CURRENT POLICY
Since the Code of Alabama 1975 was implemented, the laws concerning midwifery have held true. In Alabama only certified nurse midwives are allowed to practice under the supervision of a physician in a hospital setting. Midwives are allowed to be licensed in the state of Alabama but cannot practice. Most midwives have licensure in the state but travel out of state with their clients to avoid prosecution. In the past decade many bills have been proposed in changing the policy regarding midwives but all have been shut down.
Current law, regulations, rules, funding sources or organizational policies
In the mid 1970s the state of Alabama sought to end the practice of midwifery by allowing the permits to expire and not renewing them or issuing any additional permits. It was at this time that the state of Alabama wrote and enacted the Code of Alabama 1975. In this code Alabama set strict rules and regulations on midwifery. In section 34-19-3 the code of Alabama states that it is illegal for anyone other than a licensed nurse practitioner to practice nurse midwifery in the state. The code goes further into describing the role of lay midwives, “(b) Nothing in subsection (a) of this section shall be construed as to prevent lay midwives holding valid health department permits from engaging in the practice of lay midwifery as heretofore provided until such time as the permit may be revoked by the county board of health”; unfortunately, the state stopped issuing permits to lay midwives (Code of Alabama 1975).
Regarding the rules and regulations set by the Code of Alabama 1975, a nurse midwife many only practice under the supervision of a qualified physician, if any abnormalities are discovered the nurse midwife must noti...
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...en’s Health, 59(1), 17-27.
Ellis, Hannah (2014). Press Release: Consumers and Lawmakers Support Home Birth Safety Act. Alabama Birth Coalition. Retrieved March 16, 2014 from http://www.alabamabirthcoalition.org/blog/.
Johnson, K. C., & Daviss, B. A. (2005). Outcomes of planned home births with certified professional midwives: large prospective study in North America. Bmj, 330(7505), 1416.
Vollers, Anna C. (17 January, 2014). Two north Alabama lawmakers partner with midwife advocates to sponsor controversial new decriminalization bill. AL.com. Retrieved March 16, 2014 from http://blog.al.com/wire/2014/01/two_north_alabama_lawmakers_pa.html.
Webb, Katherine. (12 March, 2014) Midwives for Alabama Mothers? Why the Practice is Illegal and Who Wants to Change That. Weld. Retrieved March 16, 2014 from http://weldbham.com/blog/2014/03/12/midwives-for-alabama-mothers/.
Contrary to having doctors deliver babies today, midwives were called upon to deliver babies during the eighteenth century. There were many more midwives than there were doctors during that time. In addition, Martha served as a midwife, nurse, physician, mortician, pharmacist, and attentive wife simultaneously (40). Aside from being able to deliver babies, midwives were also highly experienced in medical care—they tended to wounds, diagnosed illnesses, and made medicine. Midwives were more accessible and abundant when compared to doctors—they did not require any formal training or education. When the medical field was underdeveloped, the midwives were the leading resource when it was related to medical conflicts.
Access to quality healthcare is a growing concern in the United States especially in light of healthcare reform coverage expansions made possible by the Patient Protection and Affordable Care Act of 2010. It is estimated that 94% of all Americans will acquire healthcare coverage under the law, an increase of nearly 30 million people (King, 2011). This dramatic influx of patients into the healthcare system has projected to cause an immediate increase in added pressure on an already challenged healthcare workforce (King, 2011). Notably, at a time when healthcare demands are growing, graduate rates from medical schools remain unchanged while advanced practice registered nurse (APRN) graduate rates are rising (Cipher, Hooker, Guerra, 2006). The increased availability of APRNs, along with enhanced delivery of healthcare skills, gives the role a unique advantage in the current state of healthcare. These specialized advanced practice nurses provide services often at a patient’s first (and in some cases, primary) point of contact into the healthcare system (Brassard, 2013). Due to this, many states have started to take action to mitigate the increased healthcare system burden by enhancing the APRN’s scope of practice by broadening prescriptive authority. This has been shown to be one of the fundamental ethical avenues of increasing not only access to healthcare, but also efficiency and quality of care (Ross, 2012).
