Safeguarding modern midwifery

About the Author

Uniting clinical expertise and legal perspective to reveal how midwifery is interpreted—and often misinterpreted—across courts and hospitals.

Martha E Merrill-Hall portrait
Martha E Merrill-Hall JD MS CNM

Martha has led CNM practice across private, Indian Health Service, hospitalist, and critical access settings while litigating personal injury and professional malpractice cases.

Today she researches verdict trends, policy shifts, and licensure actions from the Rocky Mountains—equipping midwives, patients, and counsel with grounded legal insight.

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Why midwives & counsel read

Dual license perspective

Decades of private, IHS, hospitalist, and critical access CNM practice pair with JD work representing both plaintiffs and defendants in professional malpractice.

  • Pro bono defense of advanced practice providers facing board actions.
  • Expert witness experience in midwifery negligence claims.

Where I've practiced

Licensed across Colorado, Montana, Nebraska, Iowa, New Mexico, California, and beyond—spanning CNM hospitalist teams, Indian Health Service care, and cardiology/critical care nursing roots in Vermont and Maine.

Today I research verdicts, legal seminars, and policy shifts from the Rocky Mountains.

What Martha hopes readers gain

  • Historical context for how CNMs/CMs secured hospital privileges and where culture still lags clinical reality.
  • Plain-language breakdowns of licensure boundaries, malpractice myths, and courtroom expectations.
  • Validation for midwives, attorneys, and patients who need equitable framing of the profession’s contributions.
  • Strategies to translate courtroom narratives back into safe bedside practice.

June 20, 2024

All Midwives Are Not The Same

Updated January 12, 2026

Jorgen Haland  unsplash-image
Photo by Jorgen Haland

From a medical-legal standpoint, the ability to differentiate between types of practicing midwives in the community allows determination of specific:

 1) legal standing in the community

 2) midwifery skills and background

 3) individual standards of practice

 4) educational background/degrees/certification

 5) philosophies/attitudes and how they are applied to prospective clients

 6) relationships and/or arrangements with the medical community/ hospitals/emergency medical services

 7) contingency plans if things go wrong/choices to be made in emergencies

 8) practice settings: hospital/birth center/home

 9) financial arrangements and/or malpractice insurance coverage

 10) local rules, regulations, and community expectations for practice

      Consumers and attorneys need to understand the differences between midwives and the unique aspects of each practice.  For instance, a CPM or a Lay midwife will be judged by a different standard of care than CNMs or CMs. Some midwives practice in hospitals, others in free-standing birth centers or the client’s home. 

Variations between birth settings and how different midwives practice within them are necessary considerations for consumers and attorneys alike.   For attorneys, properly representing a consumer or defending a midwife will depend on appreciating the potential lack of equivalence among midwives.  For consumers, understanding the specifics of what individual midwife providers can and cannot provide in the childbearing process is crucial when weighing factors such as health, safety, satisfaction, and trust.