A public comment period is currently underway regarding a proposed regulation [PDF] in Virginia that would require the state’s Certified Professional Midwives to:
disclose to their patients, when appropriate, options for consultation and referral to a physician and evidence-based information on health risks associated with birth of a child outside of a hospital or birthing center, as defined in subsection E of § 32.1-11.5, including but not limited to risks associated with vaginal births after a prior cesarean section, breech births, births by women experiencing high-risk pregnancies, and births involving multiple gestation.
As Brynne Potter of Mountain View Midwives explained:
The midwifery community in Virginia believes that even though this requirement is redundant to our existing statutory requirement to practice the Midwives Model of Care, which is based on informed choice, the opportunity to establish once and for all that women are choosing midwifery care and home birth of their own free and informed will, is worthy of our close attention and support. We believe that if we can engage the Board of Medicine in an unprecedented process of looking at evidence-based criteria for competent practice, we will widen the narrow band of understanding that is forming between medical and midwifery based maternity providers. In addition, we need to be vigilant during the process to make sure that any guidelines or rules established do not create unforeseen obstacles to care for women who may fall into gray areas regarding relative risk of home or hospital birth based on current standard of practice in many hospital settings. Mandated c-sections for VBAC, twins, and breech are good examples of the conundrum many midwives and their clients face when providing and making informed decisions for care.
You do not have to be in Virginia to comment; outside organizations and individuals may also weigh in. Brynne suggests that comments address the following key points:
- Give a description of who you are and what your organization does.
- Commend the VA Board of Medicine for it’s efforts to utilize evidenced-based information as a measure for competency in developing informed choice.
- Any suggestions that you may have for resources that the Board should use while developing these documents.
- Perhaps suggest that Virginia’s work may set a new standard or precedent for other states to use.
Brynne has further discussion of the law in these three posts at her blog, Midwife Monologues.
Comments will be accepted until midnight on November 25, 2009.