A  Misunderstand over SB 1638 and the Standard of Care Client Refusal Provision   

There is a serious misunderstanding among LMs about the recent political and/or legislative events.

I have received emails and phone calls reporting that the Medical Board "rejected" that part of the Standard of Care that acknowledged the mother's right to decline medical care in situation with an 'identified risk factor' (such as VBAC, etc).  

This is NOT TRUE. 

LMs are mixing up the pending legislation and the already passed Standard of Care. 

The Standard of Care was approved by the Office of Administrative Law on March 9, 2006. It is an unchanged version of the consensus language approved by CCM and CAM members.  

What is true and why the mix-up

In the past few weeks, the wording of SB 1638 (by Senator Figueroa) was changed. The original wording was just a simple sentence that permitted the mother (i.e. midwifery clients) to sign an informed wavier, declining to have her pregnancy "obstetrically supervised". 

The theory was to use the mother's right of informed consent/informed refusal as a mechanism that would, in effect, permit the LM to be in compliance with the physician supervision provision of the LMPA in those circumstances in which the client had herself declined to have her pregnancy supervised by a "physician with obstetrical training and practice." 

This language was rejected by the Consumer Attorneys of California. The bill never even got to a hearing. As a result of this, SB 1638 as originally worded was gutted and replaced with language that currently creates the Midwifery Advisory Council and gathering of practice statistics by the OSPHD. 

Nothing has changed in regard to the Standard of Care.

The language which acknowledges the clients' right of informed refusal is intact and in force.  Period.  No problem.  Zip,  zelch,  nada.  End of story.

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