Physician Supervision Issues

Part II Non-physician primary care providers seen as a threat to Organized Medicine (OM):  In November of 2004 the AMA launched an aggressive, well-organized and well funded campaign to further restrict the legal ability of non-physician practitioners to provide primary care and be fairly compensated for these services. Non-physician practitioners who exercise critical judgments similar to physicians include […]


The following is background information on the politics of multi-disciplinary healthcare that includes the independent practice of nurse practitioners, CNMs and LMs. It is an excerpt from a much longer essay that explores why our current healthcare system: Doesn’t work for so many of us . . . answer:  because what we have now is a […]

 “Connecting up the Dots” The Conundrum of Obstetrical Supervision of California-licensed Midwives ~ A legal impossibility created and vigorously maintained by organized medicine Historical Background: From the incorporation of California as a state in 1876 until passage of the 1993 Licensed Midwifery Practice Act (LMPA), the traditional (non-medical) practice of midwifery was an independent profession. […]

Department of Consumer Affairs                                      1020 N Street, Sacramento, California 95814 The original 11-page document was defaced so pages 1 thru 4, and pages 7 thru 11 were re-typed into a WORD document. Specific details were not copied as AB 1896 was […]

Making Legislation about Mothers and Affordable Maternity Care, and not about midwives, and the doctors who refuse to provide supervision I think we are served by not focusing tightly on us, as midwives or about midwifery per se — that is, I think there is considerable advantage to not using the word “midwife” or “midwifery” as the identified focus of our legislative efforts.  For the public, midwifery is […]

The goal for the C.A.M. Care Act of 2013: * Affordable maternity care in California by making physiologically-based midwifery care in birth centers and other non-medical settings easily available to Medicaid-MediCal eligible women by licensed midwives. What does this means? Promoting legislation that: ** Includes the independent practice of licensed midwifery in the Medicaid-AIM reimbursement scheme […]

A personal invitation to 40 LMs to join me for the next 40 days in “furthering” the political action in the right direction! Dear CaLMs, I love thinking of California licensed midwives as a CaLM – calm, caring, competent, compassionate, good for California’ childbearing families. Right now the politics of licensed midwifery in California is part of […]

Excepts from my communications with employee GV Ayers of the B&P Committee of California Legislature: When it comes to the legal, legislative and political history of obstetrical supervision of midwifery, I am the idiot savant. In preparation with for a meeting in 2007 with then-Attorney General Jerry Brown on this topic, I created a document […]

link to part 4 Legislative barriers to implementing the nurse-midwifery and licensed midwifery practice acts of 1974 and 1993 In his 1999 ruling Judge Roman pointed out that ACOG-based policies and protocols referred to above would of themselves prohibit the provision of planned home birth by qualified midwifery practitioners, making it impossible for a childbearing […]

Link to part 3   New regulations needed because of ACOG’s de facto definition of “supervision” One of the reasons the proposed ‘regulatory remedy’ is necessary is because the LMPA does not itself define ‘supervision’. This was originally done to avoid inappropriate legislative entanglement (i.e. unintended consequences) and allow maximum freedom between each individual LM and her supervising MD. […]