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The Pennsylvania Code website reflects the Pennsylvania Code changes effective through 52 Pa.B. 8372 (December 31, 2022).

49 Pa. Code § 18.6. Practice of midwifery.

§ 18.6. Practice of midwifery.

 The nurse-midwife is authorized or required, or both, to do the following:

   (1)  Engage in midwifery practice as defined in §  18.1 (relating to definitions), as further provided for in this subchapter and in accordance with the ethical and quality standards of the profession as required in section 41(8) of the act (63 P. S. §  422.41(8)).

   (2)  Maintain a midwife protocol and collaborative agreements, and make them available for inspection by clients and the Board upon request.

   (3)  Prescribe medical, therapeutic and diagnostic measures for essentially normal women and their normal neonates in accordance with the midwife protocol or a collaborative agreement, or both.

   (4)  Administer specified drugs as provided in collaborative agreements or as directed by a collaborating physician for a specific patient and, if specifically authorized to do so in a collaborative agreement, relay to other health care providers medical regimens prescribed by the collaborating physician, including drug regimens.

   (5)  A nurse-midwife may, in accordance with a collaborative agreement with a physician, and consistent with the nurse-midwife’s academic educational preparation and National certification by the AMCB or its successor organizations, prescribe, dispense, order and administer medical devices, immunizing agents, laboratory tests and therapeutic, diagnostic and preventative measures.

   (6)  A nurse-midwife who possesses a master’s degree or its substantial equivalent, and National certification, and applies to the Board, is eligible to receive a certificate from the Board which will authorize the nurse-midwife to prescribe, dispense, order, and administer drugs, including legend drugs and Schedule II through Schedule V controlled substances, as defined in The Controlled Substance, Drug, Device and Cosmetic Act (35 P. S. § §  780-101—780-144), in accordance with §  18.6a (relating to prescribing and dispensing drugs) provided that the nurse-midwife demonstrates to the Board that:

     (i)   The nurse-midwife has successfully completed at least 45 hours of course-work specific to advanced pharmacology at a level above that required by a professional nursing education program.

     (ii)   The nurse-midwife has successfully completed 16 hours of advanced pharmacology within 2 years immediately preceding the application for prescriptive authority.

     (iii)   The nurse-midwife is acting in accordance with the terms and conditions set forth in a collaborative agreement with a physician.

   (7)  Perform medical services in the care of women and neonates that may go beyond the scope of midwifery, if the authority to perform those services is delegated by the collaborating physician in the collaborative agreement, and the delegation is consistent with standards of practice embraced by the nurse-midwife and the relevant physician communities in this Commonwealth, as set forth in § §  18.401—18.402 (relating to medical doctor delegation of medical services).

   (8)  Refer and transfer to the care of a physician, as provided for in the midwife practice guidelines or a collaborative agreement, or both, those women and neonates whose medical problems are outside the scope of midwifery practice and who require medical services which have not been delegated to the nurse-midwife in a collaborative agreement.

   (9)  Review and revise the midwife practice guidelines as needed.

   (10)  Carry out responsibilities placed by law or regulation upon a person performing the functions that are performed by a nurse-midwife.


   The provisions of this §  18.6 amended under section 2 of the act of April 4, 1929 (P. L. 160, No. 155) (63 P. S. §  172); and sections 8, 12 and 35(a) of the Medical Practice Act of 1985 (63 P. S. § §  422.8, 422.12 and 422.35(a)).


   The provisions of this §  18.6 adopted January 2, 1987, effective immediately and applies retroactively to December 31, 1986, 17 Pa.B. 24; amended May 19, 1989, effective May 20, 1989, 19 Pa.B. 2161; amended April 3, 2009, effective April 10, 2009, 39 Pa.B. 1625. Immediately preceding text appears at serial page (326815).

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