ARIZONA STATE SENATE
Fifty-First Legislature, Second Regular Session
FACT SHEET FOR S.B. 1157
midwives; scope of practice
Purpose
An emergency measure that prohibits licensed midwives from accepting certain services for midwifery, including a client who has had a previous Cesarean section (C-section), is pregnant with more than one fetus, or who is pregnant with a breech fetus.
Background
Statute defines midwife as a person who delivers a baby or provides health care related to pregnancy, labor, delivery and postpartum care of the mother and her infant (A.R.S. § 36-751). According to the Department of Health Services (DHS), in Arizona there are two types of midwives who may legally assist a woman with childbirth: nurse midwives certified through the Board of Nursing and midwives licensed through DHS. Currently, there are approximately 54 midwives licensed through DHS practicing in seven Arizona counties (azdhs.gov).
Laws 2012, Chapter 93 required DHS to consider adopting rules on midwives, including: 1) reducing the regulatory burden on licensed midwives, and streamlining the regulation process; 2) reviewing the midwifery scope of practice; and 3) adopting national licensure testing standards, if available. Additionally, the 2012 law provided that on receipt of an increased scope of practice request, the DHS Director was to appoint a Midwifery Scope of Practice Advisory Committee (Committee) to assist the Director in adopting and amending the rules.
DHS received a request to increase the midwifery practice scope and the Director appointed a Committee, which held seven meetings. The Director adopted rules in 2013 that expanded the scope of practice for licensed midwives. New rules went into effect on July 1, 2013, with certain rules taking effect July, 1, 2014, including: 1) allowing a certified midwife to accept a client for vaginal birth after having had a prior C-section (VBAC) or in situations when the client’s fetus is in a complete breech or frank breech presentation; and 2) requiring a midwife, before providing services, to inform a client orally and in writing of the midwife’s experience with certain types of deliveries.
There is no anticipated fiscal impact to the state General Fund associated with this legislation.
Provisions
1. Forbids a licensed midwife from accepting midwifery for services a client whohas had a C-section:
a) is pregnant with more than one fetus; or
b) is pregnant with a fetus in a complete, frank or incomplete breech position.
2. Requires any increase in the scope of practice for licensed midwives to comply with current statute.
3. Defines complete breech, Department, Director, frank breech, incomplete breech and midwife.
4. Exempts DHS from rulemaking requirements for one year for purposes of implementing this act.
5. Makes conforming changes.
6. Becomes effective on signature of the Governor, if the emergency clause is enacted.
Prepared by Senate Research
February 7, 2014
MY/NR/tf