The purpose of this consensus document is to foster communication and collaboration for future efforts in the development of U.S. midwifery legislation and regulation. The goal is to promote regulatory mechanisms that protect the public by ensuring that competent midwives provide high quality midwifery care. Midwifery is a profession that is autonomous, separate, and distinct from nursing and medicine. Only midwives can exercise the full scope of midwifery practice and provide all the competencies within this scope. This document outlines the principles of model midwifery legislation to support and regulate practice. These principles address state authority to regulate, register, and license midwives, including the establishment of education qualifications, setting standards for practice and conduct, management of complaints, and issues pertaining to liability insurance and reimbursement. Recognizing that current state laws regarding midwifery vary widely, this document is intended to serve as a guide to those engaged in the revision of existing or the development of new laws.