{"schemaVersion":"1.0","exportedAt":"2026-05-15T12:40:03.016Z","occupation":{"soc":"29-1161.00","title":"Nurse Midwives","group":"Healthcare Practitioners & Technical","sector":"62","jobZone":5,"jobZoneInferred":false},"framework":{"version":"v.26.05","description":"","contextCovered":"This framework covers nurse midwifery practice across prenatal, intrapartum, postpartum, newborn, and family planning care settings, from supervised entry-level clinical roles through organizational leadership in hospital, birth center, and community health environments.","levels":{"emerging":{"label":"Emerging","statements":["Prenatal patient health histories and symptom documentation — collect and record under clinical supervision in a hospital or birth center setting.","Fetal heartbeat and uterine measurements — monitor and report findings to supervising midwife or physician during routine prenatal visits.","Diagnostic and laboratory test orders — submit and retrieve results under direct guidance of a preceptor in an outpatient obstetric clinic.","Individualized care plans — contribute structured input to development activities under the direction of a senior nurse midwife.","Clinical procedures and examination steps — explain clearly to patients and family members using approved protocols in a supervised labor and delivery unit.","Oral contraceptive dispensing and basic family planning instructions — provide to patients following established clinical protocols under close oversight.","Electronic medical software and patient record systems — enter, retrieve, and organize patient data accurately in a supervised clinical environment.","Fetal position identification and estimated fetal size — assess using external palpation techniques under direct preceptor observation in a prenatal clinic.","Evidence-based clinical guidelines and professional literature — read and summarize to support patient care decisions under mentorship guidance.","Intrapartum patient status changes — recognize and escalate promptly to supervising clinicians during monitored labor support rotations."]},"developing":{"label":"Developing","statements":["Prenatal, intrapartum, and postpartum care across routine presentations — deliver with reduced oversight in a community birth center or hospital-based midwifery practice.","Fetal development progression — monitor across successive prenatal visits by integrating heartbeat auscultation, fundal height measurements, and position assessment in an outpatient setting.","Comprehensive patient health histories and physical condition records — document accurately and completely in electronic medical software within established clinical workflows.","Intrauterine device insertion and cervical barrier fitting — perform competently using sterile technique in a family planning or women's health clinic with periodic peer review.","Medications permitted under state regulations — prescribe appropriately for routine obstetric and gynecologic conditions while coordinating with collaborative physician partners.","Individualized health care management plans — develop and implement for low-to-moderate-risk patients by integrating assessment findings and patient preferences in a midwifery-led practice.","Diagnostic and laboratory test results — interpret and communicate findings to patients with clarity and appropriate clinical follow-up in a busy obstetric outpatient setting.","Active listening and social perceptiveness — apply consistently during patient encounters to identify psychosocial factors affecting maternal or newborn health outcomes.","Care coordination activities — manage across prenatal, birth, and postpartum phases by collaborating with nursing, neonatal, and social work teams in a hospital setting.","Family planning counseling conversations — conduct with cultural sensitivity and evidence-based guidance for patients across diverse demographic backgrounds in a community health setting."]},"proficient":{"label":"Proficient","statements":["Full-scope prenatal, intrapartum, postpartum, and newborn care — deliver autonomously for routine and moderately complex cases in a hospital or freestanding birth center.","Fetal development anomalies and deviations from normal growth patterns — identify and manage through timely diagnostic escalation and collaborative consultation in a high-volume obstetric unit.","Complex patient health records involving co-morbidities and high-risk factors — document, analyze, and synthesize to inform individualized care decisions in an integrated health system.","Full range of family planning services including IUD insertion, oral contraceptive management, and barrier fitting — provide to patients with varied clinical histories in a comprehensive women's health practice.","Pharmacological treatment regimens for obstetric and gynecologic conditions — prescribe and adjust within the full scope permitted by state regulation, applying clinical judgment to individual patient needs.","Individualized care plans for high-risk or complex pregnancies — develop, implement, and revise based on evolving diagnostic findings and patient-centered goals in a multidisciplinary care setting.","Advanced diagnostic laboratory tests including genetic screening, fetal surveillance, and maternal labs — order, interpret, and integrate into care management decisions across a diverse patient caseload.","Non-routine clinical events such as labor dystocia, postpartum hemorrhage, or neonatal compromise — assess rapidly and manage or escalate with precision in a hospital labor and delivery unit.","Clinical education sessions and procedure explanations — deliver to patients, family members, and junior staff in ways that build understanding and support informed consent across varied literacy levels.","Systems analysis of care delivery gaps or workflow inefficiencies — conduct and recommend evidence-based improvements within a midwifery practice or maternal health department."]},"advanced":{"label":"Advanced","statements":["Midwifery practice standards and clinical protocols — author, implement, and evaluate at an organizational level to elevate safety and quality across a health system's maternal care continuum.","Emerging evidence in prenatal, intrapartum, and neonatal care — synthesize and translate into updated institutional guidelines, leading policy adoption across multidisciplinary teams.","Strategic family planning program development — design and oversee at scale, integrating service delivery models that address population health needs and health equity goals in a regional or system-wide context.","Prescribing authority frameworks and scope-of-practice regulations — interpret, advocate for, and apply strategically to expand nurse midwifery capabilities within legal and institutional structures.","Mentorship and clinical supervision of emerging and developing nurse midwives — lead systematically through structured preceptorship programs that build workforce competency across a practice or health system.","Quality improvement and patient safety initiatives for maternal-newborn outcomes — lead cross-functional teams in designing, piloting, and measuring evidence-based interventions at the organizational level.","Complex ethical, legal, and psychosocial cases in midwifery practice — resolve through principled decision-making frameworks that balance patient autonomy, clinical risk, and institutional accountability.","Interdisciplinary collaboration with obstetrics, neonatology, social work, and public health — lead at an executive or program director level to integrate midwifery into comprehensive women's health service lines.","Health data analytics and outcome metrics for midwifery-managed patient populations — oversee collection, analysis, and reporting using medical and spreadsheet software to drive strategic care improvements.","Workforce development curricula, clinical education programs, and learning strategies for advanced midwifery practice — design and champion across academic-practice partnership settings to shape the next generation of practitioners."]}}},"sources":{"onet":"v30.2 (CC BY 4.0)","crosswalk":"https://skillscrosswalk.com","generator":"LER.me"},"attribution":"© EBSCOed"}