Certified nurse midwives should always function under the direction and responsible supervision of a practicing, licensed physician qualified in maternity care, even in states where nurse practitioners have independent practice authority.
The American Academy of Family Physicians believes training programs preparing certified nurse midwives, like training programs for all health care clinicians, should be constantly monitored to assure the quality of training provided and that the number of graduates reflects demonstrated needs.
The AAFP supports payment for services of certified nurse midwives as part of a physician-led care team. Services provided under direct physician supervision and billed incident-to the physician’s professional services should be paid at the same level as services provided directly by the physician. (1990) (October 2025 COD)