What are midwives technically required to do in most states? - Page 2 - Mothering Forums

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#31 of 43 Old 09-25-2008, 06:51 PM
 
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Bumping as this relates to the UC'ers wanting to become Midwives/Doula's thread......

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#32 of 43 Old 09-25-2008, 08:26 PM
 
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Originally Posted by earthmothergypsy View Post
In MN there are no requirements. Unregulated here too.

However, most mw are way too hands on for my comfort.
Most things they do don't provide any info anyway, it is all just to cover the attendant's butt. ~smiling~ The mama knows best and if you listen to her and her dh you can know all you need to know.

I guess I am just way to layed back as a birth attendant. Imho a good midwife helps/encourages the family to educate themselves enough so they don't need her, and if she IS there then she needs to sit on her hands and let the family birth in peace. I promote UC the whole time I am with a family. They have to realize that no one may be there for the birth and that they need to be ready on their own. Most don't even think about it and just assume the attendant will be there, but it isn't true. One has to be prepared.
Actually MN does have regulations, but should you feel the need to practice as a lay midwife, you can, but you cannot promote yourself or use a great number of verbiage as your title. Fun little loophole.
http://mana.org/laws/laws_mn.htm
http://www.state.mn.us/portal/mn/jsp...ency=BMP&sp2=y
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#33 of 43 Old 09-26-2008, 12:30 PM
 
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http://www.azsos.gov/public_services...9-16.htm#pgfid

Thats AZs state laws. However most mws um interpret them differently.

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#34 of 43 Old 09-26-2008, 12:32 PM
 
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This was from a while ago, but I'll add in my two cents. I'm in Manitoba, Canada, wehre midwifery is legal and even publicly funded. Our midwives have a fairly long list of "should do..." "have to do..." BUT there's a clause at everything stating that if the midwife believes it's in the patients best interests, then she doesn't have to transfer care. ie They can't do breech- but if I were to say I refused to transfer care and I would just birth the baby myself instead- she is within her limits to say ok she'll attend me anyways. I've heard one or two of the midwives make sure their clients are very aware of these guidelines "just in case" so they know to 'make a fuss'.

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#35 of 43 Old 09-26-2008, 03:50 PM - Thread Starter
 
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Last week I went to see the play "Birth." Overall I thought it was very good! Afterwards a midwife, a doula and my friend Raquel (of consciouswoman.org) sat on the stage and answered questions. I asked the midwife (who must have known who I was because if looks could kill I wouldn't be writing this) how restrictive the homebirth (with a midwife) laws are in Colorado. I told her I seemed to remember a law stating that a woman had to be transferred to the hospital if second stage lasted longer than an hour. She said in a condescending tone that I was wrong, it could last two hours, and that the laws weren't retrictive at all.

Today I decided to check the CO laws to see who was right. Ha! Unless it's your first baby, second stage of labor (without steady progress) can only last one hour - http://www.dora.state.co.us/Midwives/Rules.pdf - page 8 (and how can they know when you're in the second stage of labor unless they've done vaginal exams - another intervention). Also, the placenta must be delivered within an hour of the birth, your water cannot be broken for more than 12 hours without labor, you cannot go more than 42 weeks, fetal heart tones must be taken every 5-10 minutes during second stage, etc. No thanks.
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#36 of 43 Old 09-26-2008, 04:14 PM
 
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The mere fact that there are laws regulating how any woman's birth progresses is restrictive - how sad that she couldn't (or wouldn't) see that simple fact.

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#37 of 43 Old 09-26-2008, 05:51 PM
 
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Originally Posted by laurashanley View Post
Last week I went to see the play "Birth." Overall I thought it was very good! Afterwards a midwife, a doula and my friend Raquel (of consciouswoman.org) sat on the stage and answered questions. I asked the midwife (who must have known who I was because if looks could kill I wouldn't be writing this) how restrictive the homebirth (with a midwife) laws are in Colorado. I told her I seemed to remember a law stating that a woman had to be transferred to the hospital if second stage lasted longer than an hour. She said in a condescending tone that I was wrong, it could last two hours, and that the laws weren't retrictive at all.

Today I decided to check the CO laws to see who was right. Ha! Unless it's your first baby, second stage of labor (without steady progress) can only last one hour - http://www.dora.state.co.us/Midwives/Rules.pdf - page 8 (and how can they know when you're in the second stage of labor unless they've done vaginal exams - another intervention). Also, the placenta must be delivered within an hour of the birth, your water cannot be broken for more than 12 hours without labor, you cannot go more than 42 weeks, fetal heart tones must be taken every 5-10 minutes during second stage, etc. No thanks.
Laura
While those are very similar to the laws in az I will tell you from fact almost no mws actually do transfer for do all those things. Do I believe there should be laws? No. But just saying just cause there aren't doesn't mean there aren't women out there finding a way around them.

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#38 of 43 Old 09-26-2008, 05:53 PM - Thread Starter
 
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Originally Posted by Full Heart View Post
http://www.azsos.gov/public_services...9-16.htm#pgfid

Thats AZs state laws. However most mws um interpret them differently.
It looks like AZ laws are fairly similar to CO - other than the placenta needing to be out in 40 minutes. Also, they define what "normal progress" means (ridiculous). I'm fine with 2g, but that's about it!

