There are nine things that you really need to know about Senate Bill 1208, the Michigan Midwife Bill. This bill . . .
1.) Defines a "Licensed Midwife" as a registered professional nurse who is licensed as a midwife. The bill further states that anyone who does not hold a license would not be allowed to refer to, or advertise herself as a “midwife” in the state of Michigan.
2.) Ensures that every midwife in Michigan is educated, trained, and prepared according to accredited programs of study. To obtain a license in the state of MI, a midwife would need a minimum of a registered nursing degree, have attended at least 50 births with another licensed midwife in the previous 24 months, and pass the written examination approved by the Task Force.
3.) Defines a midwife's scope of practice as delivering a baby, nursing services performed in connection with delivering a baby, or providing health care related to pregnancy, labor, delivery, and postpartum care of a mother and her infant. “Licensed midwife” does not include the practice of medicine, osteopathic medicine, or surgery…meaning a midwife cannot perform functions that would require a physician’s expertise. Example: Vacuum extraction, cesarean, etc.
4.) Provides specific guidelines for transfer of care to make sure women choosing out of hospital birth remain low risk. High risk situations that would require transfer of care to a physician include:
preterm labor, preterm rupture of the membranes, abnormal fetal heart rate, breech or other malpresentation of the fetus, delivery that is excessively overdue, low or high amniotic fluid volume, a mother with heart disease/blood disease/or any other significant medical condition whereby the treatment of the condition is outside the scope of practice of a Licensed midwife, any other condition or circumstance that indicates to a reasonable medical professional that a physician should attend the birth.
5.) Ensures that midwives carry malpractice insurance, up to $100,000. Insurance is another layer of accountability. A midwife must comply with safety protocols and function within her scope of practice in order to obtain insurance. Insurance also helps pay for medical bills in instances of negligence causing injury or death.
6.) Provides oversight by a balanced Task Force. The proposed task force would consist of 2 nurse (licensed) midwives, 2 OBs, 1 pediatrician, 1 hospital administrator, and 2 citizens. This is the group that would be responsible for researching acceptable - accredited programs of study, collecting and publicly publishing data on outcomes, promulgating and overseeing rules of practice, and reporting such findings to the board of nursing.
7.) Ensures that collaborative care actually happens between midwives, obstetricians, birth centers, and hospitals by requiring them to have a contract of consultation. (Note: This is not the same as requiring an OB to sign a midwife's license in order to practice, like in North Carolina.) It simply means that midwives working outside the hospital have a written agreement with a physician or hospital, should the need for consultation arise.
8.) Requires all Michigan midwives to report their outcomes. Midwives would report outcomes to the proposed task force, who would put together an annual report that will be accessible by the public.
9.) Defines "freestanding birth centers" and ensures they employ only """"licensed midwives who have insurance and follow the above stated protocols for transfer of care and collaboration. This would eliminate the fact that anyone, anywhere in MI can open a “birth center”. This aspect of the bill would require all “birth centers” to be facilitated by midwives who provide educated, licensed, insured, accountable care.