A University of California, San Francisco research team told the Board of Registered Nursingadvisory committee that a statewide survey of licensed nurse midwives found the workforce skewed older, concentrated in the Greater Bay Area, and largely nationally certified. Kim Do, a certified nurse midwife and member of the study team, said the survey was sent to 700 nurse midwives licensed in California and that researchers “received a 39.5% response rate.”

The survey, conducted July 2022 to March 2023 and weighted “to ensure that the data is representative of the statewide population,” reported an average midwife age of 50.4 years, regional variation in age and practice, and racial and language gaps between providers and women of reproductive age in California. “76.1% of nurse midwives in California identify as white,” the presentation noted, while only 26.5% report speaking Spanish.

The research team, led by Joanne Spetz of UCSF’s Philip R. Lee Institute for Health Policy Studies, highlighted care patterns and workforce capacity. Among respondents, 76% were currently practicing; of those, 80% reported attending births. The team reported that 29% work full time (40 hours), 55% work part time, and 17% work more than 40 hours a week. Annual earnings were most commonly reported in a $125,000–$175,000 band. Do said the data were weighted and that the weighted estimates “may vary from the true population by plus or minus 3.05 percentage points.”

The presentation included items the committee discussed: a rise in the share of California births attended by midwives (from 8.4% in 2012 to 12.8% in 2022 in CDC data shown by the presenters); significant regional concentration in the Greater Bay Area; and concerns about clinical precepting. Do and committee members said limited precepting capacity is a bottleneck for new programs and cited competing clinical demands and productivity expectations as barriers. Anae Rappaport, a Kaiser Oakland director who spoke during public comment, said interviews with preceptors showed hospitals are limiting midwife precepting because of administrative constraints and competition with residents.

Committee members asked about education capacity. Presenters noted two current midwifery programs in the state (University of California San Francisco and California State University, Fullerton) and said San Diego State University’s program is presently suspended. Committee members discussed geographic limits on clinical placements and whether BRN rules were being misinterpreted; Board staff said BRN does not impose a 50‑mile limit but looks for adequate program support for distant clinical sites. Presenters and committee members also referenced state funding sources and pending legislation to grow training capacity: the team identified the California Health Care Foundation as funder of some workforce snapshots and mentioned two bills on the governor’s desk, SB 520 (Sen. Caballero) and AB 836 (Asm. Stephanie [last name not specified in transcript]), intended to study or fund nurse‑midwifery education expansion.

Committee members and presenters emphasized research needs to explain why the Greater Bay Area attracts and retains more midwives and to explore the recent drop in the share of respondents who report practicing to the “fullest extent of legal scope” (57.4% in the current survey vs. 72.4% reported in the BRN 2017 workforce study). Do noted that a 2020 law removed physician supervision, but the survey cannot explain whether institutional policies continue to limit practice.

The presenters said national certification is widespread: “by and large, the vast majority of nurse midwives in California have national certification,” and the American Midwifery Certification Board (AMCB) is the sole certifying body. The presentation closed with retirement and hours projections: nearly half said they planned to keep hours stable in five years, about 30% planned to reduce hours or take temporary leave, and 19% planned to leave midwifery practice or retire within five years.

No committee action was required: the presentation was informational and followed by questions, public comment, and staff clarifications about licensing and furnishing statistics posted by BRN.