Nebraska Law
Is homebirth in Nebraska illegal?
No, homebirth is legal in all 50 states. However, it is illegal for a CNM (Certified Nurse Midwife) to attend a home birth in Nebraska. The law does not mention any other type of midwife or birth worker.
What does the law state?
The Nebraska Revised Statue 38-613 (3) states:
A certified nurse-midwife may perform authorized medical functions only in the following settings:
(a) In a licensed or certified health care facility as an employee or as a person granted privileges by the facility;
(b) In the primary office of a licensed practitioner or in any setting authorized by the collaborating licensed practitioner, except that a certified nurse-midwife shall not attend a home delivery; or
(c) Within an organized public health agency.
Translation:
At this time it is a felony for Certified Nurse-Midwives (CNMs) to attend home births in Nebraska. There is NO mention of Certified Professional Midwives, Traditional Midwives, Birth Attendants, or Doulas attending home births.
Types of Midwives
CNM - Certifed Nurse Midwife
CNMs have training in both nursing and Midwifery. They are considered highly trained health care professionals and hold a master's or doctorate degree in Nurse-Midwifery. CNMs have passed a certification exam from the American Midwifery Certification Board (AMCB) and recertify every five years. They can provide care for prenatal, birth, pregnancy, and well-woman care from adolescence to beyond menopause. Depending on the state they can practice in all settings however the majority attend hospital births, here in Nebraska it is illegal for them to attend a homebirth. They also can not practice independently and must have a collaborating provider. The majority of states allow CNMs to practice independently.
CM - Certifed Midwife
A CM is not a nurse. They have completed graduate school in midwifery. They also have passed the same certification as a CMN. They provided the same type of care well-woman, prenatal, birth, and postpartum care as a CNM. CM recertifies with AMCB every five years. However, they are not recognized by many states, including Nebraska.
CPM - Certifed Professional Midwife
CPMs provide prenatal, birth, postpartum, and well-woman care. They are a non-nurse midwife. The North American Registry of Midwives (NARM) sets the certification requirements for CPMs. There are multiple pathways to becoming a CPM. They can apprentice with a midwife and complete an entry-level portfolio evaluation process or they can graduate from an accredited midwifery program. If their school is not accredited they can complete the entry-level portfolio evaluation in addition to their schooling. Then they can sit for the exam, they also must have experience in hospital birth. They recertify with NARM every three years. The practice of CPM varies by state. Here in Nebraska, it is not recognized.
DEM - Direct-entry Midwife
DEM is an independent individual trained in midwifery through various sources that may include apprenticeship, self-study, a midwifery school, or a college/university program. There is a national certifying organization, however many qualify to take the NARM exam but they can choose not to and remain unlicensed. They are a non-nurse midwife and specialize in out-of-hospital birth. They are not recognized by the state of Nebraska.
Traditional/Lay Midwife
A Traditional/Lay Midwife is an individual who is not certified or licensed as a midwife but has received informal training through self-study or apprenticeship.
Certification
Certification is administered through an organization or agency that is not part of the government. The certifying organization sets standards in the area of practice. Once the standards have been met they will grant certification and represent those certified to the public as to have met their standards of practice.
Licensure
Licensure is administered through the state. This licensure explains how the individual can use his license within the jurisdiction.
Licensed VS Unlicensed
Some states mandate Licensure other states have voluntary or optional licenses. Some states are simply unregulated and have no such license but no statute limiting (ex: Nebraska License CNM but other types of midwives are unregulated)
This is much variance between states. Some states have required licenses for any type of midwife to practice. A CPM is outright illegal in some states (NY and NC).
Usually all licenses come with their own set of requirements to qualify and regulations to follow for their practice, to keep the license such as limiting what instruments/meds can be used, if the provider can take vbac, twins, breech or past a certain gestation. Some require an overseeing obstetrician etc. So often licensure will restrict birthing families' options on whom and how they are allowed to birth with. Even if a midwife is trained in twins and had 20 years of experience delivering twins if she moves to a state with licensure that restricts twin delivery she will be unable to serve those families who want her care for twin deliveries.