Midwifery Licensing Instructions

In addition to the application and fee, please submit the following documents:

1. Completed Application: Applications may be submitted online at MyLicense.IN.gov or completed by paper and mailed to our office. 

   If you have ever held a license previously in Indiana, and are applying again for the same license type, please contact our office at (317) 234-2060 or by email at pla3@pla.in.gov to inquire about reactivating your previous license.

2. Application Fee of $50.00 - Pay by credit or debit card for applications submitted online at MyLicense.IN.gov. If applying by paper/mail make checks or money orders payable to Indiana Professional Licensing Agency. All application fees are nonrefundable.
3. Criminal Background Check - If you submit a paper application, a confirmation email advising you to do your criminal background check will be sent to the email address supplied on the application. If the application is submitted online, you may start your criminal background check process after the receipt screen appears after submitting your online application and payment.
4. Positive Response - If you have answered any of the questions on the application “yes” you must submit an affidavit detailing the occurrence/situation, the outcome, date of occurrence, if it is a malpractice payment the amount paid in your behalf. If applicable, please submit copies of all court documents and/or arrest records. Letters from attorneys or insurance companies are not accepted in lieu of your statement.
5. Verification of other state licenses - an applicant who currently holds, or has previously held, a license, certification, or registration issued by another state to practice any health profession must request verification of license status from the state that issued that license, certification, or registration. The verification must be sent directly to the board from the agency that issued the license, certification, or registration. Official electronic verification will also be accepted.
6. Certified Professional Midwife Credential - a certified copy of CPM credential certificate or card conferred by the North American Registry of Midwives
7. Postsecondary Diploma - a certified copy of diploma from postsecondary educational institution
8. Original Postsecondary Transcript - sent directly from the institution of higher learning where the applicant received a postsecondary degree, including the degree conferred and date conferred. Applicant must have either an associate's degree in nursing, midwifery (from MEAC approved program), or other similar science related degree; or, a bachelor's degree in any field. In lieu of this requirement and number 4 above, and prior to June 30, 2018, applicant may submit proof of enrollment directly from the institution of hearing learning.
9. Official MEAC-approved Program Transcript - sent directly from a Midwifery Education Accreditation Council (MEAC) approved program showing completion of a MEAC approved midwifery educational curriculum. In lieu of this requirement, and prior to June 30, 2018, applicant may submit proof of 100 births where applicant was primary attendant (see Affidavit of Additional Births Form) and a letter of reference from a licensed physician with whom the applicant is collaborating.
10. CPR card - copy of certification in adult CPR that is not expired
11. American Academy of Pediatrics certificate of completion or card - showing completion of program in neonatal resuscitation (excluding endotracheal intubation and drug administration)
12. Notarized Affidavit of Completion of Additional Births Form - submit as many affidavits as necessary to document completion of the following, which are in addition to any needed for CPM credentialing: (1) observation of 20 births; (2) attendance at 20 births conducted by a physician; (3) assistance with 20 births; (4) primary attendant at 20 births. All must have been in the United States and overseen by a NARM approved preceptor or physician. The document should be completed by the individual attesting to the additional births and notarized.;
13. Emergency Skills Training Course - certificate of completion of NARM approved emergency skills training course which is eligible for inclusion in the Midwifery Bridge Certification Program. The course(s) must include material on emergency life support procedures, identification of high-risk births for mothers, and identification of potential complications during labor.
14. Proof of Liability Insurance - must be a minimum of $100,000 per incident/$300,000 yearly aggregate.
15. Collaborative Practice Agreement
16. Name Change Documentation (if applicable) - If your name has changed or differs on any documents submitted, please include an official name change document such as a marriage license or divorce decree.

PROCESSING TIME: Processing time depends on the applicant. The applicant is responsible for the submission of all documents. If there is a positive response the license will not be issued until it has been reviewed by the Medical Licensing Board.

FAIR INFORMATION PRACTICE ACT: In compliance with IC 4-1-6, this agency is notifying all applicants that they must provide the requested information or the application will not be processed. The applicant has the right to challenge, correct, or explain information maintained by this agency. The information provided will become public record. Examination scores and grade transcripts are confidential except in circumstances where their release is required by law. A social security number is being requested by this state agency in accordance with IC 4-1-8-1. Disclosure is mandatory, and this record cannot be processed without it.

STATUTE AND RULES: Please view the statute and rules on our website as listed on the following link: https://www.in.gov/pla/4023.htm.