Since the landing of English settlers off the coast of what is now North Carolina, midwifery has been practiced. In 1917, midwifery became a licensed practice in the Old North State, and the state’s regulatory board, writes historian Sarah Mobley, registered approximately 9,000. During the 1930s, government regulations increased and the number of practitioners started dwindling. In 1983, the state allowed for nurse-midwifery and required midwives to be Certified Nurse Midwives (CNMs).
In North Carolina, midwives must be certified and practice under the direction of a medical doctor, who is a “stand by” in case of emergencies. According to obstetricians, ninety percent of births are routine, but ten percent require more medical knowledge than possessed by a midwife.
CNMs are registered nurses, who practice in hospitals and operate according to each institution’s protocols. Certified Professional Midwives (CPMs) practice apart from obstetricians and deliver births outside of hospitals. In North Carolina (unlike its neighboring states), only CNMs are allowed to practice, and the state has outlawed independent or unregistered midwifery.
Various associations disagree concerning midwifery and its overall effects. The North Carolina Medical Society deems the national standards too lenient and has placed higher expectations, including a master’s degree, on those practicing midwifery within the state’s borders. In 2001, the North Carolina Medical Society worked to oppose legislation approving what the organization calls “lay midwives.” According to various pro-midwifery associations, the medical profession has opposed such legislation because it would lower costs by increasing competition. Groups such as the North Carolina Midwifery Alliance are working to gain legal recognition from the profession by the General Assembly.