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Board of Direct Entry Midwifery - License Information

Scope of practice

A licensed direct entry midwife (LDM) supervises the conduct and labor of childbirth, advises the parent as to the progress of childbirth, and renders prenatal, intrapartum and postpartum care as defined in Oregon Revised Statutes (ORS) 687.405.

Licensed direct entry midwives provide care in the home, in birthing centers, clinics, and as teachers at midwifery schools. They are educated through self-study, apprenticeship, a midwifery school or college-based program distinct from the discipline of nursing.

On January 1, 2015, new Board of Direct Entry Midwifery law (Oregon Revised Statutes (ORS) 687.415) went into effect that requires persons performing midwifery duties in Oregon to be licensed by the State of Oregon unless:

  • The person is already licensed as a health care professional with midwifery duties within the scope of the license; or
  • The person is a traditional midwife.

LDMs are legally authorized to administer certain legend drugs and devices under ORS 687.493 and Oregon Administrative Rules (OAR) 332-025-0030, 0040 and 0050, including anti-hemorrhagics, oxygen, I.V. drip sets and catheters, and sutures.


  • Pathways to Licensure: Documentation of:
    • Submission of satisfactory evidence of having current CPM credential from the North American Registry of Midwives (NARM);
  • Clinical Experience Requirements:
    • Participation as an assistant at 25 deliveries
    • 25 deliveries for which the applicant was the primary birth attendant
    • Participation in 100 prenatal care visits
    • 25 newborn examinations, and 40 postnatal examinations
    • Have provided continuity care for at least 10 of the primary birth attendant deliveries, including four prenatal visits, one newborn examination and one postpartum exam.
    • Of these 50 births, at least 25 deliveries must have taken place in an out-of-hospital setting and 10 births must have occurred within the two years or 24 months preceding the date of application.
    • Note: If there is more than one birth attendant present at the same birth, the birth attendants must designate which birth attendant is primary.
  • Legend Drugs & Devices: Documentation of required initial education in approved legend drugs and devices on a form prescribed by the agency. Each component must be completed within the one year or 12 months immediately preceding the date of application. More information.
  • Emergency Transport: Written plan for emergency transport for mother or newborn.
  • Cardiopulmonary Resuscitation: Proof of current certification in cardiopulmonary resuscitation for adults, neonates and infants.

Application process

To obtain an application packet, please contact the HLO or download it.

Applicants must complete and submit an application form along with required documentation and pay an application fee.


Under ORS 687.430, a person licensed to practice direct entry midwifery under the laws of another state who demonstrates to HLO's satisfaction that the person has passed a written examination at least equal to the written examination required of persons eligible for licensure in Oregon may have the written examination waived pursuant to standards of the Board of Direct Entry Midwifery.

Affidavit of Licensure

Continuing education

To qualify for license renewal, an LDM must complete approved continuing education under OAR 332-020-0010 Requirements include continuing education in the use of legend drugs and devices.

Compliance with continuing education requirements is determined by random audit under OAR 332-020-0015.

Learn more on the Board of Direct Entry Midwives' page on continuing education.

License renewal

Application for license renewal should be made in advance of the license expiration date to avoid late fees and practicing with an expired license. Renewal applications are mailed to licensees approximately six weeks prior to license expiration courtesy of HLO/Board of Direct Entry Midwifery.

Renewal applications must include:

  • Self-attestation of continuing education, including legend drugs and devices
  • Evidence of having completed peer review
  • Current neonatal resuscitation
  • Current certification in cardiopulmonary resuscitation for adults and infants
  • Copy of individual MANAstats practice report (effective 6/1/12; must begin reporting to MANAstats starting 6/1/11) (MANAstats is a data collection project of the Midwives Alliance of North America.)

Licensees may use HLO's online license renewal feature only after submitting required documentation listed above and receiving approval.

Contact HLO customer service at or 503-373-8667 for more information.

Application, renewal and information update forms

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