There was a bill that parents lobbied for and got passed to open the midwifery rules to increase the scope of practice to include breeches, vbacs and twins to be legally attended by midwives, so far that effort was successful, or partially so. The department will allow home vbac- although limited to type of vbac, they will not allow the diagnosis of CPD or failure to progress to have a home vbac , they passed allowing twins and will allow breeches. But what else the health department did in the latest draft was require that we discontinue care of any all clients that refuse tests that are in rule including an ultrasound- not just for vbac and breech but for ALL moms- and they took away all the meds so not pit to stop hemorrhages, no Rhogam, no vitamin K... Although midwives have had these in rule since the 90s -
The punative parts of the rules will be in effect starting July this year, the vbac and breechs will be allowed to be attended by experienced CPM/LMs only starting July 2014. By 2015 they expect to have enough rich data to fine tune the rules and to publish outcomes and decide the fate of midwifery in AZ to come, stastically impossible to get anything meaningful out of 6 months expanded scope vbac and breech births when we only have 600 births total. But enough to show more transfer and hemorrhages because of no meds.
Any one of these problems should be enough to raise a rucus about and the combo is just a real big issue.