(18) any other condition or symptom which could threaten the life of the mother or fetus, as assessed by a midwife exercising reasonable skill and knowledge. Practice guidelines are based upon the standards, values and ethics held by the midwife. (New Section adopted effective October 1, 2016, 41 TexReg 4477). In this case, the midwife must use the form Newborn Screening Agreement for Newborn Babies of Midwife Clients to attest to her responsibility for seeing that the screening is done and to designate a facility for such screening. 115.113. (c) If on any postpartum assessment one of the following conditions exists, the midwife shall recommend referral to an appropriate health care professional and document that recommendation in the midwifery record: (4) any other condition or symptom which could threaten the health of the mother, as assessed by a midwife exercising reasonable skill and knowledge. (4) one physician member who is certified by a national professional organization of physicians that certifies family practitioners or pediatricians. Methodology / Rules. Midwives (c) If on any newborn assessment in the immediate postpartum period (first six hours of life), one of the following conditions exists, the midwife shall recommend referral and document that recommendation in the midwifery record: (2) gestational age assessment less than 36 weeks; (4) larger than 97th percentile for gestational age; or. Standards for the Practice of Midwifery in Texas. (E) continued approval of the course is not in the public interest. CNMs independently manage women's health care services relating to pregnancy, childbirth, the postpartum period, family planning, and routine gynecological needs. (a) The department shall develop a jurisprudence examination. Jurisprudence Examination. (D) shall provide reasonable access for non-English speakers and comply with federal and state laws on accessibility. License Surrender. (17) Program--The department's midwifery program. • Licensed Midwife assisted births are in birth centers or homes. Certified Nurse-Midwives (CNMs) are health care providers who care for women of all ages and stages of life. 115.125. (c) The department shall review and update the examination as needed. (3) observe the newborn for a minimum of two hours after he or she is stable with no signs of distress. Texas Midwifery Board Rules, Subchapter D covers scope of practice. (2) use universal precautions for infection control. Continuing education courses attended to fulfill licensure or license renewal requirements shall be accepted when the courses: (A) satisfy the requirements of paragraph (2)(A) - (C); and. (a) Members of the advisory board serve staggered six-year terms. (7) Commission--The Texas Commission of Licensing and Regulation. (d) If on any newborn assessment in the immediate postpartum period (first six hours of life), one of the following conditions exists, the midwife shall initiate immediate transfer to an appropriate health care professional, initiate emergency care as indicated by the situation, continue care as needed, and document that action in the midwifery record: (2) non-transient pallor or central cyanosis; (4) apgar at 5 minutes less than or equal to 6; (9) major congenital anomaly not diagnosed prenatally; (16) other abnormal newborn behavior or appearance which could threaten the life of the newborn, as assessed by a midwife exercising reasonable skill and knowledge. 115.123. Informed Choice and Disclosure Statement. A midwife shall terminate care of a client only in accordance with this section unless a transfer of care results from an emergency situation. (New Section adopted effective October 1, 2016, 41 TexReg 4477). Termination of the Midwife-Client Relationship. A midwife’s scope of practice can vary widely throughout the United States, depending on the classification of midwife and the limitations mandated by each state. (2) Newborn Screening Agreement for Newborn Babies of Midwife Clients. Rules Subch. Pursuant to Senate Bill 202, regulatory authority over Midwives has been transferred to the Texas Department of Licensing and Regulation (TDLR). 115.13. midwifery. 