The National Association of Certified Professional Midwives (NACPM) is releasing four, free interactive tools for midwives, families, advocates and lawmakers. Together, they show where people can reach birth care, how each state regulates Certified Professional Midwives (CPMs), and what the research says about birth at home, in birth centers, and in hospitals.

The tools are:

Access to Birth Care: drive-time access to hospitals with labor and delivery, midwife-run freestanding birth centers, and NARM-examined home birth midwives.
State Comparison on CPM Practice: licensure law, workforce, fees, Medicaid, scope of practice and access measures for every state.
Licensed Midwife Medications: state-by-state medication authority for licensed midwives, linked to the law.
Birth Settings in America Dashboard: the evidence from the National Academies of Sciences, Engineering, and Medicine (NASEM) 2020 report, made easy to explore.

Note: When viewing on desktop or mobile, click or hover over “Maps” on the homepage navigation menu to see the list of maps.

A word about how we built these

We built these tools with the help of artificial intelligence (AI), and we want to be open about that. Many in our community have real concerns about AI, and we share them. We take these concerns seriously:

Accuracy. AI can state wrong information with confidence. In health policy, a wrong number or a misread statute can do real harm.
Environmental cost. Data centers that run AI use large amounts of electricity and water.
Bias. AI learns from existing data, and existing data often reflects a medical system that has sidelined midwives and Black, Indigenous, and rural families.
Work and expertise. AI should not replace the paid work of researchers and designers or the judgment that comes from lived experience.

Here is the other side of the ledger. NACPM is a small nonprofit with a small staff and a limited budget. Tools like these have long been out of reach for organizations our size while larger, better-funded groups shape the maps and data that lawmakers see. AI let us close part of that gap.

We used it carefully:

People stayed in charge. Our Executive Director directed every decision, from which data to include to the words used on each map. The vast majority of this data was collected by staff over many painstaking hours spanning multiple years of reading statute and regulations. When AI was used to collect data, we forced citation with links and did staff quality checks.
Sources are cited. Every data layer lists its source. Legal claims point to a specific statute or regulation.
AI work is flagged. In our source spreadsheets, any cell researched or changed by AI is marked so staff can review it as we work inside the database.
We checked the work. Each tool went through an accuracy review against its original sources, and errors found were corrected.
No private data. The tools use public records, such as state license lists, open access NPI data, federal hospital data, and U.S. Census Bureau figures.
Caveats are visible. Where data is incomplete or comes from a directory instead of an official roster, the map says so.

What it would have cost

Built the traditional way, these three tools would likely have cost $26,400 to $100,000 in contractor fees. With AI, they took about 10 volunteer hours from our Executive Director, plus an AI subscription. Our estimate assumes freelance GIS and data visualization rates of $55 to $125 an hour, the range commonly posted for this work (Freelancer; example GIS posting). Hours are our estimate of the research, data cleaning, design, coding, and quality checks each tool requires. That range does not include ongoing updates, which contractors usually bill separately.

Our maps refresh from NACPM's own spreadsheets as staff update, revise, and continue to collect data with one button, so staff can keep them current without new costs.

Map 1: Access to Birth Care

Across the 39 states mapped so far, nearly 80% of women ages 15 to 44 live within a 30-minute drive of a midwife-run birth center or a NARM-examined home birth midwife. For more than 1.1 million of those women, a community midwife is the only maternity care within that 30-minute drive; there is no hospital with labor and delivery in reach. That is 2.8% of the birthing people midwives reach — care that would vanish if those midwives were not there. In some states, the impact is far larger. A community midwife is the only care in reach for one in eight families in Maine (12.6%), for 8.4% in Idaho, 7.2% in New Hampshire, and 6.6% in Wisconsin.

The map shows three kinds of care side by side: hospitals with labor and delivery, midwife-run freestanding birth centers, and NARM-examined home birth midwives. It measures access by real road drive times, not straight-line circles — because a hospital 20 miles away across a mountain or river is not 20 minutes away.

What makes it useful:

Adjustable drive times. Choose 30, 60, or 90 minutes for each type of care, or show where none is available.
Who staffs the birth center. Toggle birth centers staffed by NARM-examined midwives, AMCB-examined midwives, or both.
Who is covered. Coverage is counted against the number of women ages 15 to 44, using U.S. Census Bureau data.
Three ways to compare states. An access profile, a heat grid, and an access mix chart show where midwives fill gaps and where no care reaches at all. Every view follows the settings a visitor picks.
Always current. The map rebuilds from NACPM's licensed midwife spreadsheet, so new licenses appear when the data is updated.

Midwives and birth centers not yet on the map can ask to be added by filling out the form here.

Map 2: State Comparison on CPM Practice

For the first time, advocates can see every state's CPM laws on one map and compare them in seconds. The map draws on NACPM's State Report Card, our state-by-state record of midwifery law, with statute links behind the data.

