Midwives
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The Midwives program regulates licensed midwives and approved midwifery education courses. The Texas Midwifery Act defines midwifery as providing the necessary supervision, care, and advice to a woman during normal pregnancy, labor, and the postpartum period; conducting a normal delivery of a child; and providing normal newborn care from birth through the first six weeks of life.
To practice midwifery in Texas, an individual must hold a current license issued by the Texas Department of Licensing and Regulation (TDLR). For information concerning Certified Nurse-Midwives (CNMs), who are not regulated by TDLR, contact either the Texas Board of Nursing or the American College of Nurse-Midwives. For information concerning licensing and regulation of birthing centers, contact the Department of Health and Human Services Health Facility Licensing Unit.
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News and Updates
Proposed Rule Changes
April 17, 2023
The Texas Department of Licensing and Regulation proposes amendments to existing rules at 16 Texas Administrative Code (TAC) at Chapter 115, §§115.1, 115.4, 115.5, 115.13 – 115.15, 115.20, 115.21, 115.23, 115.25, 115.70, 115.80, 115.100, 115.120, and 115.121; new rules at §§115.2, 115.12, 115.16, 115.22, and 115.121; and the repeal of existing rules at §§115.2, 115.16, and 115.121; regarding the Midwives program. The proposed rules update requirements relating to approval of basic midwifery education courses, preceptor supervision of student clinical experience, informed client choice and disclosure statements, and retired midwife licenses. The proposed rules also make updates to reflect current Department procedures and remove obsolete or unnecessary language.
The proposed rules were published in the April 14, 2023, issue of the Texas Register (48 TexReg 1936). The Department will accept comments on the proposal until May 15, 2023.
The Department encourages anyone interested in the Midwives program to review the rule proposal online. Comments may be submitted electronically on the Department’s website at https://ga.tdlr.texas.gov:1443/form/gcerules.
Amarillo-Area Woman Ordered Not to Practice Midwifery Without A License
March 9, 2023
AUSTIN – On March 8, 2023, Travis County District Court Judge Amy Clark Meachum signed a Temporary Restraining Order (TRO) prohibiting Leah Hernandez from practicing midwifery without a license and from representing herself as a licensed midwife to the public.
Court documents allege that Ms. Hernandez is practicing midwifery negligently and without a license in the Amarillo area. The Randall County Sheriff’s Office has an ongoing investigation into the matter.
The TRO is not a determination of guilt and will remain in place only until a hearing scheduled for March 21, 2023, in the 345thDistrict Court of Travis County.
It is illegal for anyone to practice midwifery without being licensed as a midwife, certified nurse-midwife, or physician. If you have information that anyone, including Leah Hernandez, is practicing midwifery without a license in Texas, please file a complaintwith TDLR.
TDLR Health Monitor – October 2022 Edition
October 20, 2022
Articles in the October 2022 edition of The Health Monitor include updates on:
- Raising Awareness in October For Audiology, Dyslexia and Massage Therapy
- Proposed Rule Amendments For Orthotists and Prosthetists
- Podiatry Applications Now Available Online
- Test Proctors Needed For HFD Exams
Working Draft Rules - Request for Informal Comments
October 17, 2022
The Texas Department of Licensing and Regulation (TDLR) has prepared a working draft of possible changes to the rules at 16 Texas Administrative Code, Chapter 115, regarding the Midwives program. The working draft rules have not been finalized and have not been submitted to the Texas Register for publication.
TDLR is seeking informal comments from the public on the working draft rules. Any informal comments that are submitted will not be formally acknowledged but will be used to consider revising the working draft rules before they are presented to the Midwives Advisory Board for a possible recommendation.
TDLR encourages anyone interested in the Midwives program to review the working draft rules online. TDLR will accept informal comments on the working draft rules until November 16, 2022. Informal comments may be submitted electronically on TDLR’s website.
Commission Adopts Rules
June 27, 2022
The Texas Commission of Licensing and Regulation adopted amendments to an existing rule at 16 Texas Administrative Code (TAC), Chapter 115, §115.7, regarding the Midwives program. The adopted rule makes the necessary rule changes for the Midwives program to align the program rules with the advisory board changes made by House Bill 1560, 87th Legislature, Regular Session (2021), the Sunset legislation for the Department.
The adoption justification was published in the June 24, 2022, issue of the Texas Register (47 TexReg 3677) and is available online. The updated rule chapter will be available on the Secretary of State website upon its effective date of July 1, 2022.
