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The Oregon Administrative Rules contain OARs filed through March 15, 2014
 
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OREGON HEALTH LICENSING AGENCY,
BOARD OF DIRECT ENTRY MIDWIFERY

 

DIVISION 15

GENERAL ADMINISTRATION

332-015-0000

Definitions

The following definitions apply as used in OAR 332-015-0000 through 332-030-0000.

(1) "Agency" means the Oregon Health Licensing Agency. The agency is responsible for the budget, personnel, performance-based outcomes, consumer protection, fee collection, mediation, complaint resolution, discipline, rulemaking and record keeping.

(2) "Antepartum" means the period of time before the onset of labor.

(3) "Board" means, pursuant to ORS 687.470, the entity that advises the agency on matters relating to the practice of direct entry midwifery, and determines practice standards, education and training, and provides consultation to the agency on all disciplinary issues in accordance with ORS 687.405 to 687.495.

(4) “Baby” means the fetus and the newborn.

(5) "Consultation" means a dialogue for the purpose of obtaining information or advice from a health care provider by phone, written notes, or in person, which may include, but is not limited to identification of and recommendation regarding management of maternal or fetal conditions.

(6) "Fetal distress" is a condition in which the fetus demonstrates progressive and irresolvable clinical signs of compromise, which may include, but are not limited to, abnormal fetal movement; loss of heart tone variability; non-reassuring fetal heart rate deceleration patterns such as late decelerations; and non-reassuring changes in fetal heart baseline rate.

(7) "Informed Consent" means the consent obtained following a thorough and easily understood explanation of the information to the mother or the mother’s guardian. Refer to OAR 332-025-0120.

(8) "Intrapartum" means the period of time from the onset of labor through the birth of the placenta.

(9) "LDM” means licensed direct entry midwife.

(10) "MANA" means the Midwives Alliance of North America.

(11) "MEAC" means the Midwifery Education and Accreditation Council.

(12) "NARM" means the North American Registry of Midwives.

(13) "Peer review" means the discussion of cases with other health care providers and students for the purpose of obtaining and providing suggestions regarding care.

(14) "Postpartum" means the period of time immediately after and up to eight weeks following the birth of the baby.

(15) "Prenatal" means the period of time from conception to the onset of labor.

(16) "Primary birth attendant" means the midwife who assumes direct responsibility for mother and baby care.

(17) "Sharps" means items that includes needles, intravenous tubing with needles attached, scalpel blades, lancets, glass tubes that could be broken during handling and syringes that have been removed from their original sterile containers.

Stat. Auth.: ORS 687.485
Stats. Implemented: ORS 183.450(7) & 687.485
Hist.: DEM 1-1993(Temp), f. & cert. ef. 12-22-93; DEM 1-1994, f. & cert. ef. 6-15-94; DEM 1-1998, f. 2-27-98, cert. ef. 3-1-98; DEM 1-1999(Temp), f. 9-1-99, cert. ef. 9-9-99 thru 2-29-00; DEM 2-1999, f. 12-17-99, cert. ef. 12-20-99; DEM 1-2002, f. 2-25-02 cert. ef. 3-1-02; DEM 1-2004, f. 6-29-04, cert. ef. 7-1-04; DEM 4-2010, f. 12-30-10, cert. ef. 1-1-11; DEM 5-2011, f. & cert. ef. 9-26-11

332-015-0030

Application Requirements

An individual applying for licensure to practice direct entry midwifery must:

(1) Meet the requirements of OAR 331 division 30.

(2) Submit a completed application form prescribed by the agency, which must contain the information listed in OAR 331-030-0000 and be accompanied by payment of the required application and license fees.

(3) Submit current certification in cardiopulmonary resuscitation for adults, neonates and infants.

(4) Submit documentation of required education in approved legend drugs and devices as provided in OAR 332-015-0070 on a form prescribed by the agency.

(5) Submit a written plan for emergency transport for mother or newborn pursuant to OAR 332-025-0020.

