Informed Consent To Midwifery Treatment

Please fill out the attached Informed Consent To Midwifery Treatment.

INFORMED CONSENT TO MIDWIFERY TREATMENT

Disclosure Statement

Disclosure Statement

The practice of direct-entry midwifery is regulated by the Department of Regulatory Agencies.  By Colorado law, a midwife is required to inform clients of the legal limitations pertaining to the practice of midwifery.  Beyond the legal requirements, the information is valuable in helping clients make more informed decisions about the type of care and the caregiver they desire.

 

Therefore please be aware of the following:

 

Education and Degrees:                                                                Contact Hours                                                   Length of time

Credential                                                                                                 to earn                                                                  to earn

Associates of Science in Midwifery                                                     Completion of 53.5 academic/lab                                   2.5 years

From Midwives College of Utah                                                                    semester credits

BFA from Western State College                                                                  99 Credits                                                                    3.0 years

Associates of Science in Wildlife

Management from Hocking College

Apprentice with Senior Midwife                                                         21.5 Clinical practicum credits                                          3.0 years

Registered with the State of Colorado                                                     NARM exam/Degree

CPM with NARM                                                                                                        Test

Neonatal Resuscitation                                                                                          Class/test

Basic Life Support                                                                                                     Class/test

 

Experience as Midwife:

Associates of Science in Midwifery from the Midwives College of Utah

3 year internship with a senior midwife

State of Colorado Midwifery registration Jan, 2010

 

Membership in Professional Organizations

Member of MANA (Midwifes Alliance of North America)

Member of CMA (Colorado Midwives Alliance)

Teacher at Midwives College of Utah

  • A midwife assists only with normal births and does not perform and surgical procedures or prescribe medications.
  • A midwife is required to perform careful risk-screening, as outlined by Colorado law, and refer the client to an appropriate caregiver, if necessary.
  • A midwife is required to inform the client of her/his background, training and credentials pertaining to midwifery.
  • A midwife must document protocols that relate to the scope and type of care she/he will provide as well as the procedure she/he will use in the case of an emergency or transfer of care.
  • A midwife will not knowingly or intentionally falsify any documents or records or violate agreements of confidentiality with the client.
  • Should the client have a complaint about the care she receives she can notify orally or in writing:

Department of Regulatory Agencies, Division of Midwifery

Complaints and Investigations Section

1560 Broadway, Suite 1300

Denver, CO 80202

Marlene Bergman Registration # 118

  • The normal birth process is the same whether the birth takes place at home, in a hospital, or in a birth center. Additional risks arise in a home birth in emergency situations due to the lack of access to immediately available medical personnel, equipment and drugs.
  • A midwife is not required to carry liability insurance at this time.
  • Colorado law provides that, if a client must receive medical care from a health care provider after receiving care from a midwife because of acts or omissions by the midwife, any physician, nurse, pre hospital emergency personnel, and health care institution providing such subsequent care may not legally be sued by the client for negligence. In order for a lawsuit to be maintained the client must prove that the above mentioned providers engaged in gross negligence or willful and wanton conduct.
  • Copies of the Midwifery Practice Act and regulations concerning direct entry midwifery practice are available from the midwife should the client request them.
  • Healthcare providers qualified to admister Vitamin K or Rho(D) immune globulin to the client are: Gunnison Valley Family Physicians located at 130 E. Virginia, Gunnison Co 81230 970-641-0211or Gunnison Family Medical Center located at 707 N. Iowa, Gunnison Co 970-641-1771. In Salida or Buena Vista Co, First Street Family Health located at 910 Rush Drive Salida, Co 719-539-6637, Mountain Medical Center located at 36 Oak Street Buena Vista, CO 719-395-8632 or Salida Family Medicine located at 320 E. First Street Salida, CO 719-539-3583

 

Prairie Love Midwifery Disclosure Statement