2. During labor, the condition of the mother and fetus shall be assessed upon initial contact, every half hour in active labor until completely dilated, and every 15 to 20 minutes during pushing, after the bag of water has ruptured or until the newborn is delivered. Care shall include the following:

a. Checking of vital signs every 2 to 4 hours and an initial physical assessment of the mother;

b. Assessment of fetal heart tones every 30 minutes in active first stage labor, and every 15 minutes during second stage, following rupture of the amniotic bag or with any significant change in labor patterns;

c. Periodic assessment of contractions, fetal presentation, dilation, effacement, and position by vaginal examination;

d. Determination of the progress of active labor for primiparas by determining if dilation occurs at an average of 1 cm/hr until completely dilated, and a second stage not to exceed 2 hours;

e. Determination of a normal progress of active labor for multigravidas by determining if dilation occurs at an average of 1.5 to 2 cm/hr until completely dilated, and a second stage not to exceed 1 hour;

f. Maintenance of proper fluid balance for the mother throughout labor as determined by urinary output and monitoring urine for presence of ketones, at least every 2 hours; and

g. Assisting in support and comfort measures to the mother and family.

3. After delivery of the newborn, care shall include the following:

a. Assessment of the newborn at 1 minute and 5 minutes to determine the Apgar scores;

b. Physical assessment of the newborn for any abnormalities;

c. Inspection of the mother's perineum for lacerations; and

d. Delivery of the placenta within 40 minutes during which time the midwife shall assess for signs of separation, frank or occult bleeding, examine for intactness, and determine the number of umbilical cord vessels.
Laura
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#39 of 43 Old 09-26-2008, 06:06 PM - Thread Starter
 
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Originally Posted by Full Heart View Post
While those are very similar to the laws in az I will tell you from fact almost no mws actually do transfer for do all those things. Do I believe there should be laws? No. But just saying just cause there aren't doesn't mean there aren't women out there finding a way around them.
I understand that many midwives (and certainly the good ones) find a way around the laws (and isn't this just a creative way of saying they break them?). But why should they have to? And how much do the laws interfere with a midwife's ability to TRULY assist a woman in labor? Surely somewhere in the back of her mind, she must be aware of the fact that the woman she's caring for isn't having a labor that would be approved of by the state. In many cases I'm sure it is an added stress.
Laura
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#40 of 43 Old 09-26-2008, 06:42 PM
 
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Originally Posted by laurashanley View Post
I understand that many midwives (and certainly the good ones) find a way around the laws (and isn't this just a creative way of saying they break them?). But why should they have to?
I don't think it's a creative euphemism, I think that we are simply smart enough to find the loopholes, and loopholes are legal! Just like here in MN. I assist mothers in a loophole in that I am not licensed, but I just don't call myself anything but a midwife. I'm not committing any sort of crime at all.

in answer to the second question, no, we shouldn't have to side step the law to be able to help a mother have the birth she is most comfortable with, but this is the status of our very invasive government. sad, really, that the knowledge of women to help other women is so completely undervalued.
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#41 of 43 Old 09-26-2008, 07:06 PM
 
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I don't believe midwives are regulated in my state of MS.

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#42 of 43 Old 09-26-2008, 11:31 PM
 
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Originally Posted by laurashanley View Post
I understand that many midwives (and certainly the good ones) find a way around the laws (and isn't this just a creative way of saying they break them?). But why should they have to? And how much do the laws interfere with a midwife's ability to TRULY assist a woman in labor? Surely somewhere in the back of her mind, she must be aware of the fact that the woman she's caring for isn't having a labor that would be approved of by the state. In many cases I'm sure it is an added stress.
Laura
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Originally Posted by mnearthmomma View Post
I don't think it's a creative euphemism, I think that we are simply smart enough to find the loopholes, and loopholes are legal! Just like here in MN. I assist mothers in a loophole in that I am not licensed, but I just don't call myself anything but a midwife. I'm not committing any sort of crime at all.
*sigh* And that is why I don't want to be a midwife any more. Too many 'loopholes' turn into nooses when you are less than wealthy/powerful and female.

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#43 of 43 Old 09-28-2008, 05:44 PM
 
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I'm sorry to butt in with no information....but after reading these posts, I am heartbroken. Why on earth is it any states business....why are they hunting after midwives and women who are striving to achieve their perfect birth?

Ugh...I just feel so sick reading the words "VBACs are illegal in my state"...that is so sad.
$$$$$$ for the most part. its certainly not evidence based.

Actually, you can be attended as a VBAC in my state (NH) but a CPM but ONLY if you have had ONE c/s. You cant if you have had more than one c/s (by a CPM) and CNM's cant attend ANY VBACs other than in a hospital.

this wasnt teh case 2.9 years ago when my first VBAC son was born. Hence my surprise earlier this year when i visited my MW to be told she could not attend.

Mass. right now has no requirements but they are working diligently to get legislation passed (some very well meaning ppl but still.....the MW i have now understands this is NOT going to be a good thing for MWs in Mass. They will now be required to do certain things, prohibited from attending certain women, etc. etc. etc.

I will go UC before agreeing to a predetermined set of requirements for birth. I will just not succumb to that sort of treatment. If I want to be checked, thats one thing but to be told i have to agree to that type of treatment...well, thats just not how i want birth to be.

I am not actively working against the Mass. legislative effort but i do NOT think its a good idea. Too many women are going to be FORCED into a hospital birth or UC birth...i don't think the decision to UC should be made on the basis of not being able to find a MW..it should be something that is decided based on the facts of teh pregnancy and birth. period. but thats just my humble opinion.
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