Midwives, particularly direct-entry midwives, specialize in the provision of maternity care to low-risk women. Previous studies have found that Licensed Midwives in Washington State provide care appropriate to low-risk women giving birth at home or in birth centers with outcomes comparable to or better than those of other providers. The development of guidelines used by Licensed Midwives to identify and care for low-risk women will be of interest to other midwives, physicians, third-party payers, and public officials concerned with the provision of high-quality, cost-effective care. Washington law recognizes Licensed Midwives as autonomous professionals whose scope of practice includes caring for women during the childbearing cycle and requires consultation with a physician only when there are deviations from normal. The law does not specify conditions that require consultation or referral. Three years of midwifery education, or the equivalent, and extensive clinical experience are required for licensure. In 1996, the state midwives association adopted “Practice Guidelines for Risk Screening and Indications for Consultation and Referral for Out-of-Hospital Birth.” The guidelines were initially developed from an exhaustive search of the evidence-based literature and then reviewed by experts in a series of consensus-building meetings with representatives from medical and nursing professional associations, educational programs, state agencies and other stakeholder groups. This presentation will describe this development process, the current guidelines and how the guidelines are used in clinical practice, as a reference in quality assurance and regulatory mechanisms, to establish consulting relationships and to negotiate contracts with public and private third-party payers. See washingtonmidwives.org
Learning Objectives: At the conclusion of the session, the participant in this session will be able to: 1. Describe the rationale and process for developing a risk-screening tool used by Licensed Midwives in Washington State. 2. List three or more conditions, based on current evidence, that require physician consultation. 3. Discuss how low-risk women and third-party payers might benefit from services provided by midwives in home and birth center practices.
Keywords: Risk Assessment, Midwifery
Presenting author's disclosure statement:
Organization/institution whose products or services will be discussed: Midwives Association of Washington State
I have a significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.
Relationship: Member of Board of Directors