12 AAC 14.200. Course of study requirements

(a) An acceptable course of study for certification as a direct-entry midwife must include

(1) the following subjects related to health and social sciences and services:

(A) communication, counseling, and teaching techniques, including client education;

(B) human anatomy and physiology relevant to human reproduction;

(C) community standards of care, including standards for midwifery and medical standards for women during the childbearing cycle;

(D) communication and collaboration with community health and social resources for women and children;

(E) documentation of client care through the childbearing cycle;

(F) informed decision making;

(G) health education, health promotion, and self care;

(H) clean and aseptic techniques, and universal precautions;

(I) psychosocial, emotional, and physical components of human sexuality, including indicators of common problems and methods of counseling;

(J) ethical considerations relevant to reproductive health;

(K) epidemiologic concepts and terms relevant to perinatal and women's health;

(L) principles of accessing and evaluating current research relevant to midwifery practice;

(M) family centered care including maternal, infant, and family bonding;

(N) appropriate referral of women and their families for treatment of disease;

(O) importance of accessible, quality health care for all women that includes continuity of care;

(2) the following subjects related to antepartum care:

(A) preconceptional factors likely to influence pregnancy outcome;

(B) basic genetics, embryology, and fetal development;

(D) identification and assessment of the normal changes in pregnancy, fetal growth, and position;

(E) nutritional requirements for pregnant women and methods of nutritional assessment and counseling;

(F) environmental and occupational hazards for pregnant women;

(G) education and counseling to promote health throughout the childbearing cycle;

(H) methods of diagnosing pregnancy including the testing of urine and blood;

(I) common discomforts of pregnancy, including the etiology and treatment of those discomforts, and the appropriate referral when indicated;

(J) assessment of physical and emotional status, including relevant historical and psychosocial data;

(K) counseling for individual birth experiences, parenthood, and changes in the family;

(L) screening and diagnostic tests used during pregnancy, including indications for use and the risks and benefits of the tests;

(M) the etiology, assessment, treatment, and appropriate referral related to abnormalities of pregnancy;

(N) identification, implications, and the appropriate treatment of various sexually transmitted diseases (STD) and vaginal infections related to abnormalities of pregnancy;

(O) special needs of the woman with Rh negative type blood;

(P) identification and care of women who are human immune deficiency virus (HIV) positive, have hepatitis, or have other diseases;

(3) the following subjects related to intrapartum care:

(A) normal labor and birth processes;

(B) anatomy of the fetal skull, including its critical landmarks;

(D) emotional changes, comfort, and support during labor, birth, and immediately postpartum;

(E) techniques to aid the spontaneous vaginal delivery of the baby and placenta;

(F) abnormalities of the four stages of labor, including the etiology and assessment of those abnormalities, and the appropriate referral, transport, and emergency measures indicated for the fetus, mother, or newborn affected by those abnormalities, including

(i) review of the side effects and administration of pharmaceutical agents, such as emergency administration of pitocin to control postpartum hemorrhage; and

(ii) performing an emergency episiotomy;

(G) adaptation of the newborn to life after birth;

(H) medical interventions and technologies used during labor and birth;

(I) assessment and care of the perineum and surrounding tissues;

(4) the following subjects related to postpartum care:

(A) anatomy and physiology of the newborn during the postpartum period;

(B) anatomy, physiology, lactation, and appropriate care of the breast;

(D) the etiology and management of the discomforts of the postpartum period;

(E) emotional, psychosocial, and sexual changes that may occur during the postpartum period;

(F) nutritional requirements for women during the postpartum period;

(G) abnormalities of the postpartum period, including the etiology, assessment, treatment, and appropriate referral of the mother or newborn experiencing the abnormalities;

(H) assessment of the breastfeeding relationship, identification of lactation problems, and making appropriated referrals;

(5) the following subjects related to neonatal care:

(A) anatomy and physiology of the newborn as they relate to the newborn's adaptation and stabilization in the first days of life;

(B) methods for assessing newborn status including relevant historical data and gestational age;

(D) administration of prophylactic treatments commonly used during the neonatal period, including state laws applicable to that administration;

(E) common screening tests for the newborn, including indications, risks, benefits, and methods of performing those tests;

(F) neonatal abnormalities, including the etiology and assessment of those abnormalities, and the screening and diagnostic test, emergency measures, appropriate transport, referral, and treatment necessary as a result of those abnormalities;

(6) the following subjects related to family planning and well woman care;

(A) steroidal, mechanical, chemical, physiological, and surgical conception control methods;

(B) issues involved in decision making regarding unplanned pregnancies and resources for counseling and referral;

(C) abnormalities of the reproductive system and breast, including the etiology and assessment of those abnormalities, and the treatment and appropriate referral of the woman experiencing those abnormalities;

(D) assessment of physical and emotional status, including relevant historical data;

(7) training on the performance of the following permitted practices:

(A) catheterization of the urinary bladder;

(B) clamping and cutting of the umbilical cord;

(D) venipuncture;

(E) capillary blood sampling, and

(F) suturing;

(8) the following subjects related to professional, legal, and other aspects of midwifery practice:

(A) peer review, chart review, case presentation, and developing midwifery protocols;

(B) data collection and analysis relevant to midwifery practice;

(D) history of midwifery, medicine, and health care in the United States;

(E) organization of maternal and infant care in the United States and the factors affecting that care; and

(F) various sites, styles, and modes of practice within midwifery.

(b) To meet the requirements of (a) of this section, a course of study must be approved by the board or accredited by the Midwifery Education Accreditation Counsel (MEAC).

(c) An applicant shall document completion of a course of study that meets the requirements of (a) of this section by submitting

(1) an official transcript, diploma, or certificate of graduation, sent directly to the department from a MEAC accredited institution where the applicant completed the course of study; or

(2) a notarized course of study certification form, provided by the department, signed by the applicant's primary preceptor.

(d) The board may require additional documentation it considers necessary to verify an applicant's study of a subject, including an essay written by the applicant on subjects studied independently.

(e) The board will maintain a list of organized courses of study that it finds meets the requirements of (a) of this section.

History: Eff. 2/18/94, Register 129; am 12/9/2001, Register 160; am 8/19/2004, Register 171

Authority: AS 08.65.030

AS 08.65.050

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