House Joint Resolution (HJR) 646 was approved by the 1999 General Assembly. HJR 646 directed the Joint Commission on Health Care to examine "the advisability of legalizing the practice of direct-entry midwifery in the Commonwealth." Specifically, the Joint Commission on Health Care was directed to examine (i) advantages and disadvantages of legalizing direct-entry midwifery, (ii) experiences of other states that have legalized direct-entry midwifery, (iii) options for effectively regulating the practice of direct-entry midwifery to ensure, to the extent possible, the health and safety of women and infants receiving direct-entry midwifery services, and (iv) other issues as may seem appropriate.

This report is divided into four sections. Section II discusses midwifery in Virginia. Section III discusses approaches in other states to midwifery. Section IV presents policy options for the Joint Commission on Health Care to consider regarding midwifery.