Virginia Regulatory Town Hall
Agency
Department of Health Professions
 
Board
Board of Medicine
 
chapter
Regulations Governing the Practice of Licensed Midwives [18 VAC 85 ‑ 130]
Previous Comment     Next Comment     Back to List of Comments
8/13/22  1:06 pm
Commenter: Jeni Rector, CPM The Village Midwife and Birth Center

Outdated midwifery law
 

I have been a Licensed Midwife in Virginia for nearly 15 years.

I own a freestanding birth center and have served over 700 families at home or in our center.

As a CPM, I have the ability to administer medications that can prevent or help manage life and death emergencies.

The current law is forcing me to practice at less than my full capability. 

The law in Virginia does not reflect our scope of practice as defined by the North American Registry of Midwives' Job Analysis (the blueprint for the NARM Exam and the list of skills requiring verification of competency by NARM Registered Preceptors). This law is outdated and adds unnecessary risks for community birth. There is only one other state (Arkansas) that licenses midwives yet restricts them from accessing these medications. Providers should be able to work within their full scope of practice.

The March of Dimes states that 47% of Virginia counties are Maternity Care Deserts. Maternity care deserts are areas where there is limited or no access to maternity health care services. Maternal mortality in the United States is higher than in all other industrialized countries, and postpartum hemorrhage is the leading cause of maternal mortality worldwide. Postpartum hemorrhage requires quick action to prevent severe maternal morbidity and mortality. It is unconscionable to withhold access to life-saving antihemorrhagic medications for any maternity care provider, but it is especially important given the maternity care desert situation in Virginia. 

If families want injectable vitamin K or erythromycin eye ointment, they need to go to the hospital to get those within the recommended time parameters. This creates unnecessary strain on already struggling hospital systems. It is unnecessary to burden hospitals with the responsibility of providing basic medications that could safely be administered outside the hospital setting. Families have to jump through unnecessary hoops to access the medications that make birth safer. Some must self-administer medications while their Licensed Midwife stands by, unable to assist them due to this outdated law. Some women have to endure the pain of being sutured without the use of a local anesthetic or choose to risk permanent damage to their bodies by not having those lacerations repaired properly.

It is time to support Virginia Licensed Midwives and the people they serve. This outdated law needs to be changed to reflect the current scope of practice of Licensed Midwives, and Virginia families deserve these life-saving medications wherever they choose to give birth.

 

 

CommentID: 127210