Mich. Admin. Code R. 338.17133 - Additional informed consent requirements
Rule 133.
(1)
Additional informed consent processes are required when a patient presents to a
licensed midwife under any of the following circumstances:
(a) Previous cesarean birth at the inception
of care.
(b) Fetus in a breech
presentation when it is likely in the midwifes judgment the fetus will present
in breech presentation at the onset of labor.
(c) Twin or multiple gestation at the time of
discovery by the midwife.
(2) A licensed midwife shall disclose to the
patient his or her practice guidelines surrounding the management of the
pregnancies listed in subrule (1) of this rule, which must include the licensed
midwifes level of experience, type of special training, care philosophy, and
outcome history relative to such circumstances.
(3) The disclosure must contain information
regarding the licensed midwifes care team and style of management to be
expected under such circumstances, including a description of conditions under
which the licensed midwife shall recommend transfer or transport.
(4) The licensed midwife shall practice
within the limits of his or her practice guidelines described in this
rule.
(5) The licensed midwife shall
provide the patient with an informed choice document and written informed
consent, specific to the conditions listed in subrule (1) of this rule, which
includes the potential increased risks and benefits of the following:
(a) The circumstances listed in subrule (1)
of this rule.
(b) Birth outside a
hospital setting associated with the circumstances listed in subrule (1) of
this rule.
(c) Medical care options
associated with the circumstances listed in subrule (1) of this rule, including
the risks of cesarean section, both in the current pregnancy and any future
pregnancies.
(6) A
licensed midwife shall provide an abbreviated informed consent appropriate to
the emergent situation with documentation to follow once the situation has
stabilized.
Notes
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