TDLR Health Monitor – June 2022 Edition
June 24, 2022
Articles in the June 2022 edition of The Health Monitor includes updates on:
- Recent Rule Amendments
- Updated Massage Therapy Consultation Document
- Speech-Language Pathology Clinical Deficiency Plan
- Hear Her Texas
Beware Of People Posing As TDLR Inspectors
April 26, 2022
Inspectors for the Texas Department of Licensing and Regulation will never request or accept money under any circumstances while calling, visiting or conducting an inspection.
Real TDLR inspectors will:
- introduce themselves;
- show their State of Texas employee ID card;
- provide their contact information upon request; and
- provide their TDLR business card upon request.
Real TDLR inspectors cannot and will not:
- accept payment for license fees;
- request money for violations; or
- charge for inspections.
If someone posing as a TDLR employee approaches or calls you, please contact TDLR and law enforcement immediately. Impersonating a public servant is a third-degree felony in Texas.
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Commission Adopts Rules
April 22, 2022
The Texas Commission of Licensing and Regulation adopted new rules at 16 Texas Administrative Code, Chapter 100, §§100.1 - 100.3, 100.11, 100.60 - 100.65, and 100.70 - 100.72, the repeal of existing rules at §§100.1, 100.10, 100.31 and 100.50, amendments to existing rules at §§100.20, 100.30, and 100.40, with the addition of subchapter titles to an existing chapter, regarding General Provisions for Health-Related Programs. The adopted rules implement Senate Bill (SB) 40, 87th Legislature, Regular Session (2021) and Tex. Occ. Code §51.501 by providing guidelines to health professionals for the use of telehealth and remote continuing education, update and amend outdated rule language, and relocate certain podiatry-specific provisions to the podiatry chapter.
The adoption justification was published in the April 22, 2022, issue of the Texas Register (47 TexReg 2128). The updated rule chapter will be made available upon its effective date of May 1, 2022.
Midwives Educational Summit
December 10, 2021
The TDLR Midwives Educational Summit is a one-day educational conference, hosted by the Texas Department of Licensing and Regulation, for the purpose of discussing emerging topics and best practices in midwifery. The Midwives Educational Summit on December 10 will consist of two parts. Part I will be the presentations from our speakers. Part II will be breakout sessions (lasting 30 minutes), to allow interaction between summit attendees. Continuing education credit will be awarded to individuals who attend all of Part I. Register now and join us online December 10!
Continuing Education Requirements
October 25, 2021
HB 1560, the Sunset legislation for the Texas Department of Licensing and Regulation, repealed Occupations Code §203.304 from the Midwives statute, and transferred authority regarding the continuing education requirements to TDLR’s enabling statute, Chapter 51 of the Texas Occupations Code.
Please note that no changes were made, and Midwives program licensees are still required to obtain continuing education (CE) credits as specified in the program rules.
Rule Review Adoption Justification
March 26, 2021
At their meeting held March 3, 2021, the Texas Commission of Licensing and Regulation adopted the rule review of 16 Texas Administrative Code (TAC) Chapter 115, Midwives, effective March 15, 2021.
The rule review adoption was published in the March 26, 2021 issue of the Texas Register (46 TexReg 2050).
TDLR encourages all persons interested in the Midwives program to review the rule review adoption. The adoption justification is available online.
Rule Review Adoption Justification
March 26, 2021
At their meeting held March 3, 2021, the Texas Commission of Licensing and Regulation adopted the rule review of 16 Texas Administrative Code (TAC) Chapter 100, General Provisions for Health-Related Programs, effective March 15, 2021.
The rule review adoption was published in the March 26, 2021 issue of the Texas Register (46 TexReg 2050).
TDLR encourages all persons interested in the General Provisions for Health-Related Programs to review the rule review adoption. The adoption justification is available online.
Call for Subject Matter Experts
February 26, 2020
TDLR is seeking subject matter experts (SMEs) to assist our Enforcement Division with complaint case reviews. SMEs review complaint cases, generally involving standard of care issues, during the investigation stage of the enforcement process.
We currently have a shortage of Behavior Analyst, Podiatrist, and Speech-Language Pathologist SMEs.
If you are interested in becoming a SME, please complete the Expert Witness Application. Once the application is submitted, you will receive a questionnaire to complete and return. Documents are screened and contracts are issued to approved SMEs.
