What is the purpose of a board of … whatever? When it comes to licensing boards, it is to protect the public by ensuring basic levels of competency. For example, the Oregon State Board of Nursing, which licenses Certified Nurse-Midwives, says
The Oregon State Board of Nursing safeguards the public’s health and well-being by providing guidance for, and regulation of, entry into the profession, nursing education and continuing safe practice.
The Oregon Medical Board, which licenses MD’s and DO’s, also has the same mission:
The mission of the Oregon Medical Board is to protect the health, safety, and well being of Oregon citizens by regulating the practice of medicine in a manner that promotes quality care.
In addition to its licensing functions, the Board conducts investigations, imposes disciplinary action, and supports rehabilitation, education, and research to further its legislative mandate to protect the citizens of Oregon. The Oregon Medical Board is also responsible for the scope of practice of First Responders and EMTs.
What does the Oregon Board of Direct Entry Midwifery and the Oregon Health Licensing Agency do? Well, the stated mission of OHLA is
The Oregon Health Licensing Agency (OHLA) protects the health, safety and rights of Oregon consumers by ensuring only qualified applicants are authorized to practice. OHLA establishes, communicates and ensures compliance of regulatory standards for multiple health and related professions.
That, however, is far from the truth when it comes to licensed midwives in the state of Oregon. In reality, the BDEM and OHLA have…
- Failed to remove the license of a midwife who abandoned a woman with a retained placenta. Seriously? Someone who’s read one book on childbirth knows that a placenta that doesn’t come out within a couple of hours of the birth of the baby is a serious problem. And a midwife who leaves a woman in that situation? Well, that’s a serious problem as well. But apparently the Oregon Board of Direct Entry Midwifery doesn’t think so. When the Board declined to do anything about it, board member Kate Davidson, CNM, resigned in protest, saying in her resignation letter:
After the Board’s decision not to revoke the license of a midwife who left a patient with a placenta undelivered, I do not feel I can honestly continue to serve and maintain my own personal integrity. I feel this was an egregious act and failure to revoke the license conflicts with the Board’s duty to protect the public.
- Progressively reduced the number of absolute risk criteria so that Oregon DEMs can attend riskier and riskier births. Between 1993 and 2009, eighteen different criteria were either loosened, reduced to non-absolute criteria, or removed from consideration altogether by the board. Oregon midwives are now not required to even consult with a medical doctor when an infant is born at home at 35 weeks, much less transfer care.
- Refused to discipline midwives whose actions contributed to the death of a child. Case 05-4228 brought before the board was a complaint about a midwife’s management of fetal heart rate which led to fetal demise. According to notes from the board’s meeting on 5/19/2005, the board found that the midwife DID NOT CHECK FETAL HEART TONES APPROPRIATELY but did not discipline the midwife or make her name known to the public.
- Ensured that DEMs are not required to provide risk information about homebirth with malpresentations, multiple gestation, VBAC, and postdates. The disclosures have been required by the legislature, but every time the deadline approaches to implement, OHLA pushes it back.
The Oregon Health Licensing Agency filed temporary administrative rules with the Secretary of State Office on Octoner [sic] 15, 2011, to extend the implementation date to June 1, 2012, which will require each licensed direct entry midwife provide risk information to clients, as published on the agency’s website, regarding out-of-hospital birth, malpresentation birth (breech), multiple gestations (twins), vaginal birth after cesarean (VBAC), and births exceeding 42 weeks gestation (post-dates.)
- Allowed multiple members of the board (the chair and vice-chair, in fact) to have a serious conflict of interest. Melissa Cheyney, board chair, is also the director of research for MANA, whose stated goal is “to unify and strengthen the profession of midwifery,” basically a lobbying group for midwives. Somehow Cheyney and Susan Moray, who is MANA’s press officer (and is also employed as continuing education coordinator by the Oregon Midwifery Council, yet another lobbying organization for Oregon midwives) are allowed to maintain their positions as virtual lobbyists for midwives while running a board that is supposed to be protecting Oregon women from bad midwives.
