Shots fired from the Georgia Medical Board
Earlier this month, the Georgia Composite Medical Board issued a position statement that appeared to be about IV hydration therapy and the clinics that offer these services. However, on closer inspection, there is something more troubling nestled inside this announcement. The board reinforced that APRNs (advanced practice registered nurses, which includes certified nurse midwives) must continue to practice under physician supervision. They clarified that this does not mean broad standing orders or simply signing a protocol agreement — which has been the loose definition generally accepted — but rather the direct participation of a physician in the care being offered to each patient. They also specified that a physician should not supervise skills they themselves do not have.
The Georgia Medical Board further reinforced that APRNs cannot pay physicians for these supervisory services. Essentially, they are saying that doctors do not work for nurses — it should be the reverse. One can't help but wonder if this is in response to Amani v. the State of Georgia, in which one of the central complaints is that certified nurse midwives offering home birth in Georgia are forced to pay physicians for the supervision the state requires. It bears repeating that no other state in the United States requires this strict level of supervision of nurse midwives. And if APRNs cannot pay physicians, but are required to work under them, the logical conclusion is that physicians must own and operate all IV hydration clinics, med spas, and nurse midwife home birth practices.
Also worth noting: the board's statement that physicians should not supervise skills they do not have is significant, because it is not typical for physicians to start IVs or attend home births.
What does this mean for you?
The most concerning thing about this statement is that it turns a blind eye to the severe access-to-care crisis Georgia is already facing. We have a physician shortage, and requiring physician oversight for procedures that fall squarely within the training, education, and scope of practice of other providers simply does not make sense.
NACPM Georgia stands with the UAPRN of Georgia in demanding that policies be enacted that remove unnecessary practice restrictions for all types of providers in this state. This means:
Supporting full practice authority for APRNs, Physician Assistants, and direct-entry midwives
Removing unnecessary barriers that limit the practice of any provider and restrict a person's access to the type of care provider they choose
Recognizing that restrictive oversight impedes healthcare delivery
Empowering all non-physician providers — including APRNs, Physician Assistants, and direct-entry midwives — to practice fully within their training and education
What can you do?
Please know that when you support the work we do, you are supporting more than just home birth and midwifery. You are protecting the right to choose your provider across many specialties. You are increasing access to care in a state with serious and well-documented gaps. Georgia has a long history of choosing power and privilege over the needs of its people. This is just another example of why we have to keep fighting.
We envision a future where people in Georgia can access respectful, timely care in the setting of their choice. Where midwives can practice freely, with ready access to consultation when needed. Where a home birth transfer to the hospital happens smoothly and without the kind of bias that impedes care. Where mothers and babies are healthy and unafraid.
Use your voice by contacting your legislators and letting them know this matters to you.
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Feel free to use this template to send your legislator a personal email:
Dear Representative/Senator [LAST NAME],
My name is [YOUR NAME], and I am a constituent in your district. I am writing to urge you to take action on a growing healthcare access crisis in Georgia — one that affects pregnant people, families, and communities across our state.
Recent statements from the Georgia Composite Medical Board have raised serious concerns about the ability of Advanced Practice Registered Nurses (APRNs), including Certified Nurse Midwives, to practice to the full scope of their training and licensure. Georgia already ranks among the worst states in the nation for maternal health outcomes, and policies that further restrict credentialed providers will only deepen that crisis.
As your constituent, I am asking you to support the following solutions:
1. Allow all credentialed providers to practice to their full scope. APRNs and Certified Nurse Midwives have the education, training, and certification to safely provide care. Artificial restrictions not backed by evidence harm patients.
2. End mandatory physician supervisory requirements for these practitioners. Research does not support the claim that physician supervision improves safety or quality of care. These requirements reduce access, particularly in rural and underserved communities, without a meaningful benefit to patients.
3. License Certified Professional Midwives (CPMs) as primary maternity care providers. CPMs are nationally certified specialists in low-risk home and birth center care. Georgia is one of only a handful of states that does not license CPMs, leaving families without legal access to safe, qualified midwifery care. Licensing CPMs with mandated third-party payer coverage would expand the maternity care workforce and free up physicians to focus on high-risk patients who need them most.
4. Invest in birth center access. CPMs own or operate more than half of all birth centers in the United States. Birth centers are proven to improve outcomes and are a critical bridge to care in communities that lack hospital maternity services, including many rural Georgia counties.
Georgia families deserve a full spectrum of qualified, credentialed providers. Expanding who can practice — not restricting it — is how we solve our state's maternal healthcare crisis.
For more information on APRN advocacy in Georgia, please contact the United Advanced Practice Registered Nurses of Georgia (UAPRN) at info@uaprnofga.org. For information on CPM licensure advocacy, please contact the NACPM Georgia Chapter at nacpmga@gmail.com.
Thank you for your service to our district and your attention to this urgent issue.
Respectfully,
[YOUR NAME]
[YOUR ADDRESS]
[YOUR CITY, GA ZIP]
[YOUR PHONE/EMAIL]