SECTIONS 3650-3655 - California Statutes

BUSINESS AND PROFESSIONS CODE

SECTION 3650-3655

3650. A naturopathic doctor may perform naturopathic childbirth
attendance if he or she has completed additional training and has
been granted a certificate of specialty practice by the committee.

3651. In order to be certified for the specialty practice of
naturopathic childbirth attendance, a naturopathic doctor shall
obtain a passing grade on the American College of Nurse Midwives
Written Examination, or a substantially equivalent examination
approved by the committee, and shall establish, to the committee's
satisfaction, compliance with one of the following requirements:
(a) Successful completion of a certificate of midwifery or
naturopathic obstetrics specialty from an approved naturopathic
medical education program consisting of not less than 84 semester
units or 126 quarter units that substantially complies with the
following educational standards and requirements:
(1) The curriculum is presented in semester or quarter units under
the following formula:
(A) One hour of instruction in theory each week throughout a
semester or quarter equals one unit.
(B) Three hours of clinical practice each week throughout a
semester or quarter equals one unit.
(2) The program provides both academic and clinical preparation
that is substantially equivalent to that provided in a program
accredited by the American College of Nurse Midwives. The program
includes, but is not limited to, preparation in all of the following
areas:
(A) The art and science of midwifery, one-half of which shall be
in theory and one-half of which shall be in clinical practice. Theory
and clinical practice shall be concurrent in the areas of maternal
and child health, including, but not limited to, labor and delivery,
neonatal well care, and postpartum care.
(B) Communications skills that include the principles of oral,
written, and group communications.
(C) Anatomy and physiology, genetics, obstetrics and gynecology,
embryology and fetal development, neonatology, applied microbiology,
chemistry, child growth and development, pharmacology, nutrition,
laboratory diagnostic tests and procedures, and physical assessment.
(D) Concepts in psychosocial, emotional, and cultural aspects of
maternal and child care, human sexuality, counseling and teaching,
maternal and infant and family bonding process, breast feeding,
family planning, principles of preventive health, and community
health.
(E) Aspects of the normal pregnancy, labor and delivery,
postpartum period, newborn care, family planning, or routine
gynecological care in alternative birth centers, homes, and
hospitals.
(3) The program integrates the following subjects throughout its
entire curriculum:
(A) Midwifery process.
(B) Basic intervention skills in preventive, remedial, and
supportive midwifery.
(C) The knowledge and skills required to develop collegial
relationships with health care providers from other disciplines.
(D) Related behavioral and social sciences with emphasis on
societal and cultural patterns, human development, and behavior
related to maternal and child health, illness, and wellness.
(4) Instruction in personal hygiene, client abuse, cultural
diversity, and the legal, social, and ethical aspects of midwifery.
(5) Instruction in the midwifery management process which shall
include all of the following:
(A) Obtaining or updating a defined and relevant database for
assessment of the health status of the client.
(B) Identifying problems based upon correct interpretation of the
database.
(C) Preparing a defined needs or problem list, or both, with
corroboration from the client.
(D) Consulting, collaborating with, and referring to, appropriate
members of the health care team.
(E) Providing information to enable clients to make appropriate
decisions and to assume appropriate responsibility for their own
health.
(F) Assuming direct responsibility for the development of
comprehensive, supportive care for the client and with the client.
(G) Assuming direct responsibility for implementing the plan of
care.
(H) Initiating appropriate measures for obstetrical and neonatal
emergencies.
(I) Evaluating, with corroboration from the client, the
achievement of health care goals and modifying the plan of care
appropriately.
(b) Successful completion of an educational program that the
committee has determined satisfies the criteria of subdivision (a)
and current licensure as a midwife by a state with licensing
standards that have been found by the committee to be substantially
equivalent to those adopted by the committee pursuant to this
article.

