Practice authority can be defined as certified nurse midwife's (CNM) authority to practice with or without physician oversight. Prescriptive authority refers to a certified nurse midwife’s authority to prescribe medications. Some states require a certified nurse midwife to have a relationship with a physician that outlines procedures the nurse midwife may perform and procedures for consulting with the physician, including their authority to prescribe medications.
In some states, statute specifies whether a nurse midwife must complete a transition to practice period before practicing or prescribing independently. In other states, certified nurse midwives have full independent practice and prescriptive authority, meaning they practice independently with no physician oversight.
The map below shows the range of practice and prescriptive authority for certified nurse midwives by state, D.C. and territory. The range of authority includes:
- Full independent practice and prescriptive authority
- Full independent practice authority but transition to independent prescribing period
- Full independent practice authority but physician relationship required for prescriptive authority
- Transition to independent practice and prescribing period required
- Physician relationship required