CTS:wlj:pg
2005 - 2006 LEGISLATURE
October 3, 2005 - Introduced by Representatives Underheim, Lamb, Hahn, Hines,
Townsend, Musser, Pope-Roberts, Pettis, Owens, Molepske, Seidel,
Montgomery
and Young, cosponsored by Senators Grothman, Darling,
Lassa, Reynolds, Coggs, Erpenbach
and Olsen. Referred to Committee on
Health.
AB709,1,4 1An Act to amend 441.15 (2) (intro.) and 448.03 (2) (a); and to create 440.08 (2)
2(a) 46w., subchapter XI of chapter 440 [precedes 440.980] and 441.15 (2m) of the
3statutes; relating to: licensing midwives, granting rule-making authority,
4and providing a penalty.
Analysis by the Legislative Reference Bureau
Current law establishes the requirements for licensed registered nurses to
obtain from the Board of Nursing a license to practice nurse-midwifery. This bill
establishes requirements for the licensure by the Department of Regulation and
Licensing (DRL) of midwives who are not licensed nurses. The bill does not otherwise
affect the requirements under current law that apply to licenses to practice
nurse-midwifery.
Under the bill, the practice of midwifery is defined as providing maternity care
during the antepartum, intrapartum, and postpartum periods. The bill prohibits a
person who is not a licensed midwife or licensed nurse-midwife from using a title
that represents or implies that he or she is a midwife.
The bill regulates licensed midwives as follows:
1. The bill permits DRL to grant a license only to an applicant who holds a valid
certified professional midwife credential from the North American Registry of
Midwives or who holds a valid certified nurse-midwife credential granted by the
American College of Nurse Midwives and attends births in out-of-hospital settings.
The bill prohibits DRL from granting a license to a person who has been convicted
of a sex offense.

2. The bill allows DRL to discipline a licensed midwife who has violated any
requirement under the bill or engaged in certain conduct.
3. The bill requires that a licensed midwife disclose to a client in writing at an
initial consultation his or her qualifications, whether he or she has malpractice
insurance, and a client-specific emergency protocol.
4. The bill requires DRL to promulgate rules necessary to administer the
regulation of midwives. The rules must be consistent with standards regarding the
practice of midwifery established by the National Association of Certified
Professional Midwives and must allow licensed midwives to administer oxygen. The
bill allows DRL to promulgate rules that authorize licensed midwives to administer
oxytocin (Pitocin) as a postpartum antihemorrhagic agent, intravenous fluids for
stabilization, vitamin K, eye prophylactics, and other drugs or procedures as DRL
determines. The bill prohibits DRL from promulgating rules that do any of the
following: 1) require a licensed midwife to have a nursing degree or diploma; 2)
require a licensed midwife to practice midwifery under the supervision of, or in
collaboration with, another health care provider; 3) limit where a licensed midwife
may practice; or 4) permit a licensed midwife to use forceps or vacuum extraction.
The bill provides that a health care provider is not liable for an injury resulting
from an act or omission by a licensed midwife, even if the health care provider has
consulted with or accepted a referral from the licensed midwife.
A person who violates the provisions of the bill is subject to a $250 fine, three
months' imprisonment, or both. In addition, if DRL exercises its power under current
law to appoint an advisory committee on licensed midwives, the bill creates
requirements for the membership of the committee.
Because this bill creates a new crime or revises a penalty for an existing crime,
the Joint Review Committee on Criminal Penalties may be requested to prepare a
report concerning the proposed penalty and the costs or savings that are likely to
result if the bill is enacted.
For further information see the state fiscal estimate, which will be printed as
an appendix to this bill.
The people of the state of Wisconsin, represented in senate and assembly, do
enact as follows:
AB709, s. 1 1Section 1. 440.08 (2) (a) 46w. of the statutes is created to read:
AB709,2,22 440.08 (2) (a) 46w. Midwife, licensed: July 1 of each even-numbered year; $56.
AB709, s. 2 3Section 2. Subchapter XI of chapter 440 [precedes 440.980] of the statutes is
4created to read:
AB709,2,55 Chapter 440
AB709,3,2
1SUBCHAPTER XI
2 licensed midwives
AB709,3,3 3440.980 Definitions. In this subchapter:
AB709,3,6 4(1) "Health care provider" means a health care provider, as defined in s. 146.81
5(1), a person licensed or issued a training permit as an emergency medical technician
6under s. 146.50, or a person certified as a first responder under s. 146.50 (8).
