Monday, November 9, 2015

Arizona Being Sued for Harassment of Midwives

PHOENIX (CN) - Arizona harasses midwives and endangers mothers and children with illegal rules barring midwives from providing care if new mothers or their baby have a "prohibited" condition, the Arizona Association of Midwives claims in court.
     The association - which represents midwives, their apprentices and assistants - sued the Department of Health Services, DHS Director Cara Christ and Attorney General Mark Brnovich in Superior Court, stop enforcement of rules under HB 2247.
     The Arizona Association of Midwives (AAM) lobbied for a revision of outdated midwifery licensing rules in 2012, causing then-Gov. Jan Brewer to sign into law House Bill 2247, which allowed DHS "to engage in exempt rulemaking for two purposes: to reduce the regulatory burden on Arizona midwives and to consider increasing Arizona midwives scope of practice."
     But the new DHS rules and policies put the lives of mothers and babies at risk, the association says.
     "Since the rules revision, the Department has engaged in campaign of harassment and intimidation of the licensed midwives, targeting those midwives who have voiced concerns that the current rules and policies endanger the health and safety of mothers and babies," according to the complaint.
     Arizona midwives delivered about 1,200 babies last year.
     The complaint cites an incident in which a mother had a normal delivery, but the baby later began grunting and turned blue. The baby was taken to the emergency room, briefly placed on oxygen, and recovered.
     The midwife was told to stop caring for the mother "because the infant had a 'prohibited practice' condition," and once a baby develops such a condition, the midwife is barred forever from treating that mother, according to the complaint.
     In this case, the association says, the mother struggled to find postpartum care from another provider after she was denied care from her midwife.
     In another incident, "a midwife had a client who experienced preterm labor (labor beginning before 36 weeks gestation), a 'prohibited practice' condition for which the midwife is required to transfer care." The midwife transferred care to a physician, who transferred the woman back to the midwife after her labor subsided.
     But Arizona "told the midwife that she was prohibited from caring for that client because the client had experienced preterm labor, despite that the client had carried the child to term." The association says it "has met publicly and privately with the Department, provided the Department with evidence-based practice guidelines, and formally requested that the Department change those rules and policies at odds with patient safety or evidence-based practice," but the agency refused to take any action.
     Since it began enforcing these rules, DHS enforcement actions against midwives have increased from one in 2013 to 14 in 2014 and 19 so far in 2015.
     Of 40 practicing midwives in Arizona, almost half have had an enforcement action lodged against them.
     "As midwives, we want to spend our time caring for women and babies of Arizona. Our association has tried time and again to work with the Department of Health to improve our services and have been met with hostility," AAM President Wendy Cleckner said in a statement.
     "Our hand has been forced; we have no other recourse but to take legal action to protect the health and safety of our clients."
     The association seeks declaratory judgment and an injunction on eight claims, including numerous violations of state laws and violations of the state and federal constitutions.
     The Department of Health Services does not comment on pending litigation.
     The Arizona Association of Midwives is represented by Julie Gunnigle of Scottsdale. 

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