumption of good faith. 
Sec. 9. Appointments to the Board of Complementary Health Care 
Providers. The Governor, within 60 days following the effective date of this Act, shall 
appoint 2 licensed midwives to serve as board members on the Board of Complementary 
Health Care Providers pursuant to the Maine Revised Statutes, Title 32, section 12502. 
Sec. 10. Maine Revised Statutes headnote amended; revision clause. In 
the Maine Revised Statutes, Title 32, chapter 117, subchapter 11, in the subchapter 
headnote, the words "noncontrolled prescription drug administration" are amended to 
read "noncontrolled prescription drug dispensing and administration" and the Revisor of 
Statutes shall implement this revision when updating, publishing or republishing the 
statutes. 
Sec. 11. Appropriations and allocations. 
The following appropriations and 
allocations are made. 
PROFESSIONAL AND FINANCIAL REGULATION, DEPARTMENT OF 
Licensing and Enforcement 0352 
COMMITTEE AMENDMENT 
COMMITTEE AMENDMENT "A" to H.P. 1616, L.D. 2253 
Initiative: Allocates funds for a portion of the All Other costs associated with establishing 
a license for certified professional midwives under the Board of Complementary Health 
Care Providers. 
OTHER SPECIAL REVENUE FUNDS 
All Other 
OTHER SPECIAL REVENUE FUNDS TOTAL 
Licensing and Enforcement 0352 
2007-08 
$0 
$0 
2008-09 
$10,450 
$10,450 
Initiative: Appropriates funds for one half-time investigator position, per diem for 2 
additional board members to the Board of Complementary Health Care Providers and 
related All Other costs associated with establishing a license for certified professional 
midwives. 
GENERAL FUND 
POSITIONS - LEGISLATIVE COUNT 
Personal Services 
All Other 
GENERAL FUND TOTAL 
PROFESSIONAL AND FINANCIAL 
REGULATION, DEPARTMENT OF 
DEPARTMENT TOTALS 
GENERAL FUND 
OTHER SPECIAL REVENUE FUNDS 
DEPARTMENT TOTAL - ALL FUNDS 
SUMMARY 
2007-08 
2008-09 
0.000 
0.500 
$0 
$32,251 
$0 
$23,613 
$0 
$55,864 
2007-08 
2008-09 
$0 
$55,864 
$0 
$10,450 
$0 
$66,314 
This amendment is the majority report of the committee. The amendment replaces 
the bill and establishes a license for certified professional midwives under the Board of 
Complementary Health Care Providers. It adds 2 licensed midwives to the board. The 
amendment restricts the use of the title "licensed midwife" and the abbreviation "L.M." to 
licensed midwives who hold a current license to practice midwifery in this State. It 
authorizes licensed midwives to possess and administer a limited number of 
noncontrolled prescription drugs and substances in the course of the practice of 
COMMITTEE AMENDMENT 
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COMMITTEE AMENDMENT ,A" to H.P. 1616, L.D. 2253 
midwifery, including oxygen; oxytocin, excluding the oxytocic drug methergine, for the 
sole purpose of postpartum control of maternal hemorrhaging; vitamin K; eye 
prophylaxis; and local anesthetics or numbing agents for repair of lacerations. It requires 
midwives to report the use of the antihemorrhagic medication to the maternal and child 
health division of the Department of Health and Human Services, Maine Center for 
Disease Control and Prevention. 
It also provides that a pharmacist, acting in good faith, is not prohibited from selling 
and dispensing any of those drugs and substances to a licensed midwife. A pharmacist, 
or person acting at the direction of a pharmacist, who in good faith sells and dispenses 
noncontrolled prescription drugs and substances to a licensed midwife is not liable for 
any adverse reactions caused by any method of use by the licensed midwife. 
A 
pharmacist, or person acting at the direction of a pharmacist, who makes a report to an 
enforcement agency is immune from any civil liability that may result from that action, 
including, but not limited to, any civil liability that might otherwise arise under state or 
local laws or rules regarding confidentiality of information. 
It also establishes a 
rebuttable presumption of good faith for pharmacists. 
FISCAL NOTE REQUIRED 
(See attached) 
COMMITTEE AMENDMENT 
Approved: 03/26/08 
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LD 2253 
LR 3554(02) 
An Act To License Certified Professional Midwives 
Fiscal Note for Bill as Amended by Committee Amendment "A" 
Committee: Business, Research and Economic Development 
Fiscal Note Required: Yes 
Net Cost (Savings) 
General Fund 
Appropriations/Allocations 
General Fund 
Other Special Revenue Funds 
Revenue 
Other Special Revenue Funds 
Correctional and Judicial Impact Statements 
Fiscal Note 
2007-08 
$0 
$0 
$0 
$0 
2008-09 
$55,864 
$55,864 
$10,450 
$10,450 
Projections 
2009-10 
$43,276 
$43,276 
$6,050 
$6,050 
Projections 
2010-11 
$45,131 
$45,131 
$6,050 
$6,050 
Increases civil violation and Class E crime case-loads with a minor effect on fines. Increases the number of civil suits. 
The collection of additional filing fees may also increase General Fund revenue by minor amounts. 
Fiscal Detail and Notes 
This bill includes a General Fund appropriation of$55,864 in fiscal year 2008-09 to the Office of Licensing and 
Registration within the Department of Professional and Financial Regulation for 1 half-time Field Investigator 
position, per diem and related all other costs associated with establishing a license for certified professional midwives 
under the Board of Complimentary Health Care Providers. Information provided by the Office of Licensing and 
Registration indicates that preparation for the September 1, 2008 licensing of an estimated 22 applicants will require 
the printing of applications, customizing of the licensing system to accommodate licensing requirements, additional 
rulemaking, printing, photocopying, and postage. 
This bill also includes an Other Special Revenue Funds allocation of $10,450 in fiscal year 2008-09 to the Office of 
Licensing and Registration for the portion of the all other costs that can be supported by the revenue from application 
and licensing fees. 
LR3554(02) - Fiscal Note - Page 1 of2 
This legislation authorizes the Office of Licensing and Registration to establish fees. However, the fees are capped at 
a one-time $200 application fee and no more than $750 annually for initial and renewal licensure. This fiscal note 
assumes a fee for license renewals of$275 which is the current license renewal fee of the Board of Complimentary 
Health Care Providers. Based on these amounts and the estimated number of applicants, the anticipated revenue for 
fiscal year 2008-09 is $10,45 o. This projected revenue will not be sufficient to support the anticipated costs of the 
board, as presented by the Office of Licensing and Registration, without ongoing support from the General Fund. 
LR3554(02) - Fiscal Note - Page 2 of2