AB709,3,8 7(2) "Licensed midwife" means a person who has been granted a license under
8this subchapter to engage in the practice of midwifery.
AB709,3,10 9(3) "Practice of midwifery" means providing maternity care during the
10antepartum, intrapartum, and postpartum periods.
AB709,3,14 11440.981 Use of title; penalty. (1) No person may use the title "licensed
12midwife," describe or imply that he or she is a licensed midwife, or represent himself
13or herself as a licensed midwife unless the person is granted a license under this
14subchapter or is licensed as a nurse-midwife under s. 441.15.
AB709,3,16 15(2) Any person who violates sub. (1) may be fined not more than $250,
16imprisoned not more than 3 months, or both.
AB709,3,18 17440.982 Licensure. (1) Except as provided in sub. (2), the department may
18grant a license to a person under this subchapter if all of the following apply:
AB709,3,2019 (a) The person submits an application for the license to the department on a
20form provided by the department.
AB709,3,2121 (b) The person pays the fee specified in s. 440.05 (1).
AB709,3,2322 (c) The person submits evidence satisfactory to the department of one of the
23following:
AB709,3,2524 1. The person holds a valid certified professional midwife credential granted
25by the North American Registry of Midwives or a successor organization.
AB709,4,3
12. The person holds a valid certified nurse-midwife credential granted by the
2American College of Nurse Midwives or a successor organization, and he or she
3attends births in out-of-hospital settings.
AB709,4,7 4(2) The department may not grant a license under this subchapter to any
5person who has been convicted of an offense under s. 940.22, 940.225, 944.06, 944.15,
6944.17, 944.30, 944.31, 944.32, 944.33, 944.34, 948.02, 948.025, 948.06, 948.07,
7948.075, 948.08, 948.09, 948.095, 948.10, 948.11, or 948.12.
AB709,4,11 8440.983 Renewal of licensure. (1) The renewal date for licenses granted
9under this subchapter is specified in s. 440.08 (2) (a). Renewal applications shall be
10submitted to the department on a form provided by the department and shall include
11the renewal fee specified in s. 440.08 (2) (a).
AB709,4,16 12(2) A licensed midwife shall, at the time that he or she applies for renewal of
13a license under sub. (1), submit proof satisfactory to the department that he or she
14holds a valid certified professional midwife credential from the North American
15Registry of Midwives or a successor organization or a valid certified nurse-midwife
16credential from the American College of Nurse Midwives or a successor organization.
AB709,4,21 17440.984 Rule making. (1) The department shall promulgate rules necessary
18to administer this subchapter. Except as provided in subs. (2) and (3), any rules
19regarding the practice of midwifery shall be consistent with standards regarding the
20practice of midwifery established by the National Association of Certified
21Professional Midwives or a successor organization.
AB709,4,23 22(2) The rules shall allow a licensed midwife to administer oxygen during the
23practice of midwifery.
AB709,5,2 24(3) The rules may allow a midwife to administer, during the practice of
25midwifery, oxytocin (Pitocin) as a postpartum antihemorrhagic agent, intravenous

1fluids for stabilization, vitamin K, eye prophylactics, and other drugs or procedures
2as determined by the department.
AB709,5,3 3(4) The rules may not do any of the following:
AB709,5,44 (a) Require a licensed midwife to have a nursing degree or diploma.
AB709,5,65 (b) Require a licensed midwife to practice midwifery under the supervision of,
6or in collaboration with, another health care provider.
AB709,5,87 (c) Require a licensed midwife to enter into an agreement, written or otherwise,
8with another health care provider.
AB709,5,99 (d) Limit the location where a licensed midwife may practice midwifery.
AB709,5,1010 (e) Permit a licensed midwife to use forceps or vacuum extraction.
AB709,5,13 11440.985 Informed consent. A licensed midwife shall, at an initial
12consultation with a client, provide a copy of the rules promulgated by the department
13under this subchapter and disclose to the client in writing all of the following:
AB709,5,14 14(1) The licensed midwife's experience and training.
AB709,5,16 15(2) Whether the licensed midwife has malpractice liability insurance coverage
16and the policy limits of any such coverage.
AB709,5,18 17(3) A protocol for medical emergencies, including transportation to a hospital,
18particular to each client.
AB709,5,19 19(4) Any other information required by department rule.