All SMEs receive training on their role in reviewing complaint cases. Tasks may include the following:
- Reviewing documents and statements collected by investigators.
- Writing a report stating an opinion as to whether the respondent violated a rule or law in the provision of care to a client.
- Answering specific questions from the prosecutor about the case.
- Testifying as a witness for TDLR at hearings.
Our mission is to protect the citizens of Texas and the hard-working members of your profession. We cannot do that without your specialized knowledge of the complexities of your profession. Please consider becoming a SME today.
Notice to prospective licensees, current licensees renewing their licenses, and stakeholders
December 4, 2020
Applicants can apply for new licenses and renew licenses online. TDLR strongly encourages you to take advantage of the opportunity to apply or renew online. The process is secure and easy to use – and faster than submitting paper-based applications and supporting documents, especially as TDLR deals with significant staffing issues related to COVID-19.
- Applications submitted online can take 30 days to process once TDLR receives all required documents.
- Applications submitted by mail may face significant delays, which may take up to 90 days once TDLR receives all required documents.
Access the online licensing system here. If you need to submit a document outside of the online application, please scan the document and send it to TDLR using our online customer service form.
If you need to submit a transcript, please ask your university to send electronic transcripts to TDLR at cs.transcript@tdlr.texas.gov instead of mailing in an original or certified copy of an original transcript. If your need to submit other documents, such as receipt of fingerprint submission, please scan the document and send it electronically to TDLR using our Customer Service form.
Thank you for helping us process your application or renewal more quickly.
86th Legislative Session Update
May 27, 2020
Notice to Health Care Practitioners of New Training Requirement
House Bill 2059 requires certain health care practitioners to complete a Health and Human Services Commission (HHSC) approved human trafficking prevention training course to renew their license. The bill also requires HHSC to post a list of approved courses on their website. Licensees are required to comply with the training requirements beginning September 1, 2020. For more information, visit our Human Trafficking Prevention Training for Health Care Practitioners webpage.
TDLR Recognizes CPR Grace Periods for Midwives
May 11, 2020
For licensed midwives, TDLR will recognize any grace period recommended in response to the COVID-19 crisis by an entity providing certification in cardiopulmonary resuscitation (CPR) or neonatal resuscitation.
COVID-19: Continuing Education Waived
March 24, 2020
TDLR continuing education requirements are waived for all individual licenses expiring in March, April, and May 2020. Licensees still need to submit their renewal applications, pay the required fees, and TDLR will check their criminal histories, but they will not need to complete any TDLR-required continuing education this licensing cycle. (§51.405, Occupations Code)
Note: TDLR is not authorized to waive continuing education requirements imposed by a certifying or credentialing entity other than TDLR. If a certifying entity requires continuing education to maintain certification, and certification is required for Texas licensure, then that continuing education must be completed. If the certifying entity waives continuing education or allows it to be completed on a delayed basis due to COVID-19, then you may follow the certifying entity’s policy.
Please check the TDLR COVID-19 webpage for the most up-to-date information.
Guidance Statement on TDI Rules Related to Senate Bill 1264
December 18, 2019
The Texas Department of Insurance (TDI) has adopted emergency rules interpreting Senate Bill (SB) 1264’s prohibitions related to “surprise billing” (or “balance billing”). This Guidance Statement is intended to provide clear information concerning SB 1264 to Texas patients, clients, and health care providers under the regulatory authority of the Texas Department of Licensing and Regulation (TDLR).
SB 1264 prohibits surprise billing, with certain exceptions. Health care providers under TDLR’s regulatory authority who seek to exercise the exceptions to SB 1264’s prohibitions against balance billing must comply with all provisions of SB 1264, including as interpreted by TDI rules. See the TDI SB 1264 webpage for additional information. SB 1264 applies to a health care or medical service or supply provided on or after January 1, 2020.
TDLR will be responsible for investigating complaints and taking disciplinary action against TDLR licensees for violations of SB 1264, including as interpreted by TDI rules. Any person who believes that a TDLR-licensed health care provider has committed a balance billing-related violation may file a complaint online with TDLR. Additionally, TDLR and TDI will work together to ensure that any complaints filed with TDI regarding TDLR licensees will be referred to TDLR and investigated.
