Application Instructions

• General Information

  The Fair Information Practice Act: In compliance with IC 4-1-6, this agency is notifying all applicants that they must provide the requested information or the application will not be processed. The applicant has the right to challenge, correct, or explain information maintained by this agency. The information provided will become public record. Examination scores and grade transcripts are confidential except in circumstances where their release is required by law.

  Mandatory Disclosure of U.S. Social Security Number: Your social security number is being requested by this state agency in accordance with Ind. Code 4-1-8-1 and 25-1-5- 11(a). Disclosure is mandatory, and this record cannot be processed without it. Failure to disclose your U.S. social security number will result in the denial of your application. Application fees are not refundable.

  Abandon Applications:  If an applicant does not submit all requirements within one (1) year after the date on which the application is filed, the application for licensure is abandoned without any action of the Board. An application submitted after an abandoned application shall be treated as a new application.

• Direct Entry Midwife via Application

  Submit the following with your online application:

  1. Application Fee of $50.00: Pay by credit or debit card.  All application fees are nonrefundable.
  2. Criminal Background Check
  3. Positive Response Documentation: If you answer "Yes" to any questions on the application, explain fully in a statement that includes all details. Include the violation, location, date, cause number, and disposition. Submit copies of court documents for each instance to support the statement. If malpractice, provide the name(s) of the plaintiff(s). Please upload at the time of application.
  4. Name Change Documentation: Documentation of any legal name change if your name differs from that on any of your documents. Documentation may include a copy of your marriage certificate or divorce decree.  Please upload at the time of application.
  5. Verification of other state licenses: an applicant who currently holds, or has previously held, a license, certification, or registration issued by another state to practice any health profession must request verification of license status from the state that issued that license, certification, or registration. The verification must be sent directly to the board from the agency that issued the license, certification, or registration. Official electronic verification will also be accepted.
  6. Certified Professional Midwife Credential: a certified copy of CPM credential certificate or card conferred by the North American Registry of Midwives.  Please upload at the time of application.
  7. Postsecondary Diploma: a certified copy of diploma from postsecondary educational institution.  Please upload at the time of application.
  8. Original Postsecondary Transcript: where the applicant received a postsecondary degree, including the degree conferred and date conferred. Applicant must have either an associate's degree in nursing, midwifery (from MEAC approved program), or other similar science related degree; or, a bachelor's degree in any field. In lieu of this requirement and number 4 above, and prior to June 30, 2018, applicant may submit proof of enrollment directly from the institution of hearing learning.  Please upload at the time of application.
  9. Official MEAC-approved Program Transcript: from a Midwifery Education Accreditation Council (MEAC) approved program showing completion of a MEAC approved midwifery educational curriculum. In lieu of this requirement, and prior to June 30, 2018, applicant may submit proof of 100 births where applicant was primary attendant (see Affidavit of Additional Births Form) and a letter of reference from a licensed physician with whom the applicant is collaborating.  Please upload at the time of application.
  10. CPR card: copy of certification in adult CPR that is not expired.  Please upload at the time of application.
  11. American Academy of Pediatrics certificate of completion or card: showing completion of program in neonatal resuscitation (excluding endotracheal intubation and drug administration).  Please upload at the time of application.
  12. Affidavit of Completion of Additional Births Form: submit as many affidavits as necessary to document completion of the following, which are in addition to any needed for CPM credentialing: (1) observation of 20 births; (2) attendance at 20 births conducted by a physician; (3) assistance with 20 births; (4) primary attendant at 20 births. All must have been in the United States and overseen by a NARM approved preceptor or physician. The document should be completed by the individual attesting to the additional births and notarized. Please upload at the time of application.
  13. Emergency Skills Training Course: certificate of completion of NARM approved emergency skills training course which is eligible for inclusion in the Midwifery Bridge Certification Program. The course(s) must include material on emergency life support procedures, identification of high-risk births for mothers, and identification of potential complications during labor.  Please upload at the time of application.
  14. Proof of Liability Insurance: must be a minimum of $100,000 per incident/$300,000 yearly aggregate.
  15. Collaborative Practice Agreement:
      1. Complete names, Indiana license numbers, home and business addresses, zip codes, and telephone numbers of the practitioner and the CDEM.
      2. A list of all other offices and/or practice locations in addition to those listed in clause (1)
      3. The specific manner of collaboration between the practitioner and the CDEM, including how the practitioner and the CDEM will communicate and review charts for the first, second, and third year of collaboration:
         • Example: The first year that the individual is a certified direct entry midwife, one hundred percent (100%) of the charts must be review by the practitioner, for the second year that the individual is a certified direct entry midwife, fifty percent (50%) of the charts must be reviewed by the practitioner, and for the third year that the individual is a certified direct entry midwife, twenty-five percent (25%) of the charts must be reviewed by the practitioner.
      4. The duration of the written collaborative practice agreement between the practitioner and the CDEM (e.g. commence date, termination date, etc.)
      5. The collaborative practice agreement must have the original date and signatures of the practitioner and the CDEM.
• Direct Entry Midwife via Reciprocity

