Florida Senate - 2020                             CS for SB 1764
       By the Committee on Health Policy; and Senator Flores
       588-03103-20                                          20201764c1
    1                        A bill to be entitled                      
    2         An act relating to midwifery; amending s. 467.015,
    3         F.S.; revising responsibilities of licensed midwives
    4         providing in-hospital and out-of-hospital births;
    5         amending s. 467.016, F.S.; revising the requirements
    6         for the uniform patient informed consent form used by
    7         licensed midwives providing out-of-hospital births;
    8         providing an effective date.
   10  Be It Enacted by the Legislature of the State of Florida:
   12         Section 1. Subsection (5) of section 467.015, Florida
   13  Statutes, is amended to read
   14         467.015 Responsibilities of the midwife.—
   15         (5) The midwife, whether providing an in-hospital or out
   16  of-hospital birth, shall do all of the following:
   17         (a)Upon acceptance of a patient into care, advise the
   18  patient of the clinical outcomes of births in low-risk patients
   19  during an out-of-hospital birth and any increased risks
   20  associated with an individual having a vaginal birth after
   21  having a caesarean section, a breech birth, or a multiple
   22  gestation pregnancy. The licensed health care practitioner
   23  providing out-of-hospital births shall further advise, but may
   24  not require, the patient to consult an obstetrician for more
   25  information related to such clinical outcomes and increased
   26  risks.
   27         (b)(a) Prepare a written plan of action with the patient
   28  and the patient’s family, if any, to ensure continuity of
   29  medical care throughout labor and delivery and to provide for
   30  immediate medical care if an emergency arises. The family should
   31  have specific plans for medical care throughout the prenatal,
   32  intrapartal, and postpartal periods.
   33         (c)(b)If a home birth is planned, instruct the patient and
   34  family regarding the preparation of the environment and ensure
   35  availability of equipment and supplies needed for delivery and
   36  infant care, if a home birth is planned.
   37         (d)(c) Instruct the patient in the hygiene of pregnancy and
   38  nutrition as it relates to prenatal care.
   39         (e)(d) Maintain equipment and supplies in conformity with
   40  the rules adopted pursuant to this chapter.
   41         (f)Upon initial contact with the patient during the
   42  intrapartal period, measure and record the vital signs of the
   43  mother and fetus to serve as a baseline during labor and
   44  delivery.
   45         (g)Transfer care of the patient to a hospital with
   46  obstetrical services in accordance with the written emergency
   47  plan if any of the following occurs or presents during labor or
   48  delivery or immediately thereafter:
   49         1.An unexpected nonvertex presentation of the fetus;
   50         2.Indication that the mother’s uterus has ruptured;
   51         3.Evidence of severe and persistent fetal or maternal
   52  distress;
   53         4.Pregnancy-induced hypertension;
   54         5.An umbilical cord prolapse;
   55         6.An active infectious disease process; or
   56         7.Any other severe emergent condition.
   57         Section 2. Section 467.016, Florida Statutes, is amended to
   58  read:
   59         467.016 Informed consent.—The department shall develop a
   60  uniform patient informed consent client informed-consent form to
   61  be used by the midwife providing out-of-hospital births to
   62  inform the patient client of the qualifications of a licensed
   63  midwife and the nature and risk of the procedures to be used by
   64  a midwife and to obtain the patient’s client’s consent for the
   65  provision of out-of-hospital birth midwifery services. The form
   66  must be signed by the patient and the midwife providing out-of
   67  hospital births, and a copy must be provided to the patient. The
   68  form shall include, at a minimum, all of the following:
   69         (a)A statement advising the patient of the clinical
   70  outcomes of births in low-risk patients during an out-of
   71  hospital birth and any increased risks associated with having a
   72  vaginal birth after having a caesarean section, a breech birth,
   73  or a multiple gestation pregnancy.
   74         (b)A detailed statement explaining to the patient hospital
   75  admitting privileges and the requirements for a health care
   76  practitioner to obtain and maintain such privileges.
   77         (c)Disclosure of each hospital and specific department, if
   78  any, where the health care practitioner providing out-of
   79  hospital births has been granted admitting privileges, including
   80  the scope and duration of the admitting privileges, the current
   81  contact information for the specific hospital or department that
   82  has granted the health care practitioner admitting privileges,
   83  and a copy of documentation from the hospital or department
   84  providing proof of such admitting privileges. A health care
   85  practitioner providing out-of-hospital births who does not have
   86  admitting privileges at any hospital must explicitly state that
   87  fact on the form.
   88         Section 3. This act shall take effect July 1, 2020.