CCM edit: sec 1-D Client Disclosure Forms Required by the LMPA

by faithgibson on May 21, 2015

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Section I-D ~ Informed Consent for Community-Based Midwifery Care

A. The Licensed Midwifery Practice Act of 1993 and amendments passed in 2000, 2002, 2006 and 2013 collectively mandate that each licensed midwife provide specified information to clients seeking community-based midwifery care in California. These include the scope of licensed midwifery practice in California, arrangements for accessing medical services and certain additional topics {link here to a list of these additional topics} added by 2013 amendment. This providing midwifery clients with internet link to the text of the laws regulating licensed midwifery practice. {Link here to mfry statutes documents on the MBC website}

In particular, the law requires that licensed midwives identify appropriate arrangements for medical consultation and transfer of care during the prenatal period, for hospital transfer during labor, birth and immediate postpartum, and for how to obtain appropriate emergency medical services for mother and baby when necessary.

Medical arrangements must be specific to each client’s circumstance, discussed with her, documented in writing and retained in her chart.

In addition, licensed midwives are legally responsible for registering the births of all babies born under their care.

B. CLIENT DISCLOSURE FORM Required by the LMPA ~ Midwifery Scope of Practice, Medical Interface, Emergency Arrangements, Disclosure of Professional Liability Insurance Status , Reporting Unsatisfactory Care to MBC, Informed Consent for Community-Based Midwifery Care 

The Licensed Midwifery Practice Act (LMPA) requires that each licensed midwife provide information on the scope of licensed midwifery practice in California to clients seeking community-based midwifery care.

The LMPA also requires that licensed midwives identify appropriate arrangements for medical consultation and transfer of care during the prenatal period, for hospital transfer during labor, birth and immediate postpartum, and for how to obtain appropriate emergency medical services for mother and baby when necessary.

Medical arrangements must be specific to each client’s circumstance, discussed with her, documented in writing and retained in her chart.

In addition, licensed midwives are legally responsible for registering the births of all babies born under their care.


C. Sample Text of Medical Interface Document

Midwifery Scope of Practice as defined by the LMPA, Sec 2507 (updated in 2014):

(a) The license to practice midwifery authorizes the holder to attend cases of normal childbirth and to provide prenatal, intrapartum, and postpartum care, including family-planning care, for the mother, and immediate care for the newborn.

(b) As used in this article, the practice of midwifery constitutes the furthering or undertaking by any licensed midwife to assist a woman in childbirth so long as progress meets criteria accepted as normal. All complications shall be referred to a physician immediately.

(c) A midwife is not authorized to practice medicine and surgery by this article.

Specific Arrangements for Medical Care are as follows:

Licensed Midwife _____________________________________ License #_____

Client Name ___________________________________________ Date _______

(1) Medical/Obstetrical Consultation and Transfer of Care during your pregnancy:

__________________________________________________________________

(2) Hospital-based physician care during your labor, birth and the immediate postpartum:

__________________________________________________________________

(3) Emergency Care for you or your newborn baby during or after the birth: ___________________________________________________________________ 

As a consumer of healthcare services you have the right to check on the licensure status of any health care practitioner licensed in California. Physicians, Licensed Midwives and 18 allied health professions are licensed and regulated by the Medical Board of California (MBC). For information on Medical Board licentiates call 1- 916 / 263-2382 or visit their web site at www.caldocinfo.ca.gov/. You also have the right to report any complaints about care received to the MBC by calling 1- 800 / 633-2322. Instructions and a complaint form are available on-line by visiting the MBC Internet site

@ www.caldocinfo.ca.gov/.

If the above named licensed midwife does not carry professional liability (i.e. malpractice) insurance, I have been so informed of that fact. Initials ______

Client Signature _____________________________________ Date _______

Partner’s Signature  __________________________________ Date _______

Witness Signature  ___________________________________ Date_______