California College of Midwives
State Chapter ~ ACCM for Professionally-licensed California Midwives
Licensed Midwives Annual Report for 2008
Synopsis prepared by Faith Gibson, LM
Chair, Midwifery Advisory Council, MBC
November 2009
Total number of LMs -- 220 Filed LMAR 193 LMs who attend OOH birth 123
Clients booked 2008 - planned OOH births 2774
Withdrew from care non medical reasons 171
Mothers-to-be risked out b4 onset of labor 270
Number of women undelivered on 12-31-09 55
================================================================================PHB @ SOOL 2278
NSVD Completed @ OOH 1885
Includes > twins (16) breech (18) VBAC (100)
NSVD @ hospital 334 (includes antepartum transfers)
C-section hospital 189
=================================================================================
Total NSVD 2512
Total Cesarean deliveries 189
Total number of childbearing women served by LMs 2701
================================================================================NSVD rate: 92.3 %
Cesarean Section Rate: 7.7 %
Neonatal mortality rate 1.5 per 1,000
=================================================================================Total of mothers and babies cared for by LMs 5,104
Transfer total Breakdown ~ Elective Urgent
Antepartum: 270 221 49
Intrapartum: 319 286 33
Postpartum: 80 51 29
Neonatal: 55 16 39
=== === ===
724 574
150 Of the 1885 normal spontaneous births that occurred at the parents home or independent birth centers under the care of
licensed midwives, 1,805 mothers & 1,830 babies required NO medical or hospital care relative to childbirth or birth-related complicationsTop 3 reasons for transport relative to pregnancy, labor, birth, and up to six weeks after the birth for mother
(postpartum period) and baby (neonatal period):Elective AP - 221
1. Spontaneous miscarriage or therapeutic abortion: 59
2. Non-vertex lie @ term: 48
3. Client request for OB care 26
Urgent AP - 49
1. Preterm labor / PROM 33
2. Marked decrease fetal movement/abnor NST 6
3. Pregnancy-induced hypertension (PIH) 5
Elective Intrapartum 286
1. Failure-to-progress, maternal exhaust, dehydration: 188
2. Client request pain medication: 46
3. Prolonged rupture of membranes 31
Urgent Intrapartum 33
1. Non-reassuring FHTs 23
2. Clinical judgment of the midwife 4
3. Vaginal bleeding w/o s/s of placenta abnormality 2
Elective Postpartum 51
1. Repair perineal laceration beyond LMs skill level 24
2. Adherent retained placenta w/o excess bleeding 13
3. Excessive bleeding in later PP period 4
Urgent Postpartum 29
1. Adherent or retained placenta with excess bleeding 10
2. Postpartum hemorrhage 7
3. Unstable vital signs 3
Elective Neonatal 16
1. Poor transition to extra-uterine life 6
2. Congenital anomalies 4
3. Low birth weight (1) parental request (1) 2
Urgent Neonatal 39
1. Abnormal VS, poor color or tone 16
2. Cardiac or respiratory issues 7
3. Low Apgars 6
================================================================================
Total number mothers clients served by California licensed midwives: 2548
Total number of fetal demise after 20 wks: 9 (2 out of state)
Total neonatal mortality rate: 1.5 per 1,000 thur 6 wks, incl. antepartum transfers and births after hospital transfer
Neonatal mortality: total 4 congenital anomaly (1); neurological issues (1); unknown (2)
Maternal mortality: total 1 California licensed midwife providing care in a free-standing birth center on the Mexico-New Mexico boarder; high parity immigrant population w/ little or no prenatal care
Return to College of Midwives Home Page
