Current through Vol. 42, No. 1, September 16, 2024
(a) A Licensed or
Unlicensed Midwife shall disclose verbally and in written form to a prospective
Client at the outset of the professional relationship items 1 through 14 of
this section. This discussion must be documented by use of a disclosure form.
It must be signed and dated by the Client at the same time the Licensed or
Unlicensed Midwife and Client enter into an agreement for services. This form
must be filed in the Client's medical record. The disclosure shall include:
(1) The Midwife's name, and the license
number and expiration date if applicable;
(2) The Client's name, contact information,
and the name of the Client's primary care provider if the Client has one;
(3) A statement that the Midwife
is not an advanced practice registered nurse-midwife;
(4) Credentials of the Midwife;
(5) Documentation of compliance with
continuing education requirements if the Midwife is licensed;
(6) Disclosure of years of service as a
Midwife;
(7) A description of the
plan or protocol for transfer to a hospital;
(8) The limitations of the skills and
practices of the Midwife;
(9)
Whether the Midwife carries malpractice insurance;
(10) Emergency Plan - As part of the
disclosure form, an individual emergency plan must be established by the
Licensed Midwife and Client. The plan must include:
(A) The Client's name, address, and phone
number;
(B) The arrangements for
transport from the delivery site to a nearby hospital;
(C) The name, address and phone number of the
hospital with obstetric services that will be used for emergency transfer;
(D) The name, address, and phone
number of the hospital with obstetric services that will be used for
non-emergency transfer; and
(E) The
name and phone number of any Clinician providing backup care or co-care to the
Client;
(11) Direction on
where to find scope of practice standards of a Licensed Midwife, as provided by
rules of the Commissioner;
(12)
Notification that state law requires a Newborn to be tested for certain
heritable disorders, hearing screening and hypothyroidism, in the absence of a
signed parental waiver;
(13)
Procedures for reporting a complaint to the Department; and
(14) Any additional information or
requirement that the Department deems necessary to protect the health, safety,
or welfare of the Client.
(b) The Department will provide a template
Disclosure Statement providing this information on its website.
(c) Before the onset of labor, the midwife's
agreement can be terminated at any time that the midwife deems it necessary for
maintenance of the Client's mental and physical safety or for compliance with
these rules. When termination occurs, the reasons for termination will be given
in writing and an alternative source of care recommended; and
(d) The Client may terminate the agreement at
any time.
