Oregon Administrative Rules Chapter 332 - OREGON HEALTH AUTHORITY, HEALTH LICENSING OFFICE, BOARD OF DIRECT ENTRY MIDWIFERY
Chapter 332 – Board of Direct Entry Midwifery (BDEM)
Administered by the Health Licensing Office (HLO) under the Oregon Health Authority (OHA)
This chapter regulates the licensure, practice, education, and disciplinary standards for direct entry midwives in Oregon. Direct entry midwives are midwives who enter the profession through midwifery-specific training and apprenticeship rather than nursing or physician-based paths.
🔹 Division 1 – Rules of Procedure
Describes how the Board adopts, amends, or repeals rules.
Covers rulemaking notices, public participation, and hearing procedures.
Adopts the Attorney General’s model rules for fair administrative practices.
🔹 Division 10 – Definitions
Clarifies key terms such as:
Direct Entry Midwife (DEM) – someone licensed to provide maternity care without being a nurse.
Client – a pregnant individual under the midwife’s care.
Birth Plan – a written outline of the client’s preferences and conditions for labor and delivery.
Consultation, Referral, Transfer – defines what actions midwives must take when risks arise.
🔹 Division 20 – Licensing Requirements
Lists qualifications for obtaining a license as a direct entry midwife in Oregon:
Completion of approved educational programs or certified professional midwife (CPM) status.
Passing board-approved exams (written and practical).
CPR and neonatal resuscitation certification.
Background check and payment of fees.
🔹 Division 30 – Continuing Education
Midwives must complete a certain number of continuing education (CE) hours every two years.
CE must include emergency skills, updates in maternity care, and cultural competency.
Records must be maintained for auditing.
🔹 Division 40 – Practice Standards
Midwives may attend low-risk pregnancies, deliveries at home or birthing centers.
They must:
Conduct risk assessments.
Provide informed consent and maintain detailed records.
Transfer care to a hospital when complications exceed their scope.
Collaborate with physicians, nurses, and other healthcare professionals when needed.
Midwives cannot attend high-risk births (e.g., breech twins, preterm <37 weeks, or post-term >42 weeks) unless specific conditions are met.
🔹 Division 50 – Client Care and Risk Assessment
Requires thorough prenatal screening, regular checkups, and documented birth plans.
Identifies clinical risk factors that may require consultation, referral, or transfer.
Examples of risk conditions: gestational diabetes, high blood pressure, prolonged labor, abnormal fetal position.
🔹 Division 60 – Informed Consent
Midwives must explain:
Their training and limitations.
Risks of out-of-hospital birth.
Emergency procedures and hospital transfer policies.
Clients must sign a written consent form before care begins.
🔹 Division 70 – Professional Conduct and Discipline
Lists unprofessional conduct, such as:
Practicing without a license.
Falsifying records.
Failing to refer in high-risk cases.
Substance abuse or criminal convictions.
Violations can result in:
Fines.
Suspension or revocation of license.
Mandatory retraining or probation.
🔹 Division 80 – Complaint Process and Investigations
Describes how complaints are submitted, reviewed, and investigated by the Health Licensing Office.
The process includes:
Notification to the licensee.
Evidence gathering and hearings.
Possible disciplinary action based on findings.
🔹 Division 90 – Fees
Lists fees for:
Application.
Examination.
Initial license and renewal.
Late renewal, duplicate licenses, and verification.
🔹 Division 100 – Emergency Protocols
Midwives must be trained in responding to emergencies like:
Postpartum hemorrhage.
Neonatal resuscitation.
Cord prolapse.
Eclampsia or severe maternal complications.
Protocols must be documented, and equipment must be available at the birthing site.
🔹 Division 110 – Records Management
Specifies how to maintain, store, and protect client records.
Includes:
Retention period (typically 7–10 years).
Client access rights.
Confidentiality rules and HIPAA compliance.
✅ Summary
OAR Chapter 332 establishes the legal framework for licensing, regulating, and overseeing direct entry midwives in Oregon. The focus is on:
Ensuring safe care for low-risk pregnancies,
Setting professional and ethical standards,
Requiring ongoing education, and
Providing systems for accountability through complaint and discipline procedures.
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