(6) In addition to requirements listed in subsection (1) through (5) of this rule, an applicant must provide documentation of one of the following pathways:

(a) Pathway 1 — Certified Professional Midwives (CPM) Credential:

(A) Submission of satisfactory evidence of having current CPM credential from NARM; and

(B) Pursuant to ORS 687.420, participation as an assistant at 25 deliveries, 25 deliveries for which the applicant was the primary birth attendant, participation in 100 prenatal care visits, 25 newborn examinations, and 40 postnatal examinations. The applicant must have provided continuity care for at least 10 of the primary birth attendant deliveries, including four prenatal visits, one newborn examination and one postpartum exam. Of these 50 births, at least 25 deliveries must have taken place in an out-of-hospital setting and 10 births must have occurred within the two years or 24 months preceding the date of application.

(C) If there is more than one birth attendant present at the same birth, the birth attendants must designate which birth attendant is primary.

(b) Pathway 2 — Passage of NARM Examination:

(A) Submission of satisfactory evidence of passage of the NARM examination within three years preceding the date of application, which must include official documentation of a passing score; and

(B) Pursuant to ORS 687.420, participation as an assistant at 25 deliveries, 25 deliveries for which the applicant was the primary birth attendant, participation in 100 prenatal care visits, 25 newborn examinations, and 40 postnatal examinations. The applicant must have provided continuity care for at least 10 of the primary birth attendant deliveries, including four prenatal visits, one newborn examination and one postpartum exam. Of these 50 births, at least 25 deliveries must have taken place in an out-of-hospital setting and 10 births must have occurred in the two years or 24 months preceding the date of application.

(C) If there is more than one birth attendant present at the same birth, the birth attendants must designate which birth attendant is primary.

Stat. Auth.: ORS 687.420 & 687.485
Stats. Implemented: ORS 687.420 & 687.485
Hist.: DEM 1-1994, f. & cert. ef. 6-15-94; DEM 1-1998, f. 2-27-98, cert. ef. 3-1-98; DEM 1-2002, f. 2-25-02 cert. ef. 3-1-02; DEM 1-2004, f. 6-29-04, cert. ef. 7-1-04; DEM 4-2010, f. 12-30-10, cert. ef. 1-1-11

332-015-0040

Education

Applicant’s education must incorporate the general educational requirements listed in the NARM CPM candidate information bulletin, including:

(1) Core competencies developed by MANA;

(2) NARM written test specifications;

(3) NARM skills assessment test specifications;

(4) NARM written examination primary reference list; and

(5) NARM skills assessment reference list.

Stat. Auth.: ORS 183, 687.420, 687.480 & 687.485
Stats. Implemented: ORS 183, 687.420, 687.480 & 687.485
Hist.: DEM 1-1994, f. & cert. ef. 6-15-94; DEM 1-1998, f. 2-27-98, cert. ef. 3-1-98; DEM 2-1998, f. 4-14-98, cert. ef. 4-15-98; DEM 1-2002, f. 2-25-02 cert. ef. 3-1-02; DEM 1-2004, f. 6-29-04, cert. ef. 7-1-04; DEM 4-2010, f. 12-30-10, cert. ef. 1-1-11

332-015-0050

NARM Midwifery Examination

The qualifying examination is the NARM examination. An applicant is responsible for payment of all fees for NARM applications, examinations, and any other fees paid directly to NARM.

Stat. Auth.: ORS 676.615, 687.480 & 687.485
Stats. Implemented: ORS 676.615, 687.480 & 687.485
Hist.: DEM 1-1994, f. & cert. ef. 6-15-94; DEM 1-1998, f. 2-27-98, cert. ef. 3-1-98; DEM 1-2004, f. 6-29-04, cert. ef. 7-1-04; DEM 4-2010, f. 12-30-10, cert. ef. 1-1-11

332-015-0070

Approved Legend Drugs and Devices Prescribed Education

(1) To be granted a license, an applicant must successfully complete the Initial Legend Drugs and Devices Program consisting of 40 clock hours of instruction in the approved curriculum. Each component of the initial program must be completed within the two years or 24 months immediately preceding the date of application. The initial program must be taught by a MEAC accredited or pre-accredited school, the Oregon Midwifery Council, or by an organization authorized by the Board. The program is composed of theory, hands-on practice, and skills testing for competency.