TDLR will be working on the development of enforcement rules consistent with SB 1264 and TDI’s rules interpreting the statute. As rulemaking moves ahead, we look forward to a transparent process and engaging the public and stakeholders on this important issue.
Important Information for Healthcare Facilities Seeking to Use Out-Of-State Healthcare Providers to Assist with Tropical Storm Imelda Disaster Response
September 23, 2019
On September 19, 2019 in accordance with Sections 418.016 and 418.171 of the Texas Government Code, Governor Greg Abbott temporarily suspended all necessary statutes and rules to allow a healthcare professional licensed and in good standing in another state to practice in various facilities in Texas to assist with Tropical Storm Imelda disaster response operations.
The suspension allows a healthcare provider who holds a license, certificate, or other permit issued by another state jurisdiction satisfying qualifications for professional, mechanical, or other skills to render aid in this state to meet an emergency or disaster.
This suspension is in effect until terminated by the Office of the Governor or until the Tropical Storm Imelda disaster declaration is lifted or expires.
For the healthcare provider types listed below, a healthcare facility must submit to the TDLR by email each out-of-state provider’s name, license type, state of licensure, and license identification number to: recovery@tdlr.texas.gov
TDLR licenses the following healthcare providers:
- Athletic Trainers
- Behavior Analysts
- Dietitians
- Dyslexia Therapists and Practitioners
- Hearing Instrument Fitters and Dispensers
- Midwives
- Orthotists and Prosthetists
- Podiatrists
- Speech-Language Pathologists and Audiologists
If you have questions or need assistance, please call (800) 803-9202 Monday through Friday from 7 a.m. to 6 p.m. or email recovery@tdlr.texas.gov.
Informed Choice and Disclosure Form
January 4, 2017
TDLR has revised and updated the Licensed Midwives Informed Choice and Disclosure Form. The form includes a new requirement to provide information to prospective clients on hospital transfer.
The form is available online in English and Spanish at: https://www.tdlr.texas.gov/midwives/mwvforms.htm
Question: The new Informed Choice and Disclosure Statement Form only includes two spaces for me to list the hospitals to which I will transfer a specific client. What if there are more than two hospitals that I might transfer my client to?
Answer: If you need more space, please attach a separate page to the form listing the hospitals to which you might transfer a specific client, and then discuss the information with that client.
Please note: this list should not be a generic list of all hospitals in the area – it should be tailored to the planned birth location of each specific and individual midwifery client.
Important Information for Healthcare Facilities Seeking to Use Out-Of-State Healthcare Providers to Assist with Hurricane Harvey Disaster Response
September 14, 2017
On September 3, in accordance with Sections 418.016 and 418.171 of the Texas Government Code, Governor Greg Abbott temporarily suspended all necessary statutes and rules to allow a healthcare professional licensed and in good standing in another state to practice in various facilities in Texas to assist with disaster response operations for Hurricane Harvey. Read More >>
The suspension allows a healthcare provider who holds a license, certificate, or other permit issued by another state jurisdiction satisfying qualifications for professional, mechanical, or other skills to render aid in this state to meet an emergency or disaster.
This suspension is in effect until terminated by the Office of the Governor or until the Hurricane Harvey disaster declaration is lifted or expires.
For the healthcare provider types listed below, a healthcare facility must submit to the Texas Department of Licensing and Regulation (TDLR) by email each out-of-state provider’s name, license type, state of licensure, and license identification number to: Harvey@tdlr.texas.gov
TDLR licenses the following healthcare providers:
- Athletic Trainers
- Dietitians
- Dyslexia Therapists and Practitioners
- Hearing Instrument Fitters and Dispensers
- Midwives
- Orthotists and Prosthetists
- Podiatrists
- Speech-Language Pathologists and Audiologists
If you have questions or need assistance, please call (800) 803-9202 between 7:00 a.m. and 6:00 p.m. CDT or email Harvey@tdlr.texas.gov.
Advisory Board Meetings
Upcoming Meeting - June 12, 2023
The next Midwives Advisory Board meeting is scheduled for Monday, June 12, 2023 at 1:00 p.m. The meeting will be held via videoconference and will be viewable on TDLR's YouTube channel. Sharing of pre-recorded audio or video is not allowed during the public comment period. The agenda and staff reports are available online.
Previous Meeting - March 29, 2023
The Midwives Advisory Board met March 29, 2023 via videoconference. The meeting was archived and is available on TDLR's YouTube channel. The agenda and staff reports are available online.