Representative Jackie Biskupski
proposes the following amendments:
1. Page
6, Lines 176 through 178
:
176
(7) "Practice of Direct-entry midwifery" means practice
of providing the necessary supervision,
care, and advice to a client during essentially normal pregnancy, labor, delivery, postpartum, and
newborn periods
that is
{
in accordance
}
consistent
with
177
national professional midwifery standards and that is based upon the acquisition of clinical
178
skills necessary for the care of pregnant women and newborns, including antepartum,
2. Page
7, Lines 186 through 201
:
186
(f) obtaining medications, as specified in this Subsection (7)(f)
{
or by rule
}
, to administer
187
to clients, including:
188
(i) prescription vitamins;
189
(ii) Rho D immunolglobulin;
190
{
(iii) CDC- or ACOG-recommended agents for Group B strep prophylaxis
}
;
191
{
(iv)
}
(iii)
sterile water;
192
{
(v) IV fluids, excluding blood products;
}
(iv) one dose of intramuscular oxytocin after the
delivery of the placenta to minimize blood loss;
193
{
(vi) anti-hemorrhagic medications;
}
(v) one dose of intramuscular oxytocin if a
hemorrhage occurs, in which case the licensed Direct-entry midwife must either consult immediately
with a physician licensed under Title 58, Chapter 67, Utah Medical Practice Act, or Title 58, Chapter 68,
Utah Osteopathic Medical Practice Act, and initiate transfer, if requested, or if the client's condition
does not immediately improve, initiate transfer and notify the local hospital;
194
{
(vii)
}
(vi)
oxygen;
195
{
(viii)
}
(vii)
local anesthetics
without epinephrine used in accordance with Subsection
(7)(l);
;
196
{
(ix)
}
(viii)
vitamin K to prevent hemorrhagic disease of the newborn;
197
{
(x)
}
(ix)
eye prophylaxis to prevent opthalmia neonatorum as required by law; and
198
{
(xi) other medications that are not controlled substances as defined in Section
58-37-2
}
(x)
any other medication approved by a licensed health care provider with authority to prescribe that
medication;
199
{
and which are approved by the division in collaboration with the Licensed Direct-entry
}
{
200
Midwife Formulary Committee }
201
(g) obtaining food, food extracts, dietary supplements, as defined by the Federal Food, 3. Page
8, Lines 214 through 219
:
214
(l) managing the postpartum period including
{
:
}
215
{
(i)
}
suturing of episiotomy or first and second degree natural perineal and labial
216
lacerations, including the administration of a local anesthetic;
{
and
}
217
{
(ii) managing hemorrhage, including the administration of anti-hemorrhagic
}
218
{
medications or IV fluids;
}
219
(m) managing the newborn period including:
4. Page
14, Lines 400 through 403
:
400
(D) a promise to provide the client, upon request, separate documents describing the
401
rules governing licensed Direct-entry midwifery practice, including a list of conditions
402
indicating the need for consultation, collaboration, referral, transfer or
{
emergency
}
mandatory
transfer, and
403
the licensed Direct-entry midwife's personal written practice guidelines;
5. Page
14, Lines 412 through 414
:
412
(2) A licensed Direct-entry midwife shall appropriately recommend and facilitate
413
consultation with, collaboration with, referral to, or transfer or
{
emergency
}
mandatory
transfer of
care to a
414
licensed health care professional when the circumstances require that action in accordance with
6. Page
14, Lines 422 through 424
:
422
(4) If after a client has been informed that she has or may have a condition indicating
423
the need for
{
emergency
}
mandatory
transfer, the licensed Direct-entry midwife shall
, in
accordance with procedures established by division rule, terminate the care or
initiate transfer by:
424
(a) calling 911 and reporting the need for immediate transfer;
7. Page
14, Lines 427 through 428
:
427
physician's orders.
(5) For the period from 2006 through 2011, a licensed Direct-entry midwife must submit outcome
data to the Midwives's Alliance of North America's Division of Research on the form and in the manner
prescribed by rule.
428
{
(5)
}
(6)
This chapter does not mandate health insurance coverage for midwifery services.
8. Page
15, Lines 444 through 446
:
444
(d) The issuing of an order for a Direct-entry midwife's client does not constitute a
445
delegation of duties from the other provider to the Direct-entry midwife.
(4) A licensed health care provider may not be held civilly liable for rendering emergency medical
services that arise from prohibited conduct in Section 57-77-603, or from care rendered under a waiver
as specififed in Subsection 58-77-601(3)(b), unless the emergency medical services constitute gross
negligence or reckless disregard for the client.
(5) A licensed Direct-entry midwife shall be solely responsible for the use of medications under
this chapter.
446
Section 18.
Section
58-77-603
is enacted to read:
9. Page
15, Lines 449 through 455
:
449
(1) administer a prescription drug to a client
{
,
} {
other than those specified in
Subsections
}
in a manner that violates this chapter;
450
{
58-77-102
(7) and
58-77-602
(3)(a);
}
451
(2) effect any type of surgical delivery except for the cutting of an emergency
452
episiotomy;
453
(3) administer any type of epidural, spinal, or caudal anesthetic, or any type of narcotic
454
analgesia;
{
or
}
(4) use forceps or a vacuum extractor;
(5) manually remove the placenta, except in an emergency that presents an immediate threat to
the life of the client; or