There has been a long standing turf war Between obstetricians and midwives, but this article explains for that might be coming to an end. Britian’s National Institute for Health and Care Excellence discovered that it is safer for healthy women with uncomplicated pregnancies to give birth at home with the supervision of midwives. Studies have shown that doctors are much more like to use interventions such as forceps, spinal anesthesia and cesarean section, when unnecessary and those procedure carry risks of inaction and surgical accidents. Many studies have shown that midwives provide care just as well or even better than obstetricians, when mothers are expected to deliver a single baby at full term and the babies head is presenting first in the birth canal. “The professional society for obstetricians, however, cites evidence that planned home birth carries an increased risk of neonatal death, compared with planned hospital birth.” Some medical center are trying to have the best of both worlds by allowing midwives to have more a independence within the
The Citizens of America do not realize the freedoms they have in the birthing process. Instead of knowing all the paths women can choose from in the United States most believe the only option is in the hospital. It is not common knowledge that the midwife can be the best choice for most healthy able women bearing children. This circumstance is reinforced by more than one factor. Historically, midwives have been exiled by the medical elite during the turn of the twentieth century. Another aspect that can be taken into account is that the birthing process is generational, meaning the tradition is passed down through the mother to her own daughter. These two factors play a major role in continuing the popular birthing norms of America. These reasons cause most people to lose interest when advocates of midwives try to convey their message. Through the examination of American birth models, the focus will be on the following: the historical context of the midwife up to modern day assumptions, the comparison and contrast of American practices in relation to the other countries of the world, and the financial break down and services a mother would receive in from an OB/GYN versus a midwife. These three factors will be used to fully exemplify the importance and necessity a midwife has on a birth, advocate for the knowledge of midwifery to the common public, and call for more American women to take advantage of such a powerful opportunity by educating themselves on what options they have when they become pregnant
My plans after obtaining my advanced degree is to acquire licensure to practice as AGNP in the state of Texas. The Texas BON acknowledges that APN education, experiences, and competency levels vary, hence, holds individual APN accountable for knowing and practicing within their own scope of practice and competency always. The APN’s education is the grounds to their scope of practice: however, the APN can expand the scope of practice within the role and population-focus, as long as it remains within limits of the law. The Texas BON restricts the scope of practice for the APNs. The Nurse Practitioner Supervision Laws require¬¬¬¬¬ APN to work under physician supervision within seventy five mile perimeter. In addition, there is the Texas ' Nurse Practitioner Prescribing Laws which require APNs to prescribe medications under physician supervision and APNs are not allowed to prescribe schedule two drugs. All prescriptions written by the NPs must include the supervising physician 's name, address, Drug Enforcement Administration (DEA) number and phone number (Texas BON,
In the absence of an agreement determining when life begins, state sovereignty has allowed state legislators the authority to shape a state’s policy on abortion. Thus, what has occurred across the United States is the ability for states to enact legislation which places severe limitations on when and how a pregnancy may be te...
"Letter from Two Obstetrician-Gynecologists Opposing the Partial-Birth Abortion Ban Act of 2003, March 10, 2003." Abortion: An Eternal Social and Moral Issue. Sandra M. Alters. 2008 ed. Detroit: Gale, 2008. Information Plus Reference Series. Opposing Viewpoints in Context. Web. 12 Feb. 2014.
National Council for the State Boards of Nursing, APRN background, (2012). Report of the nursing policy and legislative efforts. Retrieved from https://www.ncsbn.org/428.htm#Nurse_Practitioner_Certification
The SSSC codes of conduct contains 10 codes 5 are for employees and other 5 are for employers where as in the NMC there is 4 codes which are, prioritise people, practise effectively, preserve safety and promote professionalism. Both codes are very similar even when dealing with different patient groups both codes state in 1.1 to prioritise people and treat each person as an equal individual. These both codes of conduct should be followed correctly at all times by anyone working in the health and social care. The NMCs aim is there to protect the public and decides if a nurse or midwife is fit to practice up to their high standards. The NMC was published on the 29th January 2015 but didn’t come effective to 31st March 2015.
