Oregon Health Licensing Agency (OHLA) is the regulatory agency for Oregon midwives.
- A primary role of a regulatory agency is to ensure consumer safety
Statement of Health Licensing Agency (precursor of OHLA) in 2001:
The Health Licensing Office was created in 1999 with protection of public health and consumer rights as a cornerstone value, and protecting the interests of Oregon’s consumers through sound industry regulation and enforcement shapes the decisions made by our staff daily.
CONSUMER OHLA QUIZ
TRUE or FALSE:
- OHLA was mandated to collect outcomes data on Licensed Direct Midwives (LDMs).
Answer: True. Data collection was legally mandated in 1993.
- The data OHLA collected is available to the consumer on their website.
Answer: False. Data was never collected.
- OHLA has now hired a private midwifery advocacy company to collect Oregon data.
Answer: True. Starting June 1, 2011, midwives will submit their outcome data to MANAstats which is managed by a biased, special interest group dedicated to the promotion of the profession of midwifery. Interestingly enough, two officers of MANA sit on the Oregon Board of Direct Entry Midwifery (BDEM), one as co-chair, which presents a direct conflict of interest between promotion of midwifery vs protection of the public.
- MANAstats have in the past been readily available to consumers.
Answer: False More information on MANAstats: What Else is MANA Hiding?
- OHLA has also punted data collection to the Department of Vital Statistics .
Answer: True. And this data will continue to be incomplete and not available in a timely manner (usually 5 to 6 years).
- OHLA investigates all term fetal and neonatal deaths that occur during planned out of hospital births with LDMs.
Answer: False. Only if there is a complaint filed.
- OHLA investigates all serious neonatal morbidity.
Answer: False. Only if there is a complaint filed.
- A baby could die or be seriously injured and no investigation would necessarily take place.
- Hospitals report to OHLA when they receive a mortality or serious morbidity as a result of a homebirth transfer.
Answer: False There had been severe under reporting of Oregon LDMs until January 1, 2010, when mandatory reporting went into effect with HB 2059. Before that, hospitals rarely reported deaths or severe injuries. Even with the new rules, there is at least one large hospital system that has a policy of refusing to report negative outcomes.
- I can go on the OHLA website and find out if my midwife had a past disciplinary action.
Answer: False. Past disciplinary actions of an LDM are not evident when a consumer does a license inquiry, and neither are current investigations. Even a midwife that has had multiple disciplinary actions will have “none” in the “unresolved disciplinary action” box of her license inquiry.
- If I file a complaint to OHLA about the circumstances of my babies birth, an obstetrician or perinatologist will review the records to determine whether or not appropriate action was taken.
Answer: False. “Subject Matter Experts” utilized by OHLA in cases involving LDMs are primarily other LDMs. No obstetricians or perinatologists are utilized as SMEs.
- The State of Oregon has plenty of evidence for the safety of homebirth with LDMs
Answer: False. The State of Oregon has no safety evidence on this profession after 18 years of licensing and public reimbursement.
- If I file a complaint about a midwife with OHLA, I can expect to have my case resolved and the midwife disciplined quickly.
Answer: False. Investigations involving LDMs often take as long as three years to find resolution, during which time midwives being investigated continue to work unfettered.
- If the behavior of a midwife is found to have contributed to the death or injury of an infant, she will receive a final order from the BDEM.
Answer: False. There have been several instances of fetal/infant demise where no violations were found and no final order was issued, even though there was evidence that the midwife did not perform properly. For example, in 2005, there was a complaint about management of fetal heart rate leading to fetal demise. Per BDEM notes 5/19/05 , the board found that the midwife performed “appropriately” but did not check fetal heart tones frequently enough. Many complaints with outcome of death or serious morbidity end without a Final Order issued as standards in Oregon are remarkably unrestrictive.
EXTRA CREDIT BONUS QUESTION:
What other regulatory agency of a licensed profession capable of inflicting or suffering harm or death does not initiate mandatory investigation of any mortality or severe morbidity?
- Oregon State Board of Nursing publishes all disciplinary actions on their website on a monthly basis, with actions published on licensee’s license inquiry: http://www.oregon.gov/OSBN/current_topics.shtml.
- Oregon Medical Board publishes all disciplinary actions on their website on a monthly basis. Scanned copies of Interim Stipulated Orders, Orders of Emergency Suspension, Stipulated Orders, Final Orders, Termination Orders, Modification Orders and Voluntary Limitations are all included and publicly available. All are posted to each individual licensee’s license inquiry. http://www.oregon.gov/OMB/bdactions.shtml