CA clarifies role, scope of practice for midwives

Starting next month, California licensed midwives will have increased independence and authority in attending births. Assembly Bill 1308, which goes into effect January 1, removes the state requirement that all licensed midwives be supervised by a physician. Licensed midwives had been unable to fulfill that requirement since it went into effect 20 years ago because physicians’ malpractice insurance prohibited them from supervising midwives.

Licensed midwives will now be authorized to operate birth centers without physician supervision and will have increased access to drugs, tests, and medical devices used in their practice. AB 1308 also clarifies the scope of practice for licensed midwives, allowing them to attend cases of normal birth (no twins, only births between 37 and 42 weeks). The law requires them to provide medical records and inform physicians on the status of labor if a woman has to be transferred to the hospital. In addition, AB1308 limits physician liability, making it easier for physicians to consult with midwives. Last year, the state’s 300 licensed midwives attended about 2,300 births. California has about 500,000 births annually.