From the wall today, via Carris Sparrevohn: I am concerned and appalled at the response from some members of my profession regarding the passage of AB1308 and so must finally speak out. In the passage of this bill California midwives and the families we serve, have lost nothing and have gained an amazing and unbelievable victory. Constance Rock and Sarah Davis, as your state organization representatives, have worked tirelessly to obtain this monumental and extraordinary change for all LMs in California, bringing California in line with the rest of the country. All other states which license midwives have restrictions on scope of practice similar to what California will now have. These two women deserve your support and thanks. For 20 years licensed midwives in California have identified supervision as the single most significant barrier to providing care, that they face. They have pleaded with their membership organization to find a way to remove this unattainable requirement. In the interim LMs have continued to serve the women of this state with the constant threat of prosecution from the Medical Board of California (MBC) for not having a physician supervisor. Any midwives that have been the subject of a MBC investigation have also been charged with not having supervision, while at the same time the board has refrained from prosecuting LMs simply for not meeting that requirement. This restraint on the part of the board came as a result of huge financial cost to Allison Osborn in her 1999 trial and administrative law decision. In 2004 and 2005 when the LM Standard of Care was crafted and adopted in regulation, we all rejoiced in the clause that would allow us to continue care for women who declined medical intervention. As one of the crafters of that clause, I can say that it was adopted ONLY to allow us the ability to not abandon our clients that refused medical care. It was never intended to allow us to expand our scope of practice beyond serving women with normal pregnancies, labors and births! In the passage of AB 1308 this clause has been replaced with something different. We now will have the right, in statute, to continue with parallel care for those women who no longer fit the definition of ‘normal’. This is huge for women who need a hospital birth but who still want to have care from the midwife they know and trust. Additionally, against all odds, physician supervision has been removed from our law and we will now be independent practitioners. The removal of physician supervision opens the door for us to dialog with hospitals and physicians as recognized independent practitioners, allowing us to better serve the women and families in our care. To believe that we have lost something it to not understand what we had in the first place. We have lost nothing, save having codified in law what was before only in regulation. No other health care practitioner who is licensed by the state has the right to waive their scope of practice because their client has asked it of them. It is not reasonable to believe that licensed midwives should have rights not accorded to other health care practitioners. I would like to point out that the restrictions currently codified in law via AB 1308 will affect about 1% of the women LMs serve (based on information from the LMAR over the last 4 years). This is far better than the law affecting 100% of the women we serve! And as a sidebar to keep this in perspective, please remember that it is the task of our government to pass laws that are designed to provide some measure of safety to the public. That’s why you have to strap your child into a car seat before you drive anywhere! Now is the time for all midwives, despite our differences, to pull together and show a unified front. I challenge my midwifery colleagues to openly participate in the regulatory process over the next year or two. There remains much work to complete and if we fight amongst ourselves we will not be able to accomplish as much as if we work together for the benefit of mothers and babies! Please show your support by contributing to CAM today so the work can continue!
Posted on: Sat, 14 Sep 2013 21:40:17 +0000
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