CA Bus & Prof Code Section 2746.52

Notwithstanding Section 2746.5, the certificate to practice nurse-midwifery authorizes the holder to perform and repair episiotomies, and to repair first-degree and second-degree lacerations of the perineum, in a licensed acute care hospital, as defined in subdivision (a) of Section 1250 of the Health and Safety Code, and a licensed alternate birth center, as defined in paragraph (4) of subdivision (b) of Section 1204 of the Health and Safety Code, but only if all of the following conditions are met:

(a)

The supervising physician and surgeon and any backup physician and surgeon is credentialed to perform obstetrical care in the facility.

(b)

The episiotomies are performed pursuant to protocols developed and approved by all of the following:

(1)

The supervising physician and surgeon.

(2)

The certified nurse-midwife.

(3)

The director of the obstetrics department or the director of the family practice department, or both, if a physician and surgeon in the obstetrics department or the family practice department is a supervising physician and surgeon, or an equivalent person if there is no specifically identified obstetrics department or family practice department.

(4)

The interdisciplinary practices committee, if applicable.

(5)

The facility administrator or his or her designee.

(c)

The protocols, and the procedures which shall be developed pursuant to the protocols, shall relate to the performance and repair of episiotomies and the repair of first-degree and second-degree lacerations of the perineum, and shall do all of the following:

(1)

Ensure that all complications are referred to a physician and surgeon immediately.

(2)

Ensure immediate care of patients who are in need of care beyond the scope of practice of the certified nurse midwife, or emergency care for times when the supervising physician and surgeon is not on the premises.

(3)

Establish the number of certified nurse–midwives that a supervising physician and surgeon may supervise.