Information on Medical Board of California Topics 1998 - 2005 

Documentation on Physician Supervision   

California College of Midwives 

Ron Joseph, Former Exec Dir. MBC

Seven Point Request for Medical board Assistance   
On-Line Version of report Members, MBC

  eOb.Gyn.News articles acknowledging
short and long term complications of Cesarean Section

Elective C-Section Revisited --
Guest Editorial
Placenta Previa, C-Section History Up Accreta Risk -- Risk is at least 25%
Cesarean Rate Portends Rise in Placenta Accreta --
Maternal mortality is 7%
Cesarean Birth Associated With Adult Asthma -- Three times greater risk

Snyopsis of 1994 Report for MBC Mfry Implementation Committee 
~ How to protect physicians from vicarious liability (CNM legal source)

History and Background of the Licensed Midwifery Practice Act


  California College of Midwives
  Clinical Characteristics of Competency 

   Canadian Medical Association article:
Outcomes of planned home birth versus planned hospital births 
after regulation of midwifery in British Columbia

12 Fact Sheets on Safety of Midwifery Model of Care

American Medical Literature on the Safety of Home Birth
27 abstracts from professional, peer-reviewed US sources

American Public Health Assoc. Recommends Improved Access 
to home-based midwifery care and North American Registry of Midwives' national credential (CPM) for direct-entry midwives

Judge Roman's Ruling // Alison Osborn Case // Aug 1999

Dr. Neal D. Kohatsu, MD, MPH Medical Director, MBC April 12, 2001  RE: April 6, 2001 Meeting with Midwives >>>  Physician Supervision 

Historical and Contemporary Documentation 
on background circumstances of physician supervision of LMs, 
referred to during Public Commentary, General Meeting Feb 2, 2002   

1.  Sample Documentation on Physician Supervision Controversy ~ 

Legislative Memorandum, Office of Governor Earl Warren, 1949 repeal of mfry application for state certification -- notes that midwives, unlike nurses "operates independently and not under the supervision of a physician";
(b) 1977 Letter from Chief of OB-GYN, Stanford University Hospital, vitriolic opposition to midwifery licensing bill; (c) Letters from MBC to Faith Gibson 
(d) Discussion Paper, MBC Phy Supervision from 1994 Mfry Implementation Committee Meetings (CNM legal source)
  resources for RT case                                                                           

e) Transcript Judge Colonge, Lobbyist for 3 doctor-owed California  malpractice carriers, former lobbyist for CMA 

(f) 1997 MBC "Action Report" quarterly newsletter to all 100,000+ California doctors, requesting all  those interested in providing physician supervision to contact MBC
(there were no responses); 

2. Sample letters from physicians, why they are unable to have supervisory relationship under provisions LMPA 

(a) Letter from Marsden Wagner, MD, MSPH
(b) letter from obstetrician Don Creevy Re: AB1418, supporting midwives and collaborative relationship between LMs and obstetricians; 

Midwives writing to obstetricians asking for their participation as supervisors and several their negative responses from those physicians: 1. Sue Tinseth; 2. North County Coastal Midwives letter and replies 3. Certified Letter receipts from Midwives writing to obstetricians asking for their participation as supervisors 

3.  Senate Office of Research 13-page report on the Survey of California LMs

4.  ObGynNews 9/15/93 article acknowledging ACOG insisted on phy supervision; 
ACOG policy statements on Home birth and Abortion, CAOG letter 1980
CAOG letter & List of accomplishments
, March 2000 
CAOG letter & Doctor's Opinion on LMs
, May 2000

MBC Status Report on Health Policy 1993 "allied health care professional has not done really done anything to benefit patients ...due to the way they are used....they. really only serve to increase income of physicians", 

5.  Client letters documenting refusal of prenatal care because they were seeing a midwife and/or planning a home birth

6.  Letter from Norcal Insurance Company May 1999 stating that doctors
cannot supervise, consult with or back-up any midwife for home birth

7.  World-wide CS and Infant mortality rates compared -- US one of highest CS rate without lowing infant mortality; Synoptic articles from ObGynNews on the short and long-term complications of Cesarean surgery, including abnormal placentation such as previa, accreta and percreta ~  ElectiveC-Section Revisited - Aug 1, 2001; Placenta Previa, Hx C-Section up Risks Accreta Risk, Sept 15, 2001;
Cesarean Rate Portends Rise in Placenta Accreta, Mar 1, 2001; Cesarean Birth Associated with Adult Asthma, Jun 15, 2001

8.  SB 1479 Intent Section,  
UCSF Home Birth Consent Concurrent care and/or hosp. transfer

Synopsis of 1999 Osborn Decision on Phys Supervision
Specific Arrangement for Access to Medical Care for Clients
of California LMs; 

Letters to midwives from physicians or institution documenting successful methods
for appropriate interface between clients of midwives and medical careproviders 
1. North County Clinic;  
2. Loma Linda Univ Hosp  
3. From Karen Baker, LM; 
4.  San Francisco Gen Hosp;
5. Working arrangement between OB group and Six San Deigo LMs & CNMs

General Meeting February 2002

Medical Board of California

Members, MBC,  Assemblyman Firebaugh

Information for Medical Board Members

 and Agency Staff, following the recent quarterly Board Meeting

May 2000 Newport Beach Quarterly Meeting 

Testimony Submitted to Sunset Review Committee

Assembly Member Firebaugh

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