115.119. (G) be a licensed physician in Texas actively engaged in the practice of obstetrics. Office hours. Administration of Oxygen. Today, just about 10 percent of US births are … Act--The Texas Midwifery Act, Texas Occupations Code, Chapter 203. continue to care for the client after discussing and documenting the risks in the midwifery record, which shall include informing the client that her condition may worsen and require transfer; manage the client in collaboration with an appropriate health care professional; or, terminate the midwife-client relationship; or. (4) be supervised and conducted by a course supervisor/administrator who shall: (A) be responsible for all aspects of the course; and, (B) have two years of experience in the independent practice of midwifery, nurse-midwifery or obstetrics; and, (C) have been primary care giver for at least 75 births including provision of prenatal, intrapartum, and postpartum care; and, (D) have met initial licensure requirements; or, (E) be a Certified Professional Midwife (CPM); or, (F) be American College of Nurse Midwives (ACNM) certified; or. • Certified Nurse-Midwives are regulated by the BNE. If a person or entity violates any provision of Texas Occupations Code, Chapters 51 or 203, this chapter, or any rule or order of the executive director or commission, proceedings may be instituted to impose administrative penalties, administrative sanctions, or both in accordance with the provisions of Texas Occupations Code, Chapter 51 and 203 and any associated rules. Independent practice is not defined by the place of employment, the employer-employee relationship, requirements for physician co-signature, of the method of reimbursement for services. Termination of the Midwife-Client Relationship. among providers. (c) A member of the advisory board may be removed from the advisory board pursuant to Texas Occupations Code §51.209, Advisory Boards; Removal of Advisory Board Member. The advisory board shall provide advice and recommendations to the department on technical matters relevant to the administration of this chapter, including scope of practice and health related standards of care. Austin, TX 78711, (800) 803-9202 [in state only] (3) act to resolve problems that are identified. 115.6. Scope of Nursing and Midwifery Practice Framework: definition of scope of midwifery practice. (New Section adopted effective October 1, 2016, 41 TexReg 4477). See the Texas Midwifery School website. (New Section adopted effective October 1, 2016, 41 TexReg 4477). (New Section adopted effective October 1, 2016, 41 TexReg 4477). (f) If on any newborn assessment after the immediate postpartum period, one of the following conditions exists, the midwife shall initiate immediate transfer to an appropriate health care professional and document that action in the midwifery record: (6) inability to urinate or pass meconium within 24 hours of birth; (13) any other abnormal newborn behavior or appearance which could threaten the life of the newborn, as assessed by a midwife exercising reasonable skill and knowledge. 115.25. (6) "Midwife" means a person who practices midwifery and has met the licensing requirements established by this chapter and commission rules. 115.111. There are two types of midwives who may legally practice in the state of Texas: Certified Nurse Midwives (CNM) and Licensed Midwives (LM). I will work within the scope of practice as set forth by the Texas Midwifery Board to bring you the highest standard of care in a safe and respectful manner. 115.100. A midwife who fails to apply for license renewal by March 1 of the end of a renewal period in which the midwife is currently licensed, may apply for late license renewal on or before March 1 of the following year. reimbursement for home birth services. We advocate the practice of Texas nurse-midwives in the health care system as an ideal way of achieving safe, high quality, cost effective, and satisfying care for women and children. (c) Midwives are authorized to purchase equipment and supplies listed in the American Heart Association Cardiopulmonary Resuscitation Guidelines and the American Academy of Pediatrics Neonatal Resuscitation Guidelines for the administration of oxygen. 115.117. Acrobat Reader is necessary to view .pdf files. (11) Health authority--A physician who administers state and local laws regulating public health under the Health and Safety Code, Chapter 121, Subchapter B. The ACC develops the certification exam and sets the requirements for ongoing certification. (3) any other prohibited practice as delineated by the Act, §203.401 (relating to Prohibited Practices). Nurse-Midwifery practice is founded upon the principles of continuity of care, empowerment of women, family … Bus. Newborn Screening. Abstract. (b) It is an emergency if, during labor, delivery, or six hours immediately following placental delivery, the midwife determines that transfer is necessary and the client refuses transfer. (2) The midwife may terminate care for any reason by: (A) providing a minimum of 14 days written notice, during which the midwife shall continue to provide midwifery care; (B) making an attempt to tell the client in person and in the presence of a witness of the midwife's wish to terminate care and the date that care will be terminated; (C) providing a list of alternate health care providers; and. 115.112. (2) proof of satisfactory completion of a continuing education course covering the current Texas Midwifery Basic Information and Instructors Manual, and: (A) satisfactory completion of a mandatory basic midwifery education course approved by the department and the North American Registry of Midwives (NARM) exam or any other comprehensive exam approved by the department; (B) Certified Professional Midwife (CPM) certification by NARM; or. The enforcement authority granted under Texas Occupations Code, Chapters 51 and 203 and any associated rules may be used to enforce Texas Occupations Code, Chapters 51, 203 and this chapter. Initial Application for Licensure. Monday to Friday 8:30 am to 4:30 pm (Closed statutory holidays) Due to the COVID-19 pandemic, our office is closed to walk-in traffic until further notice. 