  Submit the following with your online application:

  1. Application Fee of $50.00: Pay by credit or debit card.  All application fees are nonrefundable.
  2. Criminal Background Check
  3. Positive Response Documentation: If you answer "Yes" to any questions on the application, explain fully in a statement that includes all details. Include the violation, location, date, cause number, and disposition. Submit copies of court documents for each instance to support the statement. If malpractice, provide the name(s) of the plaintiff(s). Please upload at the time of application.
  4. Name Change Documentation: Documentation of any legal name change if your name differs from that on any of your documents. Documentation may include a copy of your marriage certificate or divorce decree.  Please upload at the time of application.
  5. Verification of State Licensure(s) - Current license verification is required.  The official license verification must be sent directly from the licensing authority to the Board at pla3@pla.in.gov. If licensee holds more than one license, all license verifications are required to be submitted by licensee's first renewal.
  6. Collaborative Practice Agreement:
     1. Complete names, Indiana license numbers, home and business addresses, zip codes, and telephone numbers of the practitioner and the CDEM.
     2. A list of all other offices and/or practice locations in addition to those listed in clause (1)
     3. The specific manner of collaboration between the practitioner and the CDEM, including how the practitioner and the CDEM will communicate and review charts for the first, second, and third year of collaboration:
        • Example: The first year that the individual is a certified direct entry midwife, one hundred percent (100%) of the charts must be review by the practitioner, for the second year that the individual is a certified direct entry midwife, fifty percent (50%) of the charts must be reviewed by the practitioner, and for the third year that the individual is a certified direct entry midwife, twenty-five percent (25%) of the charts must be reviewed by the practitioner.
     4. The duration of the written collaborative practice agreement between the practitioner and the CDEM (e.g. commence date, termination date, etc.)
     5. The collaborative practice agreement must have the original date and signatures of the practitioner and the CDEM.

Renewal Instructions

• Renewal Information
  • Direct Entry Midwifery licenses expire on March 31st of the odd years.
  • In addition, all midwives must make their annual report by March 31 of each year.
  • If you have a positive response to any of the renewal questions, you must submit a positive response statement by uploading the document in your account. Your license cannot be renewed until this information is received and, upon further review, additional information may be requested by the Committee.

  Renewal notices are sent approximately ninety (90) days prior to the expiration date.  Licensees with a valid email address on file will be emailed the renewal information.  Licensees that do not have a valid email address on file will be mailed license renewal information.  This notice is mailed to the licensee's address of record with the Committee. The Committee has no way of knowing whether or not a notice reaches its destination; therefore, when a notice has been e-mailed to a valid e-mail address or mailed, the duty of the Committee has been performed.

• Reinstatement Information

  If your license has been expired for three or more years, you must reinstate your license to practice.  Please submit your reinstatement online with additional documentation:

  • Reinstate Online!
  • Total reinstatement fee:  $100.
• Continuing Education Requirements

  In order to renew your certified direct entry midwife license you are required to have completed no less than fifteen (15) hours of continuing education each licensure year. The Committee is currently on a two (2) year renewal cycle. The continuing education must have been completed during the renewal period prior to license renewal. In addition, all continuing education programs must be sponsored, accredited or approved by any of the organizations listed below (see 844 IAC 17-1-6).

  Retain all certificates of completion for a minimum of three (3) years.  Do not submit certificates of completion unless requested to do so by the Committee.

  Credit Hours Required

  • A licensee who renews a license shall complete no less than thirty (30) hours of continuing education in courses or programs approved by any of the approved sponsors in each two (2) year renewal period.
  • Continuing education acquired in any area other than that related to the practice of midwifery will not be accepted.
  • Continuing education credit units or clock hours must be obtained within the renewal period and may not be carried over from one (1) licensure period to another.
  • At least one (1) hour of pharmacology must be completed annually.
  • At least one (1) hour in each two (2) year renewal period shall be completed regarding the following:
    • ​Emergency life support procedures
    • Identification of high risk births for mothers
    • Identification of potential complications during labor
  • At least 50% of all continuing education must be obtained from courses attended in-person.