AB709,5,23 20440.986 Disciplinary proceedings and actions. (1) Subject to the rules
21promulgated under s. 440.03 (1), the department may conduct investigations and
22hearings to determine whether a violation of this subchapter or any rule
23promulgated under this subchapter has occurred.
AB709,6,2 24(2) Subject to the rules promulgated under s. 440.03 (1), the department may
25reprimand a licensed midwife or deny, limit, suspend, or revoke a license granted

1under this subchapter if the department finds that the applicant or the licensed
2midwife has done any of the following:
AB709,6,43 (a) Intentionally made a material misstatement in an application for a license
4or for renewal of a license.
AB709,6,65 (b) Subject to ss. 111.321, 111.322, and 111.34, practiced midwifery while his
6or her ability to engage in the practice was impaired by alcohol or other drugs.
AB709,6,77 (c) Advertised in a manner that is false or misleading.
AB709,6,98 (d) In the course of the practice of midwifery, made a substantial
9misrepresentation that was relied upon by a client.
AB709,6,1110 (e) In the course of the practice of midwifery, engaged in conduct that evidences
11an inability to apply the principles or skills of midwifery.
AB709,6,1212 (f) Obtained or attempted to obtain compensation through fraud or deceit.
AB709,6,1313 (g) Allowed another person to use a license granted under this subchapter.
AB709,6,1614 (h) Violated any law of this state or federal law that substantially relates to the
15practice of midwifery, violated this subchapter, or violated any rule promulgated
16under this subchapter.
AB709,6,19 17(3) Subject to the rules promulgated under s. 440.03 (1), the department shall
18revoke a license granted under this subchapter if the licensed midwife is convicted
19of any of the offenses specified in 440.982 (2).
AB709,6,22 20440.987 Advisory committee. If the department appoints an advisory
21committee under s. 440.042 to advise the department on matters relating to the
22regulation of licensed midwives, the committee shall consist of only the following:
AB709,6,23 23(1) Two members who are licensed midwives.
AB709,6,25 24(2) One member who is licensed as a nurse-midwife under s. 441.15 and who
25practices in an out-of-hospital setting.
AB709,7,1
1(3) One member who is a physician specializing in obstetrics and gynecology.
AB709,7,3 2(4) One public member who has received midwifery care in an out-of-hospital
3setting.
AB709,7,6 4440.988 Vicarious liability. No health care provider shall be liable for an
5injury resulting from an act or omission by a licensed midwife, even if the health care
6provider has consulted with or accepted a referral from the licensed midwife.
AB709, s. 3 7Section 3. 441.15 (2) (intro.) of the statutes is amended to read:
AB709,7,98 441.15 (2) (intro.) No Except as provided in sub. (2m), no person may engage
9in the practice of nurse-midwifery unless each of the following conditions is satisfied:
AB709, s. 4 10Section 4. 441.15 (2m) of the statutes is created to read:
AB709,7,1211 441.15 (2m) Subsection (2) does not apply to a person granted a license to
12practice midwifery under subch. XI of ch. 440.
AB709, s. 5 13Section 5. 448.03 (2) (a) of the statutes is amended to read:
AB709,7,2014 448.03 (2) (a) Any person lawfully practicing within the scope of a license,
15permit, registration, certificate or certification granted to practice midwifery under
16subch. XI of ch. 440,
to practice professional or practical nursing or nurse-midwifery
17under ch. 441, to practice chiropractic under ch. 446, to practice dentistry or dental
18hygiene under ch. 447, to practice optometry under ch. 449, to practice acupuncture
19under ch. 451 or under any other statutory provision, or as otherwise provided by
20statute.
AB709, s. 6 21Section 6 . Nonstatutory provisions.
AB709,8,322 (1) Notwithstanding section 440.987 (1) of the statutes, as created by this act,
23an initial member of an advisory committee appointed under section 440.987 (1) of
24the statutes is not required to be a licensed midwife under section 440.982 of the
25statutes, as created by this act, if the appointment occurs before the first day of the

113th month beginning after publication and at the time of the appointment the
2individual holds a valid certified professional midwife credential granted by the
3North American Registry of Midwives or a successor organization.
AB709, s. 7 4Section 7. Effective dates. This act takes effect on the first day of the 13th
5month beginning after publication, except as follows:
AB709,8,76 (1) The treatment of section 440.987 of the statutes and Section 6 of this act
7take effect on the day after publication.
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