New Law Gives Midwives More Autonomy, but Limitations Remain

A new state law (AB 1308) gives midwives more autonomy and lifts the requirement that a doctor be present during childbirth, KQED's "The California Report" reports. The law took effect Jan. 1 (Dembosky, "The California Report," KQED, 1/10).

Details of Increased Autonomy

The law removes the requirement that licensed midwives must practice under a physician's supervision. The provision had been in place since 1999 but was not enforced by the state Medical Board because of an administrative judge ruling (Norberg, "Capitol Desk," California Healthline, 10/11/13).

According to "The California Report," the supervision requirement was mostly designed to protect doctors from being sued if complications arose during childbirth.

Shannon Smith-Crowley, a lobbyist for the California Association of Obstetricians and Gynecologists, said, "If a physician is 1% responsible, but a midwife has no liability insurance, the physician can be on the hook for all the economic damage."

In addition to lifting the supervision requirement, the new law allows licensed midwives to:

• Order ultrasounds, prescription drugs and lab tests; and
• Accept Medi-Cal coverage, which supporters say is an important step in giving low-income women a choice in the kind of childbirth care they receive.

Limitations Remain

However, the law specifies that licensed midwives:

• Are prohibited from offering their services to women pregnant with twins or those with breech babies; and
• Must send a woman to a doctor if there are any abnormalities with the pregnancy.