3651.5. A naturopathic doctor certified for the specialty practice
of naturopathic childbirth attendance shall do both of the following:
(a) Maintain current certification in neonatal resuscitation and
cardiopulmonary resuscitation.
(b) File with the committee a written plan for the following:
(1) Consultation with other health care providers.
(2) Supervision by a licensed physician and surgeon who has
current practice or training in obstetrics to assist a woman in
childbirth so long as progress meets criteria accepted as normal. The
plan shall provide that all complications shall be referred to a
physician and surgeon immediately.
(3) Emergency transfer and transport of an infant or a maternity
patient, or both, to an appropriate health care facility, and access
to neonatal intensive care units and obstetrical units or other
patient care areas.

3652. (a) A certificate of specialty practice in naturopathic
childbirth attendance shall expire concurrently with the licensee's
naturopathic doctor's license.
(b) The certificate may be renewed upon submission of the renewal
fee set by the committee and evidence, to the committee's
satisfaction, of the completion of 30 hours of continuing education
credits in naturopathic childbirth, midwifery, or obstetrics. Fifteen
hours may be applied to the 60 hours of continuing education
required for naturopathic doctors.
(c) Licensing or disciplinary action by the committee or a
judicial authority shall be deemed to have an equal effect upon the
specialty certificate to practice naturopathic childbirth issued to a
licensee, unless otherwise specified in the licensing or
disciplinary action. When the subject of a licensing or disciplinary
action relates specifically to the practice of naturopathic
childbirth by a licensee holding a specialty certificate, the action
may, instead of affecting the entire scope of the licensee's
practice, suspend, revoke, condition, or restrict only the licensee's
authority under the specialty certificate.

3653. (a) Naturopathic childbirth attendance does not include the
use or performance of any of the following:
(1) Forceps delivery.
(2) General or spinal anesthesia.
(3) Cesarean section delivery.
(4) Episiotomies, except to the extent that they meet the same
supervision requirements set forth in Section 2746.52.
(b) Naturopathic childbirth attendance does not mean the
management of complications in pregnancy, labor, delivery, or the
neonatal period. All complications shall be referred to an
obstetrician or other licensed physician and surgeon as appropriate.

3654. In addition to Section 3640, a naturopathic doctor who holds
a specialty certificate in naturopathic childbirth attendance may
administer, order, or perform any of the following:
(a) Postpartum antihemorrhagic drugs.
(b) Prophylactic opthalmic antibiotics.
(c) Vitamin K.
(d) RhoGAM.
(e) Local anesthetic medications.
(f) Intravenous fluids limited to lactated ringers, 5 percent
dextrose with lactated ringers, and heparin and 0.9 percent sodium
chloride for use in intravenous locks.
(g) Epinephrine for use in maternal anaphylaxis pending emergency
transport.
(h) Measles, mumps, and rubella (MMR) vaccine to nonimmune,
nonpregnant women.
(i) HBIG and GBV for neonates born to hepatitis B mothers, per
current Centers for Disease Control guidelines.
(j) Antibiotics for intrapartum prophylaxis of Group B
Betahemolytic Streptococcus (GBBS), per current Centers For Disease
Control guidelines.
(k) Equipment incidental to the practice of naturopathic
childbirth, specifically, dopplers, syringes, needles, phlebotomy
equipment, suture, urinary catheters, intravenous equipment,
amnihooks, airway suction devices, neonatal and adult resuscitation
equipment, glucometer, and centrifuge.
(l) Equipment incidental to maternal care, specifically,
compression stockings, maternity belts, breast pumps, diaphragms, and
cervical caps.

3655. (a) A licensee holding a speciality certificate in
naturopathic childbirth attendance shall disclose to each client, in
writing, the following:
(1) The qualifications and credentials of the naturopathic doctor.
(2) A copy of the written plan for consultation, emergency
transfer, and transport.
(3) A description of the procedures, benefits, and risks of birth
in the home or outside of a hospital setting.
(4) The status of liability coverage of the licensee for the
practice of naturopathic childbirth attendance.
(b) The form must be signed by the client, filed in the client's
chart, and a copy given to the client.