Sen. Salvador files bill in North Carolina Senate to expand midwife licensure and improve maternal health

A new bill filed by State Sen. DeAndrea Salvador aims to strengthen North Carolina’s maternal health system and expand access to licensed midwives across the state, according to the North Carolina State Senate.

The bill, filed as SB 908 on April 29 during the 2025 regular session, was formally listed with the short title: ‘Janell Green Smith Maternal Health Acc. Act.’

The following is our breakdown, based on the actual bill text, and may include interpretation to clarify its provisions.

In essence, this bill establishes the Dr. Janell Green Smith Maternal Health Accountability Act and the Accessing Midwives Act to create a statewide framework for safer, more transparent maternity care and expanded midwife licensure. It requires hospitals to adopt safe labor discharge plans, emergency protocols, bias and respectful care training, and formal transfer agreements with midwives, and to report detailed maternal and neonatal outcomes by race, payer, geography and provider type. The bill licenses certified professional midwives and certified midwives under a new council that sets standards, education, drug formularies, fees and discipline. It also builds doula and midwifery workforce support, creates a maternal health reporting and navigation system, and mandates reimbursement parity for midwives in private insurance and Medicaid. Most provisions take effect Oct. 1, 2026.

Of the three sponsors of this bill, Natalie S. Murdock proposed the most bills (92) during the 2025 regular session.

Bills in North Carolina follow a multi-step process before becoming law. A lawmaker starts by filing a bill, which is assigned to a committee for review. The bill must be read three times in each chamber. If one chamber changes the bill after the other passes it, both must agree on the final version. Once both chambers approve the same bill, it goes to the governor, who has 10 days (or 30 if the legislature is not in session) to sign, veto, or let it become law without a signature.

You can read more about the bills and other measures here.

Salvador graduated from Wake Forest University in 2011 with a BS and again in 2013 from the University of North Carolina Charlott with a BS.

Salvador, a Democrat, was elected to the North Carolina State Senate in 2021 to represent the state’s 39th Senate district, replacing previous state senator Rob Bryan.