2. 115.75. (New Section adopted effective October 1, 2016, 41 TexReg 4477). Licensed Midwives may independently manage women's health care services relating to pregnancy, childbirth, and the postpartum period. Transfer of Care in an Emergency Situation. 115.7. The Certified Nurse-Midwife (CNM) is a Master's prepared advanced practice nurse who independently manages the health care of women focusing on common primary care issues, family planning, gynecologic needs, childbearing and care of newborns in a variety of settings. • In Texas, Medicaid recognizes CNMs as primary care providers for women. (b) Initial licensure after interim of more than four years. (5) include didactic curriculum instructors who: (A) have training and credentials for the course material they will teach; and. 115.122. (c) The midwife shall assist only in normal, spontaneous vaginal deliveries as allowed by the Act or this chapter. D. § 831.60(b)(9) , (c)(8). The nurse-midwife is educated and trained to provide a broad range of health care services for women and newborns. If the midwife performs the tests, then she or he must have been appropriately trained. Standards for the Practice of Midwifery in Texas. 115.1. The jurisprudence examination must have been taken no more than one year prior to the date of application. cover scope of practice. (3) If a client elects not to accept a non-emergency transfer, the midwife shall: (B) manage the client in collaboration with a physician or another licensed health care professional who has current obstetric or pediatric knowledge and who is working under the supervision and delegation of a physician. "Scope of practice" is defined as roles, functions, responsibilities and activities that a midwife is educated and competent to carry out; has beneficial outcomes for woman and baby; is accepted as contemporary midwifery practice by the profession; and meets legislative requirements, professional standards or evidence, and local or organisational policy. Definitions. Ongoing continuing education is a requirement for re-licensure every two years. All continuing education taken by midwives for the purpose of obtaining or renewing a midwifery license must be in accordance with this section. (New Section adopted effective October 1, 2016, 41 TexReg 4477). registered midwives (RM) St andards. (b) Course reciprocity. (New Section adopted effective October 1, 2016, 41 TexReg 4477; amended effective May 1, 2019, 44 TexReg 1849). Obtain Complaint Information without Consent of Client. (New Section adopted effective October 1, 2016, 41 TexReg 4477). In Texas, out-of-hospital (OOH) births are almost exclusively performed by midwives. (a) In order for an individual to legally practice midwifery in Texas, she/he must be currently licensed by the department. 115.121. (e) If on any newborn assessment after the immediate postpartum period, one of the following conditions exists, the midwife shall recommend referral to an appropriate health care professional and document that recommendation in the midwifery record: (4) any other abnormal newborn behavior or appearance which could adversely affect the infant, as assessed by a midwife exercising reasonable skill and knowledge. 115.116. Texas: Consortium of Texas Certified Nurse Midwives (CTCNM) 4000 Sunflower Lane Belton, TX 75613 gale@infohwy.com, National: American College of Nurse Midwives (ACNM) 8403 Colesville Rd, Suite 1550 Silver Spring, MD 20910 Phone 240-485-1800 Fax: 240-485-1818 www.midwife.org, Texas:Association of Texas Midwives P.O.Box 887Elmendorf, TX 78112 Phone: 432-664-8815 www.texasmidwives.com, National/International: The North American Registry of Midwives (NARM) 5257 Rosestone Dr. Lilburn, GA 30047 Phone: 1-888-842-4784 www.narm.org, "To advance the quality and accessibility of midwifery in Texas.". All fees must be made payable to the department and are nonrefundable. (E) a review of student, staff and preceptor files, to include coursework, protocols, and financial records. Be Certified by the North American Registry of Midwives (Certified Professional Midwife or C.P.M.) Texas Midwifery Board Home Page Thank you for visiting the Department of State Health Services (DSHS) webpage. 