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New Law Creates Partnerships Between Oregon Midwives and Pharmacists
Salem, OR, September 14, 2001 -- Implementation work has begun on a state law that creates a new working relationship between the state´s pharmacists and licensed midwives.
Senate Bill 730 passed the 2001 Oregon Legislature and received Governor John Kitzhaber´s signature on June 19. An emergency clause of the legislation made the bill effective on July 1st of this year.
The Senate Bill allows for licensed direct entry midwives to use ´legend´ drugs and devices to assist with childbirth. Drugs approved for limited uses include neonatal ophthalmic medications, vitamin K, postpartum antihemorrhagics, Rho(D) immune globulin, epinephrine, intravenous fluids, local anesthetics and oxygen.
Prior to the passage of SB 730, the Public Health Officer with the Department of Human Services had a legal mandate to assist licensed midwives to gain access to these medications and devices if the midwife encountered a barrier. Missing from the equation was the authority for the Public Health Officer to directly provide the medication or force a local health care provider to provide assistance. Senate Bill 730 was introduced by Senator Bill Fisher (R-Roseburg) at the request of the Oregon Midwifery Council, and supported by the state´s Board of Direct Entry Midwives.
"This a landmark bill for Oregon´s midwives," says Susan K. Wilson, Director of the Oregon Health Licensing Agency, the state regulatory agency that licenses midwives. "Access to these medications is important for midwives because they are necessary to provide an appropriate level of healthcare to pregnant and postpartum women. Prior to the passage of SB 730, licensed direct entry midwives had to rely on the supportive relationship with a health care professional who had prescription privileges to have access to these drugs and devices."
Members of the medical community met with licensed midwives on July 30th to begin the task of drafting new Administrative Rules. Representatives from the state Board of Pharmacy and the Oregon Medical Association (OMA) met with licensed midwives and Oregon Health Licensing Agency staff.
The process is moving ahead with cautious interest from the Oregon Medical Association. "Pediatricians in Oregon recognize that home deliveries are occurring, " says Dr. James Lace, Salem pediatrician and member of the OMA Governmental Affairs committee. "We would prefer that babies are delivered in the controlled setting of a hospital or birthing center, but we also honor the right and choice of a mother to seek an alternative or home setting for a birth. We want to ensure that a birth outside of a hospital is safe and that the newborn and mother are receiving an optimal level of medical care."
The 1993 Legislature created a voluntary program for licensing direct entry midwives in Oregon, and created a Board of Direct Entry Midwifery to establish practice standards for licensed midwives in the state. Currently, 34 midwives are licensed.
Despite the traditional opposition relationship between licensed direct entry midwives and the urban medical community in Oregon, a closer working relationship has been created as a result of the passage of Senate Bill 730. "The process is very open and negotiable for implementing the new law," says Dr. Lace. "I am very optimistic we can work together on behalf of mothers and babies in Oregon."
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