Modernize the Collaborative Agreement

The United States is facing a maternal healthcare provider shortage

• 56% of counties in the US do not have a certified nurse midwife (Ollove, 2016)

• Reducing barriers to practice, including retiring collaborative agreements, increases the availability of midwifery care, especially in rural counties (Kozhimannil et al, 2016)

The health of birthing people and their families is improved with effective healthcare provider team work, referral mechanisms, and sufficient resources, not a signed agreement with a single provider (Renfrew et al, 2014)

Laws that support midwives practicing at the top of their education, experience, and licensure improve maternal and neonatal health outcomes (Vedham et al, 2018)

The American College of Nurse-Midwives and the American College of Obstetricians and Gynecologists published a joint statement supporting the independent practice of midwives. It states, "Obgyns and CNMs/CMs are experts in their respective fields of practice and are educated, trained, and licensed independent clinicians who collaborate depending on the needs of their patients" (ACOG, 2018).

The requirement for a signed collaborative agreement between a board-certified midwife and a physician will remain in place with hopes for future work to support midwives who deliver care in the home setting