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Midwifery regulation and education in Hawaii, USA
1
University of Hawaii School of Nursing and Dental Hygiene, Nursing, Honolulu- Hawaii, United States
2
University of Hawaii at Mānoa, Nursing, Honolulu, United States
Eur J Midwifery 2026;10(Supplement 1):A315
ABSTRACT
BACKGROUND:
The educational preparation of Certified Nurse-Midwives (CNMs), Certified Midwives (CMs), and Certified Professional Midwives (CPMs) achieves the International Confederation of Midwives essential competencies for midwifery practice in the United States of America. CNMs are licensed as advance practice registered nurses though the State of Hawaii Board of Nursing. Until recently no licensing pathway existed for midwives who were not CNMs. In 2019, Hawaii passed legislation for licensing of CPMs and CMs. In 2025, an updated bill continues to support regulation and licensing of CPMs and CMs.
PURPOSE:
To present challenges and issues regarding midwifery regulation and education in Hawaii.
DISCUSSION:
The Hawaii midwifery bill to regulate and license CMs and CPMs was heavily debated at public legislative sessions. Passionate and emotional testimony in support and against regulation and licensing of midwifery was submitted by a divided community. Supporters voiced maternal and newborn safety concerns, standards of care, insurance coverage, hospital access in homebirth transfers, continuing education, peer review, and reporting birth outcomes. Opponents were concerned with restriction of cultural practitioners, criminalizing unlicensed birth attendants, limiting autonomy, scarcity of birth attendants in remote areas, and lack of access to midwifery education in the State.
EVIDENCE WHERE RELEVANT:
The ICM's global goal of accessible midwifery care for all childbearing women faces barriers in Hawaii. Some women may lose access to birth attendants if practitioners cannot meet educational and licensing standards or are prohibited from practice. This problem is exacerbated by lack of local midwifery education programs to bridge these compliance gaps.
KEY MESSAGE:
The health and well-being of mothers and babies hinges on ensuring global standards of midwifery care. Achieving this critically depends on creating accessible and affordable education for all midwifery pathways and fostering strong collaboration among midwives locally and worldwide. Unified commitment to education and midwifery will ensure midwifery care is globally recognized and valued. Regulation - implementation 1
The educational preparation of Certified Nurse-Midwives (CNMs), Certified Midwives (CMs), and Certified Professional Midwives (CPMs) achieves the International Confederation of Midwives essential competencies for midwifery practice in the United States of America. CNMs are licensed as advance practice registered nurses though the State of Hawaii Board of Nursing. Until recently no licensing pathway existed for midwives who were not CNMs. In 2019, Hawaii passed legislation for licensing of CPMs and CMs. In 2025, an updated bill continues to support regulation and licensing of CPMs and CMs.
PURPOSE:
To present challenges and issues regarding midwifery regulation and education in Hawaii.
DISCUSSION:
The Hawaii midwifery bill to regulate and license CMs and CPMs was heavily debated at public legislative sessions. Passionate and emotional testimony in support and against regulation and licensing of midwifery was submitted by a divided community. Supporters voiced maternal and newborn safety concerns, standards of care, insurance coverage, hospital access in homebirth transfers, continuing education, peer review, and reporting birth outcomes. Opponents were concerned with restriction of cultural practitioners, criminalizing unlicensed birth attendants, limiting autonomy, scarcity of birth attendants in remote areas, and lack of access to midwifery education in the State.
EVIDENCE WHERE RELEVANT:
The ICM's global goal of accessible midwifery care for all childbearing women faces barriers in Hawaii. Some women may lose access to birth attendants if practitioners cannot meet educational and licensing standards or are prohibited from practice. This problem is exacerbated by lack of local midwifery education programs to bridge these compliance gaps.
KEY MESSAGE:
The health and well-being of mothers and babies hinges on ensuring global standards of midwifery care. Achieving this critically depends on creating accessible and affordable education for all midwifery pathways and fostering strong collaboration among midwives locally and worldwide. Unified commitment to education and midwifery will ensure midwifery care is globally recognized and valued. Regulation - implementation 1
| eISSN: | 2585-2906 |
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