New Law Expands Nurse Midwife Roles in Virginia to Tackle Maternity Care Gaps

A significant shift in Virginia's approach to maternity care is on the horizon with the recent signing of House Bill 1904. This legislation, set to take effect July 1, 2025, addresses critical staffing shortages by allowing certified nurse midwives, licensed certified midwives, and nurse practitioners with pediatric privileges to serve on 24-hour on-call duty rosters for nursery care when physicians are unavailable.

Virginia’s Maternity Care Desert

The timing couldn't be more critical. Virginia, like many states, faces severe maternity care shortages, particularly in rural areas. According to the March of Dimes, approximately 36% of counties in Virginia qualify as "maternity care deserts," meaning they lack hospitals offering obstetric care, birth centers, OB/GYNs, and certified nurse midwives. These shortages leave thousands of pregnant women without adequate access to essential prenatal, delivery, and postpartum services.

The legislation passed through the Virginia General Assembly with minimal opposition, according to an article from Cardinal News. The bill also embraces modern healthcare delivery methods by permitting telehealth consultations with physicians for nursery care, potentially extending specialized expertise to remote locations.

For certified nurse midwives, who already manage comprehensive pregnancy and birth care for many Virginia families, this expansion of responsibilities aligns with their extensive training and expertise. Certified nurse midwives complete graduate-level education in midwifery and hold national certification, possessing either a master's or doctoral degree in nursing practice.

Will Hospitals Be on Board?

While the law creates the framework for this expanded role, its real-world impact will ultimately depend on individual hospital implementation. 

Each hospital board will need to develop and approve policies allowing these advanced practice providers to take on the expanded responsibilities. Some facilities may embrace the change immediately, while others might move more cautiously, particularly those with established preferences for physician-led care models.

Patient Benefits

For patients, especially those in underserved areas, the potential benefits are substantial. More flexible staffing arrangements could mean more reliable coverage for nurseries, potentially reducing the need for transfers to distant facilities and allowing more mothers and babies to remain together in their home communities.

Nurse midwives have long demonstrated excellent outcomes in maternal and infant care. Research published in the Journal of Midwifery & Women's Health shows that midwifery care is associated with lower rates of cesarean births, reduced use of interventions during labor, and higher rates of breastfeeding success—all while maintaining safety standards comparable to physician care for low-risk pregnancies.

Model for Other States

As Virginia implements this change, healthcare systems will be watching closely to evaluate its effectiveness in addressing care shortages. If successful, HB 1904 could serve as a model for other states grappling with similar challenges in ensuring equitable access to quality maternity care.

For the more than 92,000 babies born annually in Virginia, this legislative change represents a promising step toward ensuring that quality nursery care remains available, regardless of geographic location or time of day.

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