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III. Standards of Practice for Community-Based Midwifery
STANDARD ONE ~ The licensed midwife shall be accountable to the client, the midwifery profession and the public for safe, competent, and ethical care.
STANDARD TWO ~ The licensed midwife shall ensure that no act or omission places the client at unnecessary risk.
STANDARD THREE ~ Within realistic limits the licensed midwife shall provide continuity of care to the client throughout the childbearing experience according to the midwifery model of practice.
STANDARD FOUR ~ The licensed midwife shall respect the autonomy of the mentally competent adult woman and work in partnership with her, recognizing individual and shared responsibilities. The licensed midwife recognizes the healthy woman as the primary decision maker throughout the childbearing experience.
STANDARD FIVE ~ The licensed midwife upholds the client’s right to make informed choices about the manner and circumstance of normal pregnancy and childbirth (per SB 1479) and shall facilitate this process by providing complete, relevant, objective information in a non-authoritarian and supportive manner, while continually assessing safety considerations and the risks to the client and informing her of same.
STANDARD SIX: The licensed midwife is required by the LMPA to refer the client to a physician if at any point during pregnancy, childbirth, or postpartum care the client’s condition deviates from normal. The category of deviations differs from variation in that deviations are clinically significant conditions likely to have a detrimental affect on the health of the childbearing woman and/or unborn or newborn baby. The midwife employs clinical judgment to distinguish a ‘variation’ from a ‘deviation’ in each individual circumstance, taking into account all other relevant aspects of the situation. ^O^ fg
STANDARD SEVEN ~ The licensed midwife shall collaborate with other healthcare professionals (including other midwives) as needed. When the client’s condition or needs exceed the midwife’s scope of practice, shall consult with and refer to a physician or other appropriate healthcare provider.
STANDARD EIGHT ~ Should the pregnancy deviate from normal and primary care be transferred to a physician, the licensed midwife may, at the cient’s request, continue to counsel, support, and advise the client. ^O^ fg
STANDARD NINE ~ The licensed midwife shall maintain complete and accurate health care records.
STANDARD TEN ~ The licensed midwife shall ensure confidentiality of information except with the client’s consent, or as required to be disclosed by law, or in extraordinary circumstances where the failure to disclose will result in immediate and grave harm to the client, baby, or other immediate family members or her professional caregivers. ^O^ fg
STANDARD ELEVEN ~The licensed midwife shall make a good-faith effort to ensure that a second professional midwife or other qualified birth attendant (defined below) is present when the baby is expected to be born and for the first hour following the delivery or until mother and neonate are both stable. Qualified assistance is limited to state-licensed MDs, RNs, CNMs, LMs, EMTs, and midwifery students enrolled in a MBC-approved midwifery training program. Professional second-call assistants must be certified in neonatal resuscitation and adult CPR, and trained in the management of excessive postpartum bleeding and PPH. ^O^ fg
STANDARD TWELVE ~ The licensed midwife shall order, prescribe or administer only those prescription drugs and procedures authorized in the Licensed Midwifery Practice Act and in accordance with the client’s informed consent. ^O^ fg
STANDARD THIRTEEN ~ The licensed midwife shall order, perform, collect samples for, or interpret those screening and diagnostic tests for, a woman or newborn as identified in the Licensed Midwifery Practice Act and in accordance with the client’s informed consent. ^O^ fg
STANDARD FOURTEEN ~ The licensed midwife shall participate in the continuing education and evaluation of self, colleagues, and the maternity care system.
STANDARD FIFTEEN~ The licensed midwife is responsible for regularly and critically assessing evidence-based research in determining ‘best practices’ and developing or updating midwifery policies, guidelines, and protocols. ^O^ fg