historical Info – Origin of the LMPA as 2004 request to Sen Figueroa via Vince Marchand

by faithgibson on November 22, 2004

in Practice Issues - Safety & Cost

Copy of my 2004 email to Vince Marchand, consultant for the Senate Business and Professions Committee and sharing office space with Senator Figueroa’s staff

Suggests for SB 1638 ~ 2006 amendment the 1993 LMPA

11/22/2004

Dear Vince,
Called the MBC to talk to Linda Whitney today but haven’t heard back from her yet.

Here is the reporting policy from the California College of Midwives guidelines (top half). The 2nd half is my own statistical report for last year, using the CCM reporting criteria as an example.

The summary that I included is its just FYI and not currently a part of the CCM requirements

I am recommending that the CCM form be used as the basis for legislation for reporting requirements. If you have additional questions, just give me a ring.


California College of Midwives Bi-annual Reporting Requirements

Each California Licensed Midwife providing primary midwifery care in homes, hospitals or birth centers shall document client-related data for each calendar year and shall submit this biennially with each renewal of licensure.

Client data shall not be name identified.

A. This information, in simple form, shall include:

1. Name and license number of the Midwife
2. Fiscal year being reported
3. The total number of clients served:

a) as primary caregiver
b) supportive or complimentary services

4. The number and location of live births attended by the midwife as primary caregiver

5. The number and location of stillbirths attended by the midwife as primary caregiver

6. The number of women transferred to a physician’s care during the antepartum period, the week of pregnancy and reason for referral

7. The number and reason for elective hospital transfers

8. The number & reason for any urgent/emergency transports via 911 & paramedics 9. A description of any complications resulting in mortality or significant morbidity for mother and/or infant **

**Morbidity & mortality defined:

1. Mortality – Died within 28 days of the birth
2. Immediate Morbidity – Required emergency surgery &/or admission to the intensive care unit
3. Long-term Morbidity – Known to have suffered permanent disability or otherwise to require on-going medical care or to reside in a nursing home

Sample of CCM’s Licensed Midwife Report

1) Faith Gibson, LM# 041

2) 2003

3) Total number of clients served:
a) as primary caregiver — 20
b) supportive or complimentary services – 4

4) The number and location of live births attended by the midwife as primary caregiver:
13 / all vag del @ home
5) The number and location of stillbirths attended by the midwife as primary caregiver
none

6) The number of women transferred to a physician’s care during the antepartum period, the week of pregnancy such transfer occurred, and reason for referral

1 — moved to Germany at 26 wks;
1 — preterm labor @ 36 wks, vag del @ hosp;
1 — elective Cesarean Section @ 40 wks, fear baby was too big (actual wt. of baby 7# 11ozs);
1 — 42 wks induction @ Kaiser , vag del @ hosp, baby 10# 7 ozs

7) The number and reason for elective hospital transfers:
total 4:

1 for prolonged rupture of membranes, induction of labor in hosp
3 for lack of progress, maternal desire for epidural

Birth Outcomes:
2 vag del @ hosp
2 cesareans

8) Number of urgent/emergency transports

1 newborn with frank blood in stool immediate (<30 mins) after birth
baby evaluated & tested positive for maternal blood, no medical treatment needed,
released after evaluation completed

9) Description of any complications resulting in mortality or significant morbidity for mother and/or infant

      none

Summary:

Total clients served in 2003 by LM #041 – 24

Total complimentary care for planned hospital births – 4 — all vaginal deliveries

Total planned home birth with midwife (PHB) –  20

Total pre-labor hosp. transfer-of-care                      4 — 3 vaginal delivery & 1 CS 

Total PHB that started labor at home                     17

Total planned home birth / completed @ home   13 

Total hosp. transfer after onset of labor                     3 — 2 vaginal births; 1 CS  

Biggest baby    ~ 10# 7 ozs; — normal vaginal birth
Smallest baby  ~ 6#4 ozs

Total normal vaginal births   22

Total cesarean sections          2 — 1 prenatal & 1 intrapartum

C-section rate for mother who began labor at home — 4 1/2%


{future} Link to legislative text of SB 1638 – 2006, Senator Figueroa 

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