  Approval of Continuing Education Programs

  To receive credit for continuing education programs, the program must be sponsored, accredited, or approved by any of the following organizations:

  1. Certifying bodies recognized by the North American Registry of Midwives
  2. Indiana Midwives Association
  3. American Academy of Pediatrics
  4. American College of Nurse Midwives
  5. Other organizations who provide coursework relevant to the practice of midwifery as approved by the board.

Fee Schedule

• Midwifery Applications/Renewals

  Midwifery Application/Renewal	Fee
  Initial Application	$50.00
  Active Renewal - Prior to March 31 of odd-numbered years	$50.00
  Reinstatement - Expired over three years:	$100.00

• FAQs

  I have submitted an application for licensure and am no longer taking the position and therefore no longer need an Indiana license.  What do I need to do and can you refund my application fee?

  • You will need to email us that you wish to withdraw your application.  All fees are non-refundable unless otherwise stated according to IC 25-1-8-2(e).

  How long will it take to obtain my license?

  • The timeframe to obtain licensure will be dependent upon multiple factors.  This may include time for required documents to be received and reviewed by staff. Please note that if you have a positive response on your application a delay will occur, as positive responses may be reviewed by the Committee.  The Committee may determine to request a personal appearance.  If an appearance is requested, a letter will be sent to you via email.

  When does my Direct Entry Midwifery license expire?

  • All  licenses expire March 31 of odd-numbered years. Renewal notifications will be sent approximately 90 days prior to the expiration date.  The renewal fee is $50.

  Do I need to obtain continuing education to renew my license?

  • Yes, see above section on Continuing Education.
• Informed Disclosure of Practice

  IC 25-23.4-4 lays out the requirements for informed consent and disclosure of practice.  The Committee cannot provide specific guidance.  If you have questions regarding these requirements please consult with private counsel.

  IC 25-23.4-4-1 Requirements to accept a client

  Sec. 1. (a) All the following must occur before a certified direct entry midwife may accept a client for midwifery care:

  (1) The certified direct entry midwife must provide the potential client with an informed disclosure of practice form.

  (2) The potential client must sign and date the form.

  (3) The certified direct entry midwife must sign and date the form.

  (4) If the potential client refuses a procedure or treatment required by law, the potential client must so indicate on a separate procedure or treatment form.

  (5) The certified direct entry midwife must have an emergency plan for the care of the client if an emergency arises. As part of the emergency plan, the client must sign a release of the client's medical records that allows the certified direct entry midwife to provide the client's medical records to a physician if an emergency arises.

  (6) Subject to rules adopted under IC 25-23.4-2-6(b)(5), the certified direct entry midwife must have a collaborative agreement with a physician to provide for consultation and care for the client. The physician shall examine the client at least one (1) time during the client's first trimester and one (1) time during the client's third trimester. The collaborating physician should be located in an area close to where the delivery will occur.

  (7) The certified direct entry midwife must provide the client with a list of options for additional screening and assessments, including visits to a physician.

  (8) The certified direct entry midwife must maintain medical records on the client through the entire course of care and transfer the medical records to a treating physician if an emergency arises. The medical records must contain all the forms that are required under this subsection.

  (b) A certified direct entry midwife may not have a minor as a client unless the minor's parent or guardian has agreed in writing to use the certified direct entry midwife and all other requirements of this article have been met.

  IC 25-23.4-4-2 Disclosure of procedures and treatment

  Sec. 2. (a) A certified direct entry midwife may not perform on a client a specific procedure or treatment that is not described on the informed disclosure of practice form described in section 1 of this chapter until both of the following occur:

  (1) The specific procedure or treatment is disclosed to the client in writing on a form that is separate from the informed disclosure of practice form.

  (2) The client agrees to the procedure or treatment by signing the procedure or treatment form.

  (b) If the potential client refuses a procedure or treatment required by law, the client must so indicate on a separate procedure or treatment form, which must be maintained in the client's medical records.

  IC 25-23.4-4-3 Informed disclosure of practice

  Sec. 3. The informed disclosure of practice form must be in writing and must contain the following information:

  (1) A description of the certified direct entry midwife's education and training in midwifery, including completion of continuing education courses and participation in the peer review process.

  (2) The certified direct entry midwife's experience level in the field of midwifery.

  (3) The certified direct entry midwife's philosophy of practice.

  (4) Antepartum, intrapartum, and postpartum period conditions requiring consultation, transfer of care, and transport to a hospital.

  (5) The emergency medical backup plan, including the emergency plan and the collaborative agreement with a physician for backup care required under section 1 of this chapter.

  (6) The services to be provided to the client by the certified direct entry midwife and that a physician is required to examine the client at least one (1) time during the client's first trimester and one (1) time during the client's third trimester.

  (7) The certified direct entry midwife's current status of certification under this article.

  (8) A detailed explanation of treatments and procedures.

