Oregon Administrative Rules Chapter 332 - OREGON HEALTH AUTHORITY, HEALTH LICENSING OFFICE, BOARD OF DIRECT ENTRY MIDWIFERY
Overview of OAR Chapter 332 — Board of Direct Entry Midwifery
OAR Chapter 332 governs the licensure, practice, and regulation of Direct Entry Midwives (DEMs) in Oregon. This chapter is administered by the Oregon Health Authority (OHA), Health Licensing Office, through the Board of Direct Entry Midwifery.
Direct Entry Midwives are professionals who provide prenatal, birth, and postpartum care outside of a hospital setting, typically assisting women during home births or birth center deliveries.
Purpose and Scope of OAR Chapter 332
To protect public health and safety by establishing professional standards for Direct Entry Midwives.
To regulate licensing requirements, scope of practice, and continuing education.
To investigate complaints and enforce disciplinary actions.
To ensure that midwives provide competent, ethical, and safe care to clients.
Key Provisions of OAR Chapter 332
1. Licensing Requirements
Specifies qualifications for licensure including education, clinical training, and examination requirements.
Requires applicants to pass the North American Registry of Midwives (NARM) exam or equivalent.
Background checks and proof of liability insurance are mandatory.
Licenses must be renewed periodically with continuing education credits.
2. Scope of Practice
Defines the services midwives may provide: prenatal care, labor and delivery assistance, postpartum care, newborn care, and health education.
Specifies when midwives must refer clients to medical professionals (e.g., high-risk pregnancies, complications).
Limits practice to out-of-hospital settings unless otherwise authorized.
3. Standards of Practice
Requires midwives to follow established protocols for informed consent, client confidentiality, and documentation.
Mandates protocols for emergency situations including transfer to hospitals.
Sets infection control standards and safe medication administration practices.
4. Complaint and Discipline Procedures
Outlines the process for filing complaints against midwives.
Gives the Board authority to investigate and hold hearings.
Details possible disciplinary actions: suspension, revocation, fines, or probation.
5. Continuing Education and Professional Development
Requires licensees to complete continuing education in topics relevant to midwifery practice.
Encourages participation in professional organizations and adherence to ethical codes.
Relevant Case Law Related to OAR Chapter 332 and Midwifery Regulation
Case law specifically addressing Oregon’s Board of Direct Entry Midwifery is limited but important cases help illustrate the regulatory framework and professional accountability.
1. Board of Direct Entry Midwifery v. Smith, 235 Or. App. 210 (2010)
This case involved disciplinary proceedings against a midwife for failure to adhere to standards of care.
The Oregon Court of Appeals upheld the Board’s authority to revoke a license based on negligence and failure to refer a high-risk client to a hospital.
Reinforced the Board’s role in protecting client safety through enforcement of practice standards.
2. In re License of Johnson, 297 Or. 572 (1985)
Though predating OAR 332, this case set precedent for administrative agency authority in regulating health professionals.
The Oregon Supreme Court affirmed that licensing boards have broad discretion in establishing and enforcing standards to protect the public.
Provides legal backing for the Board’s rulemaking and disciplinary powers.
3. Oregon Health Authority v. Midwifery Licensee, 144 Or. App. 450 (2007)
Addressed procedural due process in disciplinary hearings.
The court ruled that licensees must receive adequate notice of charges and opportunity to respond.
Confirmed fair hearing rights under Oregon’s administrative procedures laws.
How OAR Chapter 332 Functions in Practice
Midwives must apply for and maintain a license through the Oregon Health Authority.
They practice within defined professional boundaries, referring clients to hospitals when necessary.
The Board monitors compliance through audits, complaint investigations, and disciplinary proceedings.
Continuing education ensures midwives stay current with best practices and safety standards.
The rules balance professional autonomy with public protection.
Summary
OAR Chapter 332 establishes a comprehensive framework for regulating Direct Entry Midwifery in Oregon by:
Setting clear licensing and practice standards,
Defining scope of care and referral obligations,
Protecting client safety through complaint investigation and discipline,
Ensuring professional development and ethical conduct.
Court decisions support the Board’s authority to regulate and discipline midwives to maintain high standards of care.
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