LITTLE ROCK, Ark. (KNWA) — Licensed Lay Midwives can practice in Arkansas only if they follow certain rules and have the necessary licensing.
The Arkansas Department of Health (ADH) defines a Licensed Lay Midwife as the following:
“A person who is licensed by ADH to practice midwifery and who performs for compensation those skills relevant to the management of care of women in the antepartum, intrapartum, and postpartum periods of the maternity cycle. Also manages care of the healthy newborn for the first fourteen (14) days of life.”
Essentially, a lay midwife manages the care of an expecting mother prior to birth, during birth and during a brief period after birth.
The Department of Health lays out rules that midwives must follow in their practice. Many of the key rules are as follows:
- Lay midwives may only provide midwifery to healthy women. A pregnant woman’s health is “determined through a physical assessment and review of the woman’s health and obstetric history.” Healthy women “are at low risk for the development of medical or obstetric complications of pregnancy or childbirth and whose expected outcome is the delivery of a healthy newborn and an intact placenta.”
- Lay midwives are responsible for the care of a healthy newborn immediately after delivery and for the newborn’s first 14 days of life, unless care is transferred to either a physician or an Advanced Practiced Registered Nurse who specializes in caring for infants and children. “After fourteen days, the LLM is no longer responsible and the client should seek further care from a physician or an APRN specializing in the care of infants and children.”
- The ADH Licensed Lay Midwifery program is supervised by ADH physicians, but lay midwives are encouraged to develop a close working relationship with one or more physicians who specialize in obstetrics and pediatrics, or certified nurse midwives in obstetric practice who agree to serve as a referral/consultation source for the lay midwife.
- Lay midwife apprentices/assistants must be under the direct supervision of the midwife while working.
- A lay midwife must keep clients informed about various requirements, including tests, procedures, treatments, medications or referrals necessary for the mother and baby’s optimal health and safety.
- Lay midwives must provide continuous evaluations starting with initial consultation and throughout the provision of care. “This includes continuously assessing safety considerations and risks to the client and informing her of the same.” Lay midwives must use their judgment in assessing when the client‟s condition or health needs exceed the midwife’s knowledge, experience or comfort level. It’s the lay midwife’s right and responsibility to terminate care under these circumstances.
- Lay midwives must document any medications that are either provided by ADH or prescribed by either a physician or certified nurse midwife and “administered at the home birth site.”
- Lay midwives must comply with all Health Insurance Portability and Accountability Act (HIPAA) provisions, as well Clinical Laboratory Improvement Amendments (CLIA).
The Department of Health also has rules for lay midwife licensing. Those rules are as follows:
- Licenses are issued upon application and favorable review.
- Licenses are valid for up to three years.
- Anyone who wants to become a Licensed Lay Midwife (LLM) must have either current North American Registry of Midwives (NARM) Certified Professional Midwives certification, current certification by the American Midwifery Certification Board as a Certified Nurse Midwife or current certification considered equivalent and approved by ADH.
- LLMs who want to renew their license must have either current Certified Professional Midwife (CPM), Certified Nurse Midwife (CNM) or Certified Midwife certification unless they were licensed continuously prior to ADH rules and have never been certified as a CPM. Those LLMs may renew their license by showing documentation of continuing education.
- LLMs are responsible for making sure their credentials and certifications are current at all times.
- LLMs who receive a CPM certificate or Midwifery Bridge Certificate (MBC) must provide verification with initial application for license renewal, or within 30 days of initial certification. A notarized copy of the certificate or a verification letter sent directly from NARM must be submitted to ADH.
- If there is a lapse or revocation of any licensure or certification held, the LLM must notify ADH within 30 days of revocation.
- An applicant must submit proof of name change with an application if the name used on the application is not the same as that on any of the supporting documentation.
- If an application for licensure or renewal is denied, the applicant may appeal that denial to the Arkansas State Board of Health within 30 days of receipt of the denial.
Click here for detailed information on what licenses a lay midwife must have to provide care to expecting mothers who have certain conditions and illnesses.