BILL NUMBER: AB 1308 AMENDED
BILL TEXT
AMENDED IN ASSEMBLY MARCH 21, 2013
INTRODUCED BY Assembly Member Bonilla
FEBRUARY 22, 2013
An act to amend Sections 2507 and 2508 of the Business and
Professions Code, relating to professions and vocations.
LEGISLATIVE COUNSEL'S DIGEST
AB 1308, as amended, Bonilla. Midwifery.
Existing law, the Licensed Midwifery Practice Act of 1993,
provides for the licensing and regulation of midwives by the Board of
Licensing of the Medical Board of California. The license to
practice midwifery authorizes the holder, under the supervision of a
licensed physician and surgeon, as specified, to attend cases of
normal childbirth and to provide prenatal, intrapartum, and
postpartum care, including family-planning care, for the mother, and
immediate care for the newborn. Under the act, a licensed
midwife is required to make certain oral and written disclosures to
prospective clients. A violation of the act is a crime.
This bill would additionally authorize a licensed midwife to
directly obtain supplies, order testing, and receive reports that are
necessary to his or her practice of midwifery and consistent with
his or her scope of practice and would require a licensed midwife to
disclose to prospective clients the specific arrangements for
referral of complications to a physician and surgeon.
This bill would state the intent of the Legislature to enact
legislation to remove barriers to care in order to provide a more
efficient and safer delivery method for mother and infant by allowing
licensed midwives to practice in a manner originally intended in
prior legislation.
Existing law requires the board, by July 1, 2003, to adopt
regulations defining the appropriate standard of care and level of
supervision required for the practice of midwifery.
This bill would require the board, by July 1, 2015, to revise and
adopt regulations defining the appropriate standard of care and level
of supervision required for the practice of midwifery and
identifying complications necessitating referral to a physician and
surgeon.
By expanding the disclosures a licensed midwife is required to
make to prospective clients, this bill would expand the scope of a
crime thereby imposing a state-mandated local program.
The California Constitution requires the state to reimburse local
agencies and school districts for certain costs mandated by the
state. Statutory provisions establish procedures for making that
reimbursement.
This bill would provide that no reimbursement is required by this
act for a specified reason.
Vote: majority. Appropriation: no. Fiscal committee: no
yes . State-mandated local program: no
yes .
THE PEOPLE OF THE STATE OF CALIFORNIA DO ENACT AS FOLLOWS:
SECTION 1. (a) The
Legislature finds and declares the following:
(1)
( a) Licensed midwives have been authorized
to practice since 1993 under Senate Bill 350 (Chapter 1280 of the
Statutes of 1993), which was authored by Senator Killea. Additional
legislation, Senate Bill 1950 (Chapter 1085 of the Statutes of 2002),
which was authored by Senator Figueroa, was needed in 2002 to
clarify certain practice issues. While the midwifery license does not
specify or limit the practice setting in which licensed midwives may
provide care, the reality is that the majority of births delivered
by licensed midwives are planned as home births.
(2)
( b) Planned home births are safer when care
is provided as part of an integrated delivery model. For a variety
of reasons, this integration rarely occurs, and creates a barrier to
the best and safest care possible. This is due, in part, to the
attempt to fit a midwifery model of care into a medical model of
care.
(b) It is the intent of the Legislature to enact legislation that
would systematically remove unnecessary barriers to care in order to
provide a more efficient and safer delivery for mother and infant by
allowing licensed midwives to practice in a manner originally
intended in the authorizing legislation.
SEC. 2. Section 2507 of the Business
and Professions Code is amended to read:
2507. (a) The license to practice midwifery authorizes the
holder, under the supervision of a licensed physician and surgeon, to
attend cases of normal childbirth and to provide prenatal,
intrapartum, and postpartum care, including family-planning care, for
the mother, and immediate care for the newborn.
(b) As used in this article, the practice of midwifery constitutes
the furthering or undertaking by any licensed midwife, under the
supervision of a licensed physician and surgeon who has current
practice or training in obstetrics, to assist a woman in childbirth
so long as progress meets criteria accepted as normal. All
complications shall be referred to a physician and surgeon
immediately. The practice of midwifery does not include the assisting
of childbirth by any artificial, forcible, or mechanical means, nor
the performance of any version.
(c) As used in this article, "supervision" shall not be construed
to require the physical presence of the supervising physician and
surgeon.
(d) The ratio of licensed midwives to supervising physicians and
surgeons shall not be greater than four individual licensed midwives
to one individual supervising physician and surgeon.
(e) A midwife is not authorized to practice medicine and surgery
by this article.
(f) A midwife is authorized to directly obtain supplies, order
testing, and receive reports that are necessary to his or her
practice of midwifery and consistent with his or her scope of
practice.
(f)
( g) The board shall, not later than July 1,
2003, 2015, revise and adopt in
accordance with the Administrative Procedure Act (Chapter 3.5
(commencing with Section 11340) of Part 1 of Division 3 of Title 2 of
the Government Code), regulations defining the appropriate standard
of care and level of supervision required for the practice of
midwifery. midwifery and identifying
complications necessitating referral to a physician and surgeon.
SEC. 3. Section 2508 of the Business
and Professions Code is amended to read:
2508. (a) A licensed midwife shall disclose in oral and written
form to a prospective client all of the following:
(1) All of the provisions of Section 2507.
(2) If the licensed midwife does not have liability coverage for
the practice of midwifery, he or she shall disclose that fact.
(3) The specific arrangements for the referral of complications to
a physician and surgeon.
(3)
( 4) The specific arrangements for the
transfer of care during the prenatal period, hospital transfer during
the intrapartum and postpartum periods, and access to appropriate
emergency medical services for mother and baby if necessary.
(4)
( 5) The procedure for reporting complaints
to the Medical Board of California.
(b) The disclosure shall be signed by both the licensed midwife
and the client and a copy of the disclosure shall be placed in the
client's medical record.
(c) The Medical Board of California may prescribe the form for the
written disclosure statement required to be used by a licensed
midwife under this section.
SEC. 4. No reimbursement is required by this act
pursuant to Section 6 of Article XIII B of the California
Constitution because the only costs that may be incurred by a local
agency or school district will be incurred because this act creates a
new crime or infraction, eliminates a crime or infraction, or
changes the penalty for a crime or infraction, within the meaning of
Section 17556 of the Government Code, or changes the definition of a
crime within the meaning of Section 6 of Article XIII B of the
California Constitution.