Today’s Mfry Council ~ surprising but wonderful news about AB 1308: supervision on chopping block

by faithgibson on August 8, 2013

in AB1308, new regs & new legislative efforts, Midwifery Council, Physician Supervision Issues

News Flash #1 ~ Tosi Marceline is newest LM member of the Midwifery Advisory Council

News Flash #2 ~ Constance Rock and Sara Davis gave their report on the most updated version of AB 1308 during today’s Midwifery Council meeting (webcast available on line!)

They had extraordiary news, but remember that AB 1308 is still a bill, not a law. Until it is has officially passed by the Legislature, and signed into law by the Governor, things could still change.

So be real happy, but don’t go too crazy — at least, not yet.

Here is the wonderful news….. Drum roll PLEASE! 

For the first time ACOG agreed to “striking supervision from the LMPA”.

However, it requires that the scope of practice for California LM be restricted to “normal birth”.

This is defined as single fetus in a vertex position between 37 and 42 wks of pregnancy. If a mfry client is determined to have a preexisting condition (including previous C-section) the mother must be evaluated by an obstetrician before returning to LM care.

The current arrangement allows concurrent prenatal care by LMs for childbearing women who have risked out for PHB. It also recognizes emergent care by an LM for a precipitous labor/birth of twins or breeches or other risked-out categories.

And yes, this creates a new set of problems that will have to be fixed at a later date.

Another provision in this amendment is language that limits the liability of physicians after transfer from licensed midwifery.

Also AB 1308 requires a regulation to be develop to create a transfer form filled out by MD or hospital employee and filed with the Medical Board of California.

Last but not least are instructions to the MBC to align the current LMAR criteria with those used by MANA and to encourage all midwives to file their stats on the LMAR and MANA both.

Watch the webcast for more details and to see the discussion. I don’t have the link right now, but i should be available in the next 24 hours.

As for the obvious issues — the lost of autonomy for childbearing women — yes, this is a real problem, one that will require a real legislative solution.

But first, we must go forward with the repeal of supervision. Then mothers and midwives and other consumer and constitutional advocates will have to get additional legislation passed that makes the brings our law back into alignment with the rights of a healthy adults to make their own health care decisions .

A healthy woman’s right to determine the manner and circumstance of her normal labor and birth is just that — a human right. Its not up to obstetricians or midwives to demand that healthy women with normal pregnancies have a highly medicalized hospital birth over their objection and fully informed decline.

Another missing piece is hospital privileges for licensed midwives, so that a mother-to-be who risks out for PHB or who simply decides she doesn’t want to give birth in an OOH setting can still have a physiologically-managed labor and birth.

So stay tune — things are just getting interesting!

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