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MidWives Under fire

If you are following along on social media, you know Assembly Woman Bonilla had a victory in Sacramento this week.

Assemblywoman Susan A. Bonilla

Assembly Woman Bonilla made two changes to the bill AB1308:

  1. She removed language in AB1308 that restated and outlined a plan for implementing California’s famously ill-conceived and unobtainable requirement of physician supervision of licensed midwives.
  2. She verbally committed to amending the existing law to take physician supervision completely off the books.

What is next?

Now the bill needs to make its way through the legislative process, including the Senate Floor, Assembly floor and to the Governors Office.

Why Are these change critical?

With the exception of California, Louisiana, and Arkansas, the laws governing the relationship between licensed midwives and physicians in the rest of the nation conform to the Standards of Practice of the National Association of Certified Professional Midwives, which are based on the following principles:

  • Licensed midwives are trained to work as autonomous providers.
  • Licensed midwives recognize that optimal care of women and babies during pregnancy, birth, and postpartum takes place within a network of consulting relationships with physicians and other providers who can provide care outside the scope of midwifery practice when needed.
  • Licensed midwives are trained to recognize abnormal or emergent conditions needing expert help outside their scope.
  • Licensed midwives have a plan for consultation and referral when such conditions arise.

What are the issues?

  • Physician supervision of licensed midwives is unworkable and unenforceable in practice, imposing liability burdens and other disincentives for physicians to enter into formal or contractual agreements with licensed midwives.
  • Because this unenforceable and unworkable provision in California law remains on the books, licensed midwives are unable to care for Medi-Cal recipients, creating discriminatory barriers to access and costing the state millions of dollars in unrealized savings each year.
  • Licensed midwives already consult with physicians as needed. Physician supervision requirements are therefore unnecessary and burdensome.
  • Imposing a supervisory relationship between a licensed midwife and a physician interferes with the midwife-client relationship for women who specifically choose alternatives to physician-led care.

References:

The bill and amendments: http://leginfo.legislature.ca.gov/faces/billHistoryClient.xhtml

CFAM: http://www.cafamiliesformidwives.org/#!legislation-developments/c1uvy

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