[§457J-14]  Scope of practice of midwifery.  (a)  The scope of practice of midwifery means the full practice of midwifery, regardless of compensation or personal profit, as determined by the director, rules adopted by the director, and midwifery standards established or recognized by the director pursuant to this chapter.  The scope of practice of midwifery shall be based on and be consistent with a midwife's education and national certification, including but not limited to:

     (1)  Evaluating the physical and psychosocial health status of clients through a comprehensive health history intake, physical examination, and risk assessment based on observation, inspection, palpation, percussion, and auscultation, of the client or clients and using diagnostic instruments and procedures;

     (2)  Formulating a diagnosis;

     (3)  Observation, assessment, development, implementation, and evaluation of a plan of care;

     (4)  Providing education and counseling related to the health promotion, disease prevention, and health care of midwife clients, with a particular focus on a healthy pregnancy and childbirth, the postpartum period, care of the newborn, and the family planning and gynecological needs of midwife clients;

     (5)  Obtaining informed consent, as required by section 671-3, in accordance with the midwife's professional requirements;

     (6)  Supervision and teaching of other personnel;

     (7)  Teaching of individuals, families, and groups;

     (8)  Provision of midwifery services via telehealth;

     (9)  Administration, evaluation, supervision, and coordination, including the delegation of administrative and technical clinical tasks, of midwifery practice;

    (10)  Provision of health care to the client in collaboration with other members of the health care team as autonomous health care professionals providing the midwifery component of health care;

    (11)  Serving as a consultant and resource of midwifery clinical knowledge and skills to those involved directly or indirectly in client care;

    (12)  Operating within a health care system that provides for consultation, collaborative management, and referral with other health care professionals;

    (13)  Referring clients who require care beyond the scope of practice of the midwife to an appropriate health care provider or health care facility, or both, equipped to address the client's health care needs;

    (14)  Initiating and maintaining accurate records;

    (15)  Admitting and discharging clients for inpatient care at freestanding birthing facilities licensed in the State;

    (16)  Participating in joint and periodic evaluation of services rendered such as peer review, including chart reviews, case reviews, client evaluations, and outcome of case statistics;

    (17)  Ordering, interpreting, and performing diagnostic, screening, and therapeutic examinations, tests, and procedures as authorized pursuant to this chapter and within the midwife's role, education, and certification, excluding the performance, supervision, and interpretation of procedures utilizing ionizing radiation; and

    (18)  Use of reasonable judgment in carrying out prescribed medical orders of a physician or osteopathic physician licensed pursuant to chapter 453 or an advanced practice registered nurse licensed pursuant to chapter 457, orders of a physician assistant licensed and practicing with physician supervision pursuant to chapter 453 and acting as the agent of the supervising physician, or orders of a midwife in accordance with this chapter.

     (b)  The scope of practice of midwifery as a certified midwife includes but is not limited to:

     (1)  Assessing and diagnosing clients and the prescription, selection, and administration of therapeutic measures, including over the counter drugs or legend drugs, or both, according to this chapter; the provision of expedited partner therapy pursuant to section 453-52; and controlled substances within the certified midwife's education, certification, and role and in accordance with this chapter;

     (2)  Complying with the Standards for the Practice of Midwifery, or successor document, of the American College of Nurse-Midwives and American Midwifery Certification Board, or successor organizations; provided that the American College of Nurse-Midwives and American Midwifery Certification Board shall have no legal authority over the director and shall have no legal authority or powers of oversight of the director in the exercise of the director's powers and duties authorized by law;

     (3)  Assisting in surgery; and

     (4)  Admitting and discharging clients for inpatient care at facilities licensed in the State as hospitals.

     (c)  The scope of practice of midwifery as a certified professional midwife includes but is not limited to:

     (1)  Assessing and diagnosing clients and the selection and administration of therapeutic measures according to the formulary authorized by section 457J-11 within the certified professional midwife's education, certification, and role; and

     (2)  Complying with the Essential Competencies for Midwifery Practice, or successor document, as defined by the International Confederation of Midwives, or successor organization; provided that the International Confederation of Midwives shall have no legal authority over the director and shall have no legal authority or powers of oversight of the director in the exercise of the director's powers and duties authorized by law.

     (d)  A midwife shall comply with the requirements of this chapter; recognize limits of the midwife's training and experience and have transfer of care protocols for situations that exceed the scope of authorized practice; consult with or refer clients to other health care providers, as appropriate; and participate in data submission and peer review requirements adopted by the department; provided that peer review conducted outside of the department shall not be used to replace investigations against a midwife licensed pursuant to this chapter by the regulated industries complaints office of the department. [L 2025, c 28, pt of §2]