Both Nurse Practitioners and Nurse Practitioner-students work closely with patients to monitor their health and provide care for acute and chronic illnesses. However, in the academic-clinical setting, the NP-student may only perform this function at the discretion of the supervising NP. Although work environments and responsibilities bestowed upon these distinctive nurses can be quite different, Nurse Practitioners, Registered Nurses and students is bound to the same laws and regulations governed by all states and territories that have enacted a nurse practice act (NPA). The NPA itself is insufficient to provide the necessary guidance for the nursing profession, therefore each NPA establishes a state board of nursing (BON) that has the authority to develop administrative rules or regulations to clarify or make the governing practice law(s) more specific (NCSBN
In the world of midwifery, women in particular are the main focus of primary care. In addition, it is about being with the women, in partnership with the women and delivering women centered care. In the perspective of midwives, it is important that women view midwives as the supporters of their journey rather than midwives doing their jobs. (Carolan & Hodnett, 2007). Midwives are the primary providers of maternity care. They have the role and responsibility to deliver continual care throughout a women's naivety and ensures that the women receive optimal care and support. Over the time of pregnancy and beyond, women and midwives have the time to create trust and develop a sense of bonding with one another. Antepartum, intrapartum, and postpartum
There is always women, who aren’t licensed, that are being enrolled into nursing (D'Antonio, 2017). The first step that you need to take, is to get a high school diploma. You will need four years of english, math for 3-4 years, science 2-4 years, social studies 3-4 years, and taking 2 years worth of foreign classes are recommended (Starting Out, 2017). The next step would be to get into a nursing program. OB nurses have graduated from medical school and completed a four year that trains the nurses about pre-pregnancy health (Web MdD, 2017). In order to get into the nursing program, you have to apply to enroll in the program. Depending on the program you chose, it will take four years of schooling to get your bachelors in nursing (Thinking of Becoming a Registered Nurse, 2017). You have the option to choose what you want to get a degree in. The options are associates, bachelors, masters, nursing diploma through the hospital, or go through the military to get two years of training (Starting Out, 2017). Then after you complete your classes required for graduation, the final step would be to pass the NCLEX exam. If you receive a letter, you met qualifications to apply for a registered nurse position in the medical industry. To become a registered nurse takes a lot of commitment with skill and shaping you into a better person (Registered nurses, 2017). When you become a registered nurse, your
. Fact sheet: Scope of practice for registered nurses and midwives. http://www.nursingmidwiferyboard.gov.au/Codes-Guidelines-Statements/FAQ/Scope-of-practice-for-registered-nurses-and-midwives.aspx# (accessed 22 January 2014).
Nurses in Texas based their practice on the Texas Nursing Practice Act (NPA) by following their rules and regulations about the nurse scope of practice, which is determined by the nurse’s education, training and competency. The nurse scope of practice provides the legal boundaries for nursing practices in order to protect the safety of the people from Texas (Westrick, 2013, p. 24). Nurses are required to have a nursing degree from a Texas nursing programs approved by the Texas Board of Nursing (BON), and a current nursing license in Texas (BON, 2013b).
The definition of Nursing is “providing to individuals and groups nursing care requiring specialized knowledge, judgment, and skill derived from the principles of biological, physical, behavioral, social, and nursing sciences” (Ohio Revised Code 4723 [ORC], (2016). It is more than providing care for the sick, it encompasses the promotion of health, prevention of illness, and care of physically ill, mentally ill, and disabled people of all ages, in all health care and community settings. Registered Nurses (RN’s) must hold a current, valid license issued under chapter 4723 ORC that authorizes the practice of nursing as a registered nurse.