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 State Health Services’ Facility Licensing Group.


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News and Updates

TDLR Adopts Administrative Rules

The Texas Commission of Licensing and Regulation adopted amendments to the Midwives program rules (16 Texas Administrative Code, Chapter 115, §115.14 and §115.70). The adopted rules implement House Bill 2059, 86th Legislature, Regular Session (2019), which requires human trafficking prevention training for health care practitioners prior to the renewal of a license, and Senate Bill 1531, 86th Legislature, Regular Session (2019), which removes conviction of a “misdemeanor of moral turpitude or a felony” from the list of items authorizing discipline of a midwife or denial of an application for a midwife license or its renewal.

The adoption justification was published in the July 24, 2020, issue of the Texas Register (45 TexReg 5184). The updated rule chapter will be made available upon its effective date of August 1, 2020.

86th Legislative Session Update

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

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.

TDLR Health Monitor – April 2020 Edition

Articles in this April 2020 edition of The Health Monitor include updates on:

  • TDLR’s response to COVID-19
  • TDLR represented at State Operations Center
  • Scam targeting DEA registrants and health professionals
  • New human trafficking prevention training required for certain health care practitioners
  • Massage Therapy rule amendments adopted
  • Penalty matrices adopted for Behavior Analysts and Dyslexia Therapy programs
  • Surprise medical billing updates
  • Verify your license online

The TDLR Health Monitor is a quarterly newsletter that provides news and information about TDLR’s medical and health-related programs. Archives of past editions of the TDLR Health Monitor can be viewed here.

COVID-19: Continuing Education Waived

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.

TDLR Proposes Amendments to Existing Rules

The Texas Department of Licensing and Regulation proposes amendments to the Midwives program rules (16 Texas Administrative Code, Chapter 115, §115.14 and §115.70). The proposed rules are necessary to implement House Bill (HB) 2059 and Senate Bill (SB) 1531, 86th Legislature, Regular Session (2019). HB 2059 creates new Occupations Code, Chapter 116, requiring human trafficking prevention training for health care practitioners prior to the renewal of a license. SB 1531 removes conviction of a “misdemeanor of moral turpitude or a felony” from the list of items in Occupations Code §203.404 authorizing discipline of a midwife or denial of an application for a midwife license or its renewal.

The proposed rules are published in the February 21, 2020, issue of the Texas Register (45 TexReg 1143). The Department will accept comments on the proposal until March 23, 2020.

The Department encourages anyone interested in the Midwives program to review the rule proposal online. Comments may be submitted by email to erule.comments@tdlr.texas.gov.

Midwives Educational Summit

TDLR will host the next Midwives Educational Summit in San Marcos, Texas on Friday, January 31, 2020. Visit the Midwives Educational Summit page for all the details. Please check back periodically for updates or sign up to receive Midwives program email notices.

Guidance Statement on TDI Rules Related to Senate Bill 1264

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

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.

Vacancies on Midwives Advisory Board

The Texas Department of Licensing and Regulation announces three vacancies on the Midwives Advisory Board established by Texas Occupations Code, Chapter 203. The pertinent rules may be found in 16 Texas Administrative Code Chapter 55. The purpose of the Midwives Advisory Board is to provide advice and recommendations to the department on technical matters relevant to the administration of this chapter. This announcement is for:

  • three licensed midwives each of whom has at least three years' experience in the practice of midwifery.

The Board consists of nine members appointed by the presiding officer of the commission, with the approval of the commission. Members serve staggered terms of six years. The terms of three members expire on January 31 of each odd-numbered year. The advisory board consists of the following members:

  • five licensed midwives each of whom has at least three years' experience in the practice of midwifery;
  • one physician who is certified by a national professional organization of physicians that certifies obstetricians and gynecologists;
  • one physician who is certified by a national professional organization of physicians that certifies family practitioners or pediatricians; and
  • two members who represent the public and who are not practicing or trained in a health care profession, one of whom is a parent with at least one child born with the assistance of a midwife.

Interested persons should complete an application on the Department website. Applicants can also request an application from the Department by telephone (800)803-9202 or e-mail advisory.boards@tdlr.texas.gov.

These are not paid positions and there is no compensation or reimbursement for serving on the Board.

TDLR Adopts Administrative Rules

The Texas Commission of Licensing and Regulation adopted amendments to existing rules regarding the Midwives program (16 Texas Administrative Code, Chapter 115, §§115.1, 115.70, 115.100, 115.112 - 115.115, 115.117 - 115.119; adopted the repeal of existing rules §115.90 and §115.111; and adopted new §115.111).

The adoption justification was published in the April 12, 2019, issue of the Texas Register (44 TexReg 1849) and may also be viewed on TDLR’s website. The updated rule chapter will be made available upon its effective date of May 1, 2019.

Midwives Educational Summit

The Texas Department of Licensing and Regulation hosted a summit on January 7, 2019 in Austin. The agenda is posted online. The summit is archived on TDLR's YouTube channel.

Informed Choice and Disclosure Form

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.

Midwives: One Year Update

In 2015, the Texas Legislature passed Senate Bill 202, which transferred the Midwives program from the Department of State Health Services to the Texas Department of Licensing & Regulation (TDLR).

