North Carolina SB 908: Janell Green Smith Maternal Health Acc. Act.

Bill Text

GENERAL ASSEMBLY OF NORTH CAROLINA
SESSION 2025
S 1
SENATE BILL 908

Short Title: Janell Green Smith Maternal Health Acc. Act. (Public)
Sponsors: Senators Murdock, Salvador, and Waddell (Primary Sponsors).
Referred to: Rules and Operations of the Senate
April 30, 2026
*S908-v-1*
A BILL TO BE ENTITLED 1
AN ACT TO RECOGNIZE MATERNAL HEALTH INITIATIVES AND TO SUPPORT AND 2
EXPAND LICENSURE AND RECOGNITION OF MIDWIVES. 3
The General Assembly of North Carolina enacts: 4
SECTION 1.(a) Chapter 90 of the General Statutes is amended by adding a new 5
Article to read: 6
"Article 10B. 7
"Maternal Health Accountability Act. 8
"§ 90-178.10. Short title. 9
This Article shall be cited and known as the "Dr. Janell Green Smith, DNP, CNM, Maternal 10
Health Accountability Act." 11
"§ 90-178.11. Legislative findings; intent. 12
(a) Findings. – The General Assembly makes the following findings: 13
(1) North Carolina continues to experience unacceptable rates of maternal 14
mortality and severe maternal morbidity, with disproportionate impact on 15
Black, Indigenous, rural, and low-income communities. 16
(2) The American College of Nurse-Midwives (ACNM) and the National 17
Association of Certified Professional Midwives (NACPM) recognize 18
Certified Nurse Midwives (CNMs), Certified Midwives (CMs), and Certified 19
Professional Midwives (CPMs) as essential providers in a safe, 20
evidence-based, and equitable maternal health system. 21
(3) National clinical standards and peer-reviewed evidence demonstrate that 22
midwifery care, when licensed, regulated, and integrated across birth settings, 23
improves continuity of care, patient satisfaction, and maternal and neonatal 24
outcomes. 25
(4) States in the southeastern United States, including South Carolina and 26
Virginia, have enacted laws to do all of the following: 27
a. Formally integrate midwives into perinatal levels of care systems. 28
b. License and regulate Certified Professional Midwives using national 29
standards. 30
c. Prohibit physician supervision or contractual gatekeeping 31
requirements. 32
d. Require equitable reimbursement for midwives providing covered 33
maternity services. 34
(5) Virginia law expressly provides for autonomous midwifery practice and 35
reimbursement parity for licensed midwives, while South Carolina law 36

General Assembly Of North Carolina Session 2025
Page 2 Senate Bill 908-First Edition
requires the integration of midwives and community birth into statewide 1
perinatal care planning, without restricting scope of practice or requiring 2
hospital privileges. 3
(6) A maternal health system that excludes community‑based providers, fails to 4
ensure accountability for hospital practices, or relies on uncompensated 5
perinatal labor undermines patient safety and worsens disparities. 6
(b) Intent. – It is the intent of the General Assembly to establish a comprehensive 7
maternal health accountability framework that promotes safety, transparency, workforce 8
sustainability, informed consent, and equitable access to care, while honoring the legacy of Dr. 9
Janell Green Smith, whose leadership advanced patient-centered maternity care and system 10
accountability. 11
"§ 90-178.12. Core principles. 12
North Carolina's maternal health system shall be governed by the following principles: 13
(1) Maternal health systems shall be accountable for patient safety, respectful 14
care, and measurable outcomes. 15
(2) Pregnant and postpartum individuals and their families shall have clear, 16
accessible pathways for reporting harm and obtaining timely support. 17
(3) Certified Nurse Midwives, Certified Midwives, and Certified Professional 18
Midwives are essential maternal health providers and must be recognized, 19
regulated, and supported across all birth settings. 20
(4) Community-based organizations, including midwifery practices and doula 21
organizations, constitute essential public health infrastructure. 22
(5) The maternal health workforce shall be sustainable, accessible, and fairly 23
compensated. 24
(6) Licensed midwifery care across hospital and community settings improves 25
continuity of care, safety, and birth outcomes. 26
"§ 90-178.13. Definitions. 27
The following definitions apply in this Article: 28
(1) CM. – Certified Midwife licensed under Article 10C of this Chapter. 29
(2) CNM. – Certified Nurse Midwife licensed under Article 10A of this Chapter. 30
(3) CPM. – Certified Professional Midwife licensed under Article 10C of this 31
Chapter. 32
(4) Department. – The Department of Health and Human Services. 33
(5) Hospital. – As defined in G.S. 131E-214.1. 34
(6) Perinatal health care provider. – A licensee under this Article and Articles 10A 35
and 10C of this Chapter. 36
"§ 90-178.14. Hospital accountability and safe discharge. 37
Hospitals providing maternal or emergency obstetric services shall do all of the following: 38
(1) Implement and maintain a safe labor discharge plan prior to the discharge of 39
any individual presenting in labor