Please watch the video. Not all information is written on this page.

Correction to video: This section didn’t make it through editing but is very important. We do not want to report that we have supervision in line 17 unless the definition of supervision for this form is met: For the purpose of this form, you are only supervised if you have a doctor who is willing to go on record as being your supervisor. In other words, they have to be willing to confirm in writing that they supervised you for that particular case. This is not a supportive doctor who accepts all your transports or will prescribe for your clients unless they will give you a letter stating they are your supervisor.

You can download the video to your computer here. The password to access the file is “midwife.”

You can also watch it on YouTube

THE 2009 CALIFORNIA LICENSED MIDWIVES ANNUAL REPORT

You can link to the form here
The actual URL is https://lmar.oshpd.ca.gov/

If you are not sure how to turn off your pop-up blocker, check this FAQ for information.

If you have problems making the form work for you, contact Robin Jones at RJones@mbc.ca.gov
If you have questions about your report, contact Claudia Breglia at claudiabreglia@gmail.com or 916-524-4036

ONLY report on services provided to clients who intended an out of hospital birth at the onset of your care in the state of California. DO NOT report on births or services provided out of state or out of the country anywhere on this form.

Read the definitions! These definitions are for the purpose of the report only and are not the same as the universally accepted definition for these items. This applies to ALL the definitions.

For the purpose of this report, postpartum for the mother means from the moment of birth until 6 weeks following the birth of the baby and for the baby means the first 6 weeks of life.

If you are the primary midwife and are away or otherwise temporarily leave your clients in the care of a backup midwife and that midwife ends up transporting your client, you should be the midwife who reports that transfer. This is different from every other place we report. The reason for that is the LMAR is concerned only with total numbers, not care given by individual midwives. No one will be lost to follow-up or get reported on multiple times, when only the primary midwife is reporting on that client. This DOES NOT apply to TRANSFER of care, it only applies to temporary coverage situations.

Remember, you are reporting to OSHPD in aggregate and OSHPD reports an aggregate of all midwives data to the medical board. They are not allowed to disclose information given by individual midwives. Your form can’t even be subpoenaed. You will not be putting yourself at any risk by answering any question honestly.

Line 13 This is all clients served during the year. It includes people who had babies in 2008 but were still being seen for postpartum care at the beginning of 2009, all the clients who left care prenatally in 2009, all the clients who had babies in 2009 whether at home or after transport, and all the clients you are seeing prenatally in 2009 who will not have their babies until 2010. Do not report on clients who you saw for well woman or postpartum care only, doula clients, or clients who planned a hospital birth but wanted additional prenatal care from you.

Line 16: Collaborative Care: This definition captures all clients who were seen by a physician or surgeon during their pregnancy. It includes clients who saw a doctor for a few visits so that insurance would cover their labwork and ultrasound, clients who started care with an OB and transferred to your care, clients who had concurrent care with a physician or surgeon during their pregnancy as well as clients for whom you or they had an issue that needed medical consult. Nurse practitioners and Certified Nurse Midwives seen at doctors offices count as collaborative care providers on line 16. It does not include a client who saw a physician for the first time when they transferred out of your care and never returned to your care.

Section E Line 18: In this section only enter fetal demises that were discovered under your care. If you don’t hear a heartbeat during a prenatal visit or during labor and the demise is confirmed after transfer, you have discovered the demise while under your care and it should be entered in this section. If the fetus has a documented heartbeat when you leave for the hospital but doesn’t when you get there, or has a heartbeat when you arrive at the hospital and dies later, you did not discover the fetal demise while it was under your care and it should NOT be entered in this section.

Section H: If you are transporting because you suspect fetal demise, the transfer of care for diagnoses is done on an emergency basis even though subsequent care decisions are elective.

Section M and N: The definition of Transfer of Care: is The receiving health care practitioner becomes the primary caregiver.
This means if you are unsure about a baby and bring it to a pediatrician who pronounces everything fine, and returns the baby to your care- that is not a transfer and should not be reported in this section.
If you bring the baby in and after examination the medical caregiver decides to admit the baby for observation or decides that the situation warrants ongoing medical observation or treatment, that is a transfer and should be reported in section M or N.