03/10/2026
‼️Action point ‼️
When we hire a licensed midwife in Texas, we are given an informed consent agreement - two pages that tell us our midwife’s license number and expiration date, her CPR and NRP information, the number of births she has attended, a few bullet points of requirements and restrictions, whether or not she has malpractice, locations of hospitals, and where to file complaints.
The regulation agency for midwives (TDLR) has proposed changes that Texas midwives do not support.
The proposed additions include:
Professional liability insurance: Expanding this section with malpractice definition and informs clients they can sue regardless if a midwife carries malpractice or not and “may, at any time, ask their midwife about their financial responsibility arrangements…”
State Medicaid/CHIP resources: Clients are directed to state programs for prenatal coverage.
Hospital preparation instructions: Clients are “strongly encouraged” to visit hospitals in advance, preregister, and pack a bag “in case of a transfer.”
Expanded prohibited acts: Frenotomies and abortion are newly included.
Why This Matters
The proposed form raises serious concerns for midwives and the families they serve:
Exceeds statutory limits: While the legal disclosure section itself remains under the 500-word limit, the additions—including insurance education, hospital logistics, and state insurance resources—extend the document well beyond the statutory intent. This makes the form longer and more burdensome for clients.
No other licensed healthcare profession is treated this way: No other licensed healthcare profession in Texas is required to include language inviting clients to investigate their provider’s personal financial assets. This single requirement uniquely burdens midwives and risks misrepresenting their practice.
Malpractice and financial disclosure concerns: The expanded professional liability section requires discussion of personal financial responsibility, placing an undue burden on midwives without improving client safety.
Insurance framing is misleading:
The insurance section frames midwifery practice as high-risk and financially precarious without evidence. This could create unnecessary fear for families and undermine trust in the provider-client relationship.
Hospital preparation language is paternalistic: Instructions to preregister, visit hospital units, and pack a hospital bag suggest that transfers are expected rather than exceptional. This over-medicalizes care and may intimidate families choosing midwifery.
New prohibited acts without legislative mandate: Adding frenotomies and abortion to the prohibited acts list changes how scope of practice is presented through a disclosure form rather than legislation or rulemaking.
REDUCED TRANSPARENCY of important information : Removing the Neonatal Resuscitation credential expiration date decreases client visibility into provider qualifications.
CURRENTLY THE PUBLIC CAN MAKE PUBLIC COMMENTS ABOUT THE PROPOSED CHANGES! WE NEED YOU TO WEIGH IN! 🎤
➡️ Submit your public comment to this email address:
advisory.boards@tdlr.texas.gov
Below is a sample public comment you may copy, paste, and adapt.
"I am a midwifery client here in Texas, and writing in regard to the proposed revisions to the Informed Choice and Disclosure Statement for Licensed Midwives as discussed in the Midwives Advisory Board meeting on Jan 13th (Agenda Item G).
I support transparency and informed choice in maternity care.
I am concerned about the proposed requirement for midwives to explain personal financial responsibility related to malpractice. As a consumer, this information would not help me make safer or better decisions about my care. Instead, it could create unnecessary fear or confusion at an already vulnerable time in pregnancy.
The proposed revisions significantly expand the Informed Choice and Disclosure Statement in ways that go beyond what is mandated in statute. I respectfully ask that this form remain focused on health, safety, and care options rather than on my provider’s personal financial situation.”
You only need to submit one comment, but more are always welcome.
Please share with your friends who use midwives!
Every comment matters. Every voice helps shape the future of midwifery in Texas. By speaking up now, we protect informed choice, preserve the integrity of the midwifery model of care and ensures that future policies truly serve families and midwives alike