It shows one layer at a time so it stays clear, using stoplight colors: green where conditions support CPMs and access to care, red where they do not. Layers are grouped into licensing law, workforce, cost to the midwife, cost to families, access to care, and a combined score.

What makes it useful:

The whole picture of a state. Click any state for its year of licensure, number of licensed midwives, fees, Medicaid coverage, scope of practice, regulatory agency, and statute links.
Ideal conditions. Tick the conditions that matter to you, such as birth center licensure or affordable fees, and the map shows which states meet them.
Compare two measures. Pick any two available measures, such as year the law passed and number of licensed midwives, and see whether they move together with a plain-language summary.
Medications. A companion page shows which medications licensed midwives may carry and give in each state.
License look-up. One click opens each state's official license search.
Sources in plain view. Every layer is cited, and legal claims point to a specific statute or regulation.

On this map, “licensed midwife” means a state-licensed, NARM-examined midwife, whatever title the state uses. (Not all states require ongoing national credentialing; thus the use of “NARM-examined” rather than CPM.)

Companion to Map 2: Licensed Midwife Medications

A companion page to the State Comparison map shows, state by state, which medications licensed midwives may obtain, carry, and give. It is built from NACPM's review of each state's midwifery statute and rules, and every entry links to the statute or rule it rests on.

What makes it useful:

Organized by when care happens. Medications are grouped into prenatal, labor and birth, newborn and postpartum care, followed by contraception, vaccines, and care between pregnancies.
Clear levels of authority. Color shows whether the law lets licensed midwives carry and give a medication, whether that authority is assumed because the medication is over the counter and the law is silent, whether another prescriber's order is needed, or whether the law prohibits it.
Entry-level medications marked. A symbol flags the medications NARM requires CPMs to be competent in, based on the 2026 list in NACPM's CPM Pharmacology Competencies.
Limits in plain view. Footnotes show limits written into the law, such as emergency use only or use pending transport.
Quick comparisons. Click a medication to move the states that authorize it to the top.

For advocates, the gaps are easy to spot. A medication CPMs are trained to use but cannot legally carry in their state is a specific, documented case for changing the rules. The page is a starting point for comparison, not legal guidance, and midwives should confirm with their state's current statutes and regulations.

Dashboard: Birth Settings in America

The 2020 NASEM report, “Birth Settings in America: Outcomes, Quality, Access, and Choice,” is one of the most important reviews of home, birth center, and hospital birth ever published. It is also long and dense. Our dashboard turns its evidence into charts anyone can explore.

What makes it useful:

Outcomes side by side. Newborn and maternal results, including cesarean and induction rates, compare community and hospital birth study by study. Each tab can be filtered by outcome type.
Breastfeeding. A separate tab shows breastfeeding results for birth center and home birth.
The world view. Results from Australia, Canada, England, and the Netherlands show what happens when midwives are fully part of the health system.
Midwifery integration. An NACPM illustrative integration score compares the U.S. with four peer countries. One finding stands out: Canada has a midwife-to-population ratio similar to ours, yet scores far higher because of how well its midwives are integrated — not how many there are.
Rights and choice. A tab on the right to choose one's provider and place of birth, including key legal cases, treats bodily autonomy as a right, not a preference.
Checked and cited. All 75 numeric study values were checked against their sources, and every chart links to its citation.

The Canada comparison carries a hopeful message: The U.S. does not need to wait for more midwives to improve outcomes. Better integration through licensure, payment, and smooth transfer of care can start now.

How advocates can use these tools

These tools were built for action. Whether your state has had licensed CPMs for decades or has no path to licensure at all, they give you evidence you can bring to a lawmaker's office tomorrow.

In states without CPM licensure:

Show legislators the drive-time map for their own district: where families have no hospital within 30 minutes and where a licensed midwife could close the gap.
Use the State Comparison map to point to neighboring states that already license CPMs, and how long their laws have worked.
Bring the NASEM dashboard to answer safety questions with national evidence, not anecdotes.

In states ready to modernize licensure:

Compare your state's fees, scope of practice, and medication list with states that meet ideal conditions — and make the case for change.
Use the Medicaid and access layers to show how payment and integration affect whether families can actually reach a midwife.
Use the Canada comparison to argue for integration: smooth transfer of care, fair payment, and full scope.

For NACPM and all advocates:

Add maps and charts to testimony, fact sheets, presentations, and grant proposals.
Track progress over time as state data is updated.
Help us keep the data right. Your local knowledge makes the tools stronger for everyone.

Help us keep it accurate

These tools are living resources, and we welcome your corrections. If you see an error, a missing midwife or birth center, or an out-of-date law, please email advocacy@nacpm.org. Midwives who want to be added to the Access to Birth Care map can fill out this anonymous form.

Every family deserves access to the care they choose, close to home. With these tools, NACPM and advocates in every state can show lawmakers where that care exists, where it is missing, and how midwives can help close the gap.

Explore the tools at: