Who Regulates?
Certified Nurse Midwives (CNMs) in North Carolina are licensed Advanced Practice Registered Nurses (APRNs) regulated by:
- Midwifery Joint Committee (MJC): This board oversees licensure, scope of practice, and compliance with state laws and rules.
Laws and Rules
To practice as a CNM in NC, you must:
- Hold a current North Carolina Registered Nurse (RN) license or hold a valid Compact RN license recognized for NC practice.
- Complete an accredited graduate-level nurse‑midwifery program
- Pass the national certification examination
- CNMs may practice independently after completing:
- 24 months of clinical experience
- 4,000 hours of practice
- CNMs who have not met this threshold must maintain a Collaborative Provider Agreement (CPA) with:
- An experienced CNM or
- A qualified physician
Laws
ARTICLE 10A - Practice of Midwifery
- §90-178.1. - Title
- §90-178.2. - Definitions
- §90-178.3. - Regulation of Midwifery
- §90-178.4. - Administration
- §90-178.5. - Qualifications for Approval
- §90-178.6. - Denial, Revocation or Suspension of Approval
- §90-178.7. - Enforcement
Rules
Practice
CNMs provide comprehensive reproductive and primary care services in multiple settings:
- Hospitals
- Out-of-hospital birth centers
- Home births
Their scope includes:
- Gynecologic and well-woman care
- Obstetrical care (prenatal, intrapartum, postpartum)
- Newborn care
- Interconceptional care
Prescriptive Authority
CNMs have prescriptive authority, including controlled substances, within their scope of practice.
If practicing under a CPA, prescribing is limited to:
- What the agreement allows
- Within the collaborating provider’s authority
CNM approval includes prescriptive authority for legend drugs and Controlled Substance Schedules II – V consistent with the scope of practice as determined by educational preparation and national certification.
DEA Numbers
If a CNM is going to prescribe or order controlled substances, the CNM must obtain a DEA number.
Website: www.deadiversion.usdoj.gov
Phone: 1 (800) 882-9539 (8:30 a.m. – 6:00 p.m. EST)
Email: dea.registration.help@usdoj.gov
Dispensing of Drugs
Information regarding dispensing of drugs other than samples may be obtained from:
North Carolina Board of Pharmacy
P.O. Box 4560
Chapel Hill, NC 27514
Phone: (919) 246-1050
Website: www.ncbop.org
Clinical Services Provided
Gynecologic & Well-Woman Care
- Routine exams and screenings
- Family planning and contraception
- Infertility evaluation and counseling
- Preconception care
- Sexual and reproductive health for partners
- Menopause and perimenopause management
- Treatment of common gynecologic conditions
Obstetrical Care
- Prenatal care: Monitoring and managing pregnancy
- Intrapartum care: Labor and delivery management, including:
- Spontaneous vaginal birth
- Amniotomy
- Local anesthesia
- Episiotomy and repair
- Management of complications and emergencies
- Postpartum care: Recovery and support after birth
- Newborn care: Initial assessment and care
Interconceptional Care
- Cancer screening (breast and reproductive tract)
- Management of minor reproductive infections
- Ongoing reproductive health between pregnancies