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Thursday, October 10, 2013
San Francisco, CA -- During the 2013 California legislative session, attorneys in our San Francisco Office represented the California Association of Midwives (CAM) in an effort to remove ambiguities in the laws governing the scope of practice for licensed (direct-entry) midwives and lay the foundation for expanding care to underserved communities and individuals.
Prior to the changes made as a result of the firm’s lobbying efforts, state law imposed, or effectively erected, structural and financial barriers that significantly and unnecessarily restricted access to professional midwifery care in California. In particular, Business & Professions Code section 2507 required that licensed midwives practice “under the supervision of a licensed physician and surgeon.” Due to insurance limitations and other liability concerns, the required supervision was rarely available.
With the qualified support of the California Medical Board, licensed midwives successfully cared for women and babies during pregnancy, birth, and postpartum, and attended births in freestanding birth centers and in homes by relying on a variety of legal theories for working around the infeasible and outdated supervision requirement. The mere existence of the requirement, however, constrained the delivery of licensed midwife services in other contexts and thereby imposed unnecessary restraints. Numerous legislative efforts over the course of two decades had, unsuccessfully, attempted to eliminate this unworkable provision.
With the support of the bill’s author, Assemblywoman Susan Bonilla, CAM’s relentless activism, and sound legal advocacy and lobbying services provided pro bono by Paul Hastings, physician supervision was finally removed from the laws governing licensed midwives when Governor Jerry Brown signed AB 1308 into law on October 9, 2013. Although more work must be done to adapt programs, such as the state’s Medi-Cal reimbursement plan, to the changes effectuated by the bill, the most significant obstacle to making safe and economic maternity care by midwives more widely available has been removed.
The Paul Hastings team was led by partner Robert Hoffman, with assistance from senior associate Jill Yung.