The program transfer took place in October 2016. As part of our mission to deliver improved services at a lower cost to Texans, TDLR reduced processing and administrative fees for each online transaction and reduced the following fees for the Midwives program:

Midwives DSHS Fee TDLR Fee $ Reduced % Reduced
Criminal History Evaluation Letter $50 $25 $25 50%

We’ve also reduced the word count in the Midwives program administrative rules to make them clear, concise, and easier to read--without impacting their effectiveness:

Midwives DSHS Rules TDLR Rules Word Difference % Reduced
Administrative Rules Word Count 20,099 7,696 12,403 62%

At TDLR, one of our core values is open and free communication. During this first year, the 3,786 Midwives program email subscribers were contacted 17 times (64,362 emails delivered) so that we could share information about meetings, rule changes, licensing, and more. In addition, all interested parties were welcomed at six public meetings of the Midwives Advisory Board.

TDLR is delivering on our promise to promote transparency and accountability, protect the health and safety of all Texans, and eliminate unnecessary barriers to doing business.  We look forward to serving you for many years to come, and always appreciate any feedback.

Important Information for Healthcare Facilities Seeking to Use Out-Of-State Healthcare Providers to Assist with Hurricane Harvey Disaster Response

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.


Vacancies on Midwives Advisory Board

The Texas Department of Licensing and Regulation (Department) announces a vacancy on the Midwives Advisory Board (Board) established by Texas Occupations Code, Chapter 203. The pertinent rules may be found in 16 Texas Administrative Code Chapter 55. The purpose of the Midwives Advisory Board is to provide advice and recommendations to the department on technical matters relevant to the administration of this chapter. This announcement is for: (1) one public Member-Parent with at least one child born with the assistance of a midwife.

The Board consists of nine members appointed by the presiding officer of the commission, with the approval of the commission. The advisory board consists of the following members:

(1) five licensed midwives each of whom has at least three years' experience in the practice of midwifery;

(2) one physician who is certified by a national professional organization of physicians that certifies obstetricians and gynecologists;

(3) one physician who is certified by a national professional organization of physicians that certifies family practitioners or pediatricians; and

(4) two members who represent the public and who are not practicing or trained in a health care profession, one of whom is a parent with at least one child born with the assistance of a midwife.

Members serve staggered terms of six years. The terms of three members expire on January 31 of each odd-numbered year. This announcement is for the nine positions listed above. Interested persons should submit an application on the Department website at: https://www.tdlr.texas.gov/AdvisoryBoard/login.aspx. Applicants can also request an application from the Department by telephone (800) 803-9202, fax (512) 475-2874 or e-mail advisory.boards@tdlr.texas.gov.

Enforcement Penalties Updates

The Texas Commission of Licensing and Regulation (Commission) provides this public notice that at their regularly scheduled meeting held March 1, 2017, the Commission adopted the Texas Department of Licensing and Regulation’s (Department) revised enforcement plan which was established in compliance with Texas Occupations Code, §51.302(c).

The enforcement plan gives all license holders notice of the specific ranges of penalties and license sanctions that apply to specific alleged violations of the statutes and rules enforced by the Department. The enforcement plan also presents the criteria that are considered by the Department’s Enforcement staff in determining the amount of a proposed administrative penalty or the magnitude of a proposed sanction. The enforcement plan is revised to include the penalty matrix for the Midwives program.

The Texas Legislature enacted Senate Bill 202 (S.B. 202), 84th Legislature, Regular Session (2015), which transferred regulatory authority of 13 programs, to include the Midwives program from the Texas Department of State Health Services to the Commission and Department. The Midwives penalty matrix provides for a single range of penalties to eliminate confusion and allow the industry to fully understand the penalties assessed. The matrix separates standard of care violations from the others to allow for an expert witness, when needed, to assist the Department in understanding the violation. This penalty matrix may differ slightly from others as the agency focuses on aligning strategic plan goals with agency resources.

The Midwives Advisory Board recommended approval of the revised matrix at their meeting held January 25, 2017. The penalty matrix was presented to the Commission on March 1, 2017, and was adopted as recommended. The Commission also requested the Midwives Advisory Board meet to discuss an issue raised during the adoption of the penalty matrix.

A copy of the revised enforcement plan is posted on the Department’s website and may be downloaded at www.tdlr.texas.gov/enforcement.htm.  You may also contact the Enforcement Division at (512) 539-5600 or by e-mail at enforcement@tdlr.texas.gov to obtain a copy of the revised plan.

This agency hereby certifies that this notice been reviewed by legal counsel and found to be a valid exercise of the agency's legal authority.

Filed with the Office of the Secretary of State on March 27, 2017.


Advisory Board Meetings

CANCELED - Upcoming Meeting - April 29, 2020

The Midwives Advisory Board meeting scheduled for Wednesday, April 29, 2020 is canceled. When the meeting is rescheduled, the date will be posted online.

Midwives Educational Summit - January 31, 2020

TDLR hosted a Midwives Educational Summit on Friday, January 31, 2020 at 9:00 a.m. The summit was held at the Embassy Suites, by Hilton, 1001 E. McCarty Lane, San Marcos, TX 78666. The agenda is available online. The Summit was not broadcast live.

Previous Meeting - January 30, 2020

The Midwives Advisory Board met January 30, 2020 in Austin. The agenda and staff reports are available online. The meeting was archived and is available on TDLR's YouTube channel.