115.15. (New Section adopted effective October 1, 2016, 41 TexReg 4477; amended effective May 1, 2019, 44 TexReg 1849). (E) any other information required by the department. (a) A midwife shall consult with, refer to, collaborate with, or transfer to an appropriate healthcare provider or facility in accordance with the Act and this chapter. The Association of Texas Midwives recognizes the negative impacts of bullying and harassment upon the practice and profession of midwifery in Texas. Certified nurse-midwife (CNM) functions include: Taking a medical history, and doing a physical exam; Ordering laboratory tests and procedures; Managing therapy (Effective August 1, 2020). (3) The department staff shall review each course application submitted for approval. The Midwifery Scope of Practice. Each BCCNM designation has its own set of Standards of Practice. (b) A midwife in attendance at childbirth who is unable to apply prophylaxis as required by Section 81.091, Health and Safety Code, due to the objection of the parent, managing conservator, or guardian of the newborn child does not commit an offense under that section and is not subject to any criminal, civil, or administrative liability or any professional disciplinary action for failure to administer the prophylaxis. States that Allow CNMs to Practice and Prescribe Independently vs those that Require a Collaborative Agreement. (c) If on initial or subsequent assessment, one of the following conditions exists, the midwife shall recommend transfer in accordance and document that recommendation in the midwifery record: (1) placenta previa in the third trimester; (2) Human Immunodeficiency Virus (HIV) positive or Acquired Immunodeficiency Syndrome (AIDS); (3) cardio vascular disease, including hypertension, with the exception of varicosities; (5) history of cervical incompetence with surgical therapy; (7) Rh or other blood group isoimmunization; (8) previous uterine surgery involving incision into the uterine myometrium, other than a low transverse cesarean section; (10) documented oligo-hydramnios or poly-hydramnios; (11) any known fetal malformation requiring immediate post-natal hospital care; (12) Preterm Premature Rupture of Membranes (PPROM); (15) triplet or higher order multiple gestation; (16) active cancer or history of ovarian, breast, uterine, or cervical cancer; (17) undiagnosed vaginal bleeding lasting longer than two weeks; or. (New Section adopted effective October 1, 2016, 41 TexReg 4477). Licensed Midwives may independently manage women's health care services relating to pregnancy, childbirth, and the postpartum period. (a) In order to renew every two years, a midwife's application for license renewal must include the following: (1) a completed license renewal application form which shall require the provision of the preferred mailing address and telephone number, and a statement of all misdemeanor and felony offenses for which the licensee has been convicted, along with any other information required by the department; (2) proof of completion of at least 20 contact hours of approved midwifery education since March 1 of the previous two-year renewal period; (3) proof of a current CPR certification for health care providers from one of the following: (B) equivalent certification for the professional rescuer from the Red Cross; (C) equivalent certification for healthcare and professional rescuer from the National Safety Council; or. This means they are not required to be nurses. 115.112. Applications for late license renewal must include the following: (1) each of the items required for timely renewal; and, 115.16. (New Section adopted effective October 1, 2016, 41 TexReg 4477; amended effective May 1, 2019, 44 TexReg 1849). CNMs are licensed as registered nurses authorized to practice as a category of advanced practice nurse (APN).Approximately 350 CNMs are authorized by the BNE to practice in Texas. 115.5. (d) The midwife shall engage in a periodic process of evaluation and quality assurance. Background. (b) A retired midwife who has previously renewed under this subsection, and then subsequently seeks to return to employment in the active practice of midwifery in Texas, must either: (1) be currently licensed under this subsection but not due for renewal, and submit the following items to the department: (A) ten hours of continuing education, taken in the 12 months preceding the application; (B) the retired midwife reinstatement fee; and, (C) a written request to return his or her license to active status; or, (2) be currently licensed under this subsection and when billed for renewal, submit all the items required for renewal with a written request to return his or her license to active status; and. Midwives Advisory Board Duties. 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