- Hired a private midwife advocacy/lobby group, who has refused to release data to them in the past, to collect safety data on Oregon midwives. That’s right. Starting June 1, 2011, OHLA started requiring Oregon licensed midwives to submit data to Melissa Cheyney’s MANAstats. Totally disregarding the fact that they have requested data from MANA before, and Cheyney denied the request. According to board meeting notes from August, 2010:
Cheyney stated that OHLA requested a state account from the MANA, in order to have the ability to retrieve aggregate data for LDMs in Oregon. Cheyney stated that the MANA board’s official policy is to give state-level accounts to professional organizations as a tool to evaluate areas where more training might be needed for the purpose of self regulation, and to not provide the data to regulatory entities. Cheyney explained that MANA’s policy was generated taking into consideration that MANA is a voluntary database. Cheyney explained that MANA suspected that, due to some state regulatory boards having very hostile relationships with midwives, the quality and quantity of data submitted might be adversely affected if regulatory authorities were provided access. Due to this policy OHLA’s request for a state level account was denied. Cheyney stated that due to multiple requests made by regulatory authorities to MANA for a state-level account, the MANA board decided to re-evaluate this policy. However, based on feedback received from contributors to the MANAstats database expressing concerns, MANA determined that state-level accounts would not be provided to regulatory entities at this time.
- Published worthless information about licensees while obfuscating information vital to making a truly informed decision about which midwife to use for a homebirth. Want to know if the midwife you’re considering has ever been disciplined by the board? Well you’re out of luck! For example, Jennifer Gallardo has had at least two final orders (case numbers 00-01 and 02-12) that resulted from cases of fetal or infant demise. What do you find when you look up her license on the OHLA website?
Unresolved Disciplinary Action: None. That’s right. OHLA will only tell you if a midwife failed to pay her fine, not whether or not she’s been disciplined. What about a midwife who gave up her license rather than have it revoked? Clare Loprinzi, the midwife who abandoned the woman with the retained placenta, eventually agreed to surrender her license to the board “in lieu of revocation” in 2002 after she was involved in an infant demise in 1999. What does OHLA say about her license?
The same thing it says about midwives who failed to pay their renewal fees. And no mention of case number 99-01, including a “proposed order to revoke license due to unprofessional conduct” which resulted in fetal demise. (an aside, because I don’t have enough hours in the day to detail all that is wrong with OHLA and the OBDEM: Why the f*ck did it take THREE YEARS to take her license away?)
And what about midwives who currently have complaints against their licenses? Shouldn’t the public be aware of that? OHLA doesn’t think so. Adele Rose of Andaluz is currently under investigation for her involvement in a fetal demise in 2010 as well as another 2010 incident. Incidentally, she was given a one month suspension (during which she was allowed to continue practicing as a midwife…) as a result of case 08-5222, which was a VBAC attempt that ended in fetal demise and an emergency hysterectomy. What does a search of her license tell us?
Nothing. Not shocking when you consider the rest of this, but it should be.
But maybe this is par for the course when it comes to reporting actions taken against licenses? I mean, Birth Without Fear is constantly telling us about how hospitals are hiding things from us. Maybe the Oregon Board of Nursing refuses to report actions against their licensees as well? Oh, look. If you go to the OBON website, it has all of the disciplinary actions taken in the last year, complete with details and the area in which the disciplined nurse lives. And if you look up those nursing licenses individually? Those violations are listed on the license with a .pdf of the final order. Nurses, schmurses. Surely the medical board, with those evil doctors who are hiding ALL those terrible hospital outcomes we always hear rumors (but never see any proof!) about on MDC, isn’t telling the public about actions taken against medical licensees! Nope. They have final orders, current to those handed down LAST WEEK, on their site, complete with names and copies of the order. Not only that, but they have temporary orders taken against doctors who are being investigated listed! And violations are all listed on the medical license look-up as well.
Oregon women who are considering a homebirth should be OUTRAGED at the lack of oversight, protection, and transparency provided by OHLA and the Oregon Board of Direct Entry Midwifery. It is clear that their real agenda is to promote midwifery and not to protect Oregon families, in direct opposition to their stated goal. When are you going to start speaking out?