  (9) A detailed description of the risks and expected benefits of midwifery care.

  (10) The availability of a grievance process in a case in which a client is dissatisfied with the performance of the certified direct entry midwife.

  (11) A statement that if the client is advised by the certified direct entry midwife or a collaborating physician that the client is or has become at risk (as described in IC 25-23.4-6), the certified direct entry midwife:

  (A) shall refer the client to a physician for consultation;

  (B) may refuse to provide or continue care; and

  (C) may transfer care of the client to a physician.

  (12) A statement disclosing whether or not the certified direct entry midwife maintains liability insurance.

  (13) That state certification of a certified direct entry midwife does not ensure that a home setting for delivery of a child is safe.

  (14) A statement that the client understands that the client is waiving the right to sue a physician or health care provider for the following:

  (A) The acts or omissions of the client's certified direct entry midwife.

  (B) For collaboration or work with a certified direct entry midwife except for in cases of gross negligence or willful or wanton misconduct by the physician or health care provider.

  IC 25-23.4-4-5 Prescription drugs

  Sec. 5. (a) Except as provided in subsection (b), a certified direct entry midwife may not dispense or administer prescription drugs.

  (b) A certified direct entry midwife may carry and administer the following medications under a protocol issued and agreed to by a physician licensed under IC 25-22.5:

  (1) Postpartum antihemorrhagic drugs in emergency situations.

  (2) Local anesthetics by infiltration or topical application, only for postpartum repair of lacerations, tears, and episiotomy.

  (3) Oxygen.

  (4) Prophylactic antibiotics for Group B Strep (also known as Beta Strep).

  (c) A certified direct entry midwife may not administer a drug intravenously and may, with a physician's order, administer the following:

  (1) Vitamin K, either orally or through intramuscular injection.

  (2) Rhogam.

  (3) Prophylactic ophthalmic antibiotics.

  specifying the circumstances under which a certified direct entry midwife may administer the substances listed in this subsection.

• Emergency Care Plans

  844 IAC 17-1-11 requires a certified direct entry midwife to develop a written emergency care plan for each client.

  The emergency care plan must:

  • Be signed by the client and midwife;
  • Be maintained in the client's record;
  • Specify the planned location of delivery;
  • Designate a hospital(s), including directions from the planned location of deliver, where the client can receive emergency care;
  • Include the name, address, and telephone number of the collaborating physician, midwife, infant's physician, and other designated providers;
  • Include the name, address, and telephone number of an emergency contact for the client;
  • Include a signed release of the client's records in accordance with IC 25-23.4-4-1(a)(5); and,
  • Be filed with the designated hospital(s).

  Sample Emergency Care Plan - This is provided for illustrative purposes only.

• Post-Birth Information

  Certified Direct Entry Midwives have certain duties after a client has given birth, pursuant to IC 25-23.4-4-6.

  After a client has given birth, the certified direct entry midwife shall:

  • Provide the client with a statement indicating that the newborn infant should be examined by a pediatrician or family practice physician for checkups beginning within two (2) weeks after birth; and,
  • Identify with the client a pediatrician or family practice physician for the care of the infant.
• Peer Review Requirements

  Pursuant to 844 IAC 17-1-7, all certified direct entry midwives must participate in peer review sessions at least twice a year.

  Approved peer review sessions must be sponsored by one of the following organizations:

  • North American Registry of Midwives
  • Indiana Midwives Association
  • Association of Indiana Midwives
  • Other organization approved by the Committee

  All peer review sessions must have at least 4 participants who hold one of the following licenses/credentials:

  • Certified Professional Midwife
  • Certified Direct Entry Midwife
  • Certified Nurse Midwife

  In addition, all certified direct entry midwives must submit the following cases for peer review within six months:

  • Death of a client or client's child;
  • Intrapartum or post-partum transport of a client from the planned delivery location to a hospital, urgent care center, physician's office or similar facility for further care or treatment; or,
  • Significant adverse event or injury to the client or client's child, whether temporary or permanent in nature
• Annual Reporting Requirements

  Before March 31 of each year, a certified direct entry midwife shall report to the Committee the following information from the previous calendar year.   All reports may be submitted to your account. Click here to access the form.

  Required Information:

  • Number of live births
  • Number of still births
  • Number of maternal deaths
  • Average number of weeks of pre-natal care provided
  • Average number of weeks of post-partum care provided
  • Number of emergency transports to the hospital or other emergency facility
  • Number of transfers of care pre-natal, intrapartum and post-partum
  • Number of referrals pursuant to 844 IAC 17-1-9 pre-natal, intrapartum and post-partum, including reasons for referrals
  • Number of mother breastfeeding 6 weeks post-partum