In the Matter of the Accusation Against: Case No. 1M-98-83794
ALISON OSBORN, L.M. OAH No. N-1999040052
P.O. Box 453; Grass Valley, CA 95945
Licensed Midwife No. LM- 16,
This matter came on regularly for hearing before Jaime Rene' Roman, Administrative Law Judge, Medical Quality Hearing Panel, Office of Administrative Hearings, in Sacramento, California, on August 16 - 20, 1999.
Complainant was represented by Mara Faust, Deputy Attorney General, Health Quality Enforcement Section, Department of Justice, State of California.
Respondent Alison Osborn, L.M. ("Respondent"), appeared by, with and through her counsel of record, Nossaman, Guthner, Knox & Elliott, LLP, Attorneys at Law, by John T. Kennedy,Esq.
During the proceeding, Complainant moved to dismiss the Fourth Cause of Action in the Accusation for want of proof. There being no objection, the motion was granted. Subsequently, Complainant moved to file a First Amended Accusation, adding an additional cause of action; the motion, over objection, was granted.
Evidence was received and the matter deemed submitted on August 20, 1999.
Synopsis of August 1999 Judicial Ruling
Medical Board of California vs.
Licensed Midwife Alison Osborn
The Administrative Judge ruled that:
1) midwifery was a separate and distinct discipline from that of the practice of medicine
2) midwifery standards of practice were unique from that of medicine’s
3) it was inappropriate for midwifery practice or its practitioners to be judged by medical doctors imposing medically-based standards.
"[m]idwifery presumes that childbirth is a healthy and normal event." Midwifery involves "socially oriented preventive care, which incorporates prenatal care and a concern for the social and emotional aspects of pregnancy and birth in order to meet the individual needs of each woman."' "Decision making is collaborative. "
In regard to physician supervision the Judge acknowledged that the medical community of obstetricians was “hostile to licensed midwives”, that “As a consequence of such hostility” midwives were “unable to gain supervision by a physician and surgeon”.
He states that “evidence presented this tribunal further establishes that, with the exception of one licensed midwife who is also a licensed physician assistant, no California licensed midwife, despite efforts for supervision, possesses a supervising physician.... Nevertheless, the evidence further established that Respondent uses at least one physician for collaborative consult, collaborative assistance, and emergent issues.” (emphasis added)
Judge Roman went on to say that the midwife “presented competent and credible evidence in the form of witnesses and documents” that “She avidly seeks, along with other midwives, to be part and parcel of the healthcare team that serves the residents of California.”
“Were this tribunal to employ the medical model on licensed midwifery, as Complainant (MBC) urges, no home births could be competently assisted. Mindful that licensed midwives, with only one exception presented before this tribunal, possess no hospital privileges, the legislation would function to permit lay persons to possess a license that would not be functional anywhere within the State of California. This tribunal declines Complainant's offer.” (emphasis added)
“In an effort to practice their art, virtually all of California's 109 licensed midwives, including Respondent, have, with the cooperation of physicians sympathetic to their plight and who seek to expand the options available to patients, developed a relationship that involves collegial referral and assistance, collaboration, and emergent assistance without direct or accountable physician and surgeon supervision of licensed midwives. In an effort to promote the efficacy of the Act, this tribunal concludes, at this time, that a licensed midwife who possesses a relationship with a California physician and surgeon as referenced herein has feasibly and reasonably satisfied the ambit of the Act”.
Accordingly, cause does not exist to revoke or suspend the license of Respondent pursuant to Business and Professions Code section 2519(e), in conjunction with sections 2507(a) and 2507(b), for unprofessional conduct arising from lack of supervision.