Valerie, would you mind specifying what a medical/nurse practice act is? How would I find that out( for a specific state)?
The medical and nurse practice acts are the portions of state law that address the licensure and regulation of physicans and nurses. These laws define the practice of medicine and nursing, specify the requirements for licensure as a physician or nurse, list the legal consequences of practice without a license, and a great deal more. There are a variety of ways to find the medical and nurse practice acts for a specific state. You might try a good search that includes the terms "statute" "medical practice act" "hawaii."
This is so confusing. I was initially thinking just to talk to someone in the government/state about the laws, but I asked a midwife working for NARM first who told me that would not be a good idea because it would alert them to the midwives. That alone is a red flag to me but I know that midwives are practicing there. Yes I have talked to quite a few of them and it seems as though collectively they don't really know their status. I have heard alegal but some midwives think they will be just fine if an issue arise because they say it's not specifically illegal.
That is an argument that has been tried (and has failed) in many other states. The legal reality is that if midwifery is not licensed in a state, and it is not exempt from the provisions of the state's nursing/medical practice acts, it is NOT LEGAL, and it is unlikely that they will be "just fine."
Other midwives are scared that without legislation they will never really be protected.
They are correct.
So midwives will be midwives. And I doubt that I will decide not to move to hawaii and practice midwifery because of that, unless it is a real risk that we are unprotected.
And that is clearly your choice. It should be clearly understood, however, that the fact that midwives have practiced without State interference for a long period of time (in Illinois it was years before the State began its crackdown) does not imply safety. All it means is that the State has not had a sufficient motive to track down and prosecute midwives. That could change with one bad outcome.
Again, is a well written informed consent release of liability document that is written/looked over by a knowledgeable lawyer going to protect me from criminal liability, from civil liability and any other liability that could come up? Or is it just a piece of paper with little value other than informing the parents what we are and "please don't get upset if something unexpected happens, because it's rare"
In short, no. A "well written informed consent release of liability document" is not going to protect you from criminal liability for practicing nursing/medicine without a license. If the State finds that you are doing things that are reserved to licensed nurses and/or physicians, and that you are not licensed as a nurse and/or physician, you are subject to criminal prosecution. It simply isn't going to work to have some paper that says "well, I am not really a midwife -- I am a doula." To the State, if it walks like a midwife and quacks like a midwife, it is a midwife, and will be prosecuted accordingly.
As to civil liability, a midwifery client cannot sign away her right to sue you for malpractice.
I am a CPM with a current license btw, but this will be my first time regularly practicing in this country. It's such a pain. Much easier in other countries.
So there is no such thing as alegal? how do i find out for sure, if the HI midwives are unsure, and I shouldn't contact the government.
No, there is no such thing as alegal. This is not a matter of opinion, it is a matter of law and of logic. Think it through (and suggest that the HI midwives also think it through) -- if a midwife is subject to criminal prosecution for practicing midwifery, how can she be "alegal"? True "alegal" status should mean that there is no law applicable to midwives, but we know that isn't true. Midwives throughout the U.S. have been prosecuted under their state's nurse/medical practice acts.
What is to be done? women are seeking midwives, midwives are taking clients. babies are coming out. If I had no family i might not mind suffering in jail as a martyr midwife like elena ermakova (if worst comes to worst), but I want to make sure that although i will probably never have an issue, it cannot become an issue. It would be iresponsible of me to put my kids and husband in the situation of risk. That shouldn't prevent me from practicing. I want to know what other states have done to overcome this.
Many midwives continue to practice in spite of the legal danger, and many of them practice without any legal issues. Others are prosecuted, with all the accompanying legal hassle and expense. Each midwife has to decide whether the risk is worth it. The most important part of that decision is a clear understanding of the legal risks in a particular state.
How are you other midwives practicing in states unlegislated (25 of them) and not running into problems (criminal and civil)? Is your informed consent protecting you? Are you just all very lucky (now I know that this is preposterous because SOMETIMES, outcomes are unexpected).
Thanks for your responses so far! please keep them coming!