(2) The initial program consists of:

(a) Eight clock hours in Pharmacology covering drugs listed in OAR 332-026-0010 and 332-026-0020;

(A) Mechanism of Pharmacological Action;

(B) Indications;

(C) Therapeutic Effects;

(D) Side Effects/Adverse Reactions;

(E) Contraindications;

(F) Incompatibilities/Drug Interactions; and

(G) Drug administration including:

(i) Dosage;

(ii) Dosage Form and Packaging;

(iii) Routes of Administration;

(iv) Onset of Action;

(v) Peak Effect; and

(vi) Duration of Action.

(b) Four clock hours of administration of medications through injection, which includes:

(A) Universal precautions including the use and disposal of sharps;

(B) Equipment including:

(i) Needles;

(ii) Filter Needles (for use with glass ampules);

(iii) Syringes;

(iv) Skin surface disinfectants; and

(v) Medication containers (ampules, multi- and single-use vials).

(C) Appropriate injection sites;

(D) Procedures for drawing up and administering drugs;

(E) Special case: Administration of Medications Intravenously; and

(F) Care of equipment.

(c) Four clock hours in advanced treatment of shock, which includes:

(A) Theory of shock; and

(B) Treatment of shock.

(d) Ten clock hours in intravenous therapy, which includes:

(A) Intravenous fluid therapy;

(B) Purpose of IV fluid therapy;

(C) Equipment;

(D) Appropriate sites;

(E) Procedure;

(F) Rate of administration; and

(G) Care of equipment.

(e) Four clock hours in neonatal resuscitation, which includes:

(A) Basic life support techniques;

(B) Cardio-Pulmonary Resuscitation (CPR);

(C) Use of oxygen; and

(D) Positive pressure ventilation (bag, valve, mask).

(f) 10 clock hours in suturing which includes:

(A) Explanation of the pelvic floor and genital anatomy;

(B) Assessing the degree of damage for repair;

(C) Use of local anesthetic;

(D) Equipment including:

(i) Sutures;

(ii) Needles; and

(iii) Instruments.

(E) Use of needle holder and working with curved needle;

(F) Knot tying (instrument knot);

(G) Basic stitching techniques including:

(i) Interrupted;

(ii) Basting;

(iii) Lock Blanket; and

(iv) Running mattress.

(H) Repairing a simple first-degree tear; and

(I) Repairing a second-degree tear; and

(3) A copy of Board-approved curriculum objectives will be retained on file at the agency and made available upon receipt of a written request and payment of an administrative fee for acquiring public records. Refer to OAR 331-010-0030.

Stat. Auth.: ORS 676.615, ORS 687.485 & 687.493
Stats. Implemented: ORS 676.615, ORS 687.485 & 687.493
Hist.: DEM 1-2001(Temp), f. & cert. ef. 10-1-01 thru 3-29-02; DEM 1-2002, f. 2-25-02 cert. ef. 3-1-02; DEM 1-2004, f. 6-29-04, cert. ef. 7-1-04; DEM 2-2008(Temp), f. 9-15-08 cert ef. 10-1-08 thru 3-30-09; DEM 1-2009, f. 3-31-09, cert. ef. 4-1-09; DEM 4-2010, f. 12-30-10, cert. ef. 1-1-11; DEM 1-2011(Temp), f. & cert. ef. 4-4-11 thru 9-27-11; DEM 5-2011, f. & cert. ef. 9-26-11

332-015-0080

License Display and Posting Requirements

(1) A licensee must show proof of valid license with the agency upon request or post the license document in public view at the licensees primary workplace.

(2) A licensee may temporarily conceal the address printed on the license document with a covering that is removable.

(3) A licensee must carry the license identification card (pocket card), or post in plain view, the official license anytime services are being provided.

Stat. Auth.: ORS 687.485 & 687.615
Stats. Implemented: ORS 687.425, 687.485, 676.606 & 676.607
Hist.: DEM 4-2010, f. 12-30-10, cert. ef. 1-1-11

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