Please Support HB 1635.

I support this bill.

Thank you all for hearing the testimony on behalf of a fellow Certified Anesthesiologist Assistant (CAA). Virginia would largely benefit from an addition of midlevel practitioners in the field of anesthesiology. I have worked with many anesthesiologists and CRNAs, I respect what everyone can bring to the table. With healthcare being short of staff, more support and quality care for patients is needed. We appreciate your openness and ability to hear about the great profession of CAAs.

My name is Karen Kelly, and I am the President of the Virginia Affiliate of the American College of Nurse-Mdwives, I'm writing to urge support of HB1635, a bill that will expand access to high-quality maternity care by ensuring Licensed Certified Midwives (LCMs) have full practice authority in Virginia—aligning their scope with Certified Nurse-Midwives (CNMs). The United States faces a maternal health crisis, with rising mortality rates and significant racial disparities. Virginia is no exception. Midwifery care has been proven to improve outcomes, reducing unnecessary interventions while increasing access to safe, cost-effective, patient-centered care. According to the World Health Organization (WHO), midwives could provide up to 90% of sexual and reproductive care. Yet, outdated policies prevent midwives from practicing to their full scope, limiting access to care, especially in underserved communities. Virginia has come so far, yet policy improvements are still needed to ensure midwives can work to their full potential. This includes allowing midwives to practice within the full scope of their education and removing barriers that limit their ability to provide care independently. Restrictions such as required written practice agreements or co-location with physicians reduce the availability of midwifery services, particularly in areas facing provider shortages. In states with these requirements, midwives are often concentrated in settings where physician employment is available rather than in communities where demand for midwifery care is greatest. HB1635 removes these barriers for Licensed Certified Midwives, highly trained professionals who complete the identical masters or doctoral midwifery education, meet the same core competencies, and pass the same national certification exam as CNMs. These midwives are prepared to provide comprehensive midwifery care in all settings, yet current policy limits their ability to do so. By passing HB1635, Virginia will: -Expand maternal healthcare access in rural and urban areas experiencing provider shortages. -Support patient choice by increasing the availability of midwifery-led care. - Strengthen Virginia’s workforce by aligning LCM practice authority with CNMs, ensuring midwives can work where they are most needed. Midwifery and medicine are complementary disciplines, each contributing uniquely to the health and well-being of childbearing people. Ensuring midwives can practice to their full capacity will help address workforce shortages and expand access to high-quality care. Multiple scholarly articles have demonstrated that states that allow midwives to practice independently have a larger midwifery workforce. In these studies, independent practice was defined simply as no need to obtain a written practice agreement with a physician. For these reasons, we urge the committee to support HB1635 and remove the unnecessary barriers preventing midwives from delivering the care Virginians need. Thank you for your time and consideration.