Prescriptive Authority for Direct Entry Midwives in Washington State: Increasing Client Access to Contraception

IF 2.1 4区 医学 Q2 NURSING
Britney Zell CPM, MSM, LM, Kristin Effland CPM, MA, Mercedes Snyder CPM, LM, Karen Hays CNM, DNP, ARNP (ret.), Wendy Gordon CPM, DM, MPH, LM
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Abstract

Improving health and achieving health equity includes access to sexual and reproductive health care for all populations, especially those most in need. However, access to life-saving and life-affirming contraception with an individual's chosen perinatal provider can be impeded by restrictive regulations that limit scope and practice authority. This is especially true for the majority of community and direct entry midwives in the United States who have historically been unable to legally provide effective contraceptive methods. Recently, licensed midwives in Washington state were the first in the nation to achieve prescriptive authority, enabling their clients to directly obtain contraception and access to medications for common prenatal and postpartum conditions. Sustained advocacy efforts in the state's capitol enabled the Midwives’ Association of Washington State to build relationships over time with legislators and government agencies to achieve this long-term goal. We present a successful midwifery-led innovation that achieved scope expansion for licensed midwives whose practice authority was limited by restrictive laws. Lessons learned are described and strategies offered to aid midwives and their advocates in other locales who want to improve health equity and access to contraception. Midwives are well positioned to provide this essential care to individuals living in underserved rural and urban areas and those from historically marginalized communities, but their ability to do so is limited by restrictive legislation.

华盛顿州直接进入助产士的处方权:增加客户获得避孕药具的机会。
改善健康状况和实现健康公平包括让所有人群,尤其是那些最需要的人群获得性健康和生殖健康护理。然而,个人所选择的围产期医疗服务提供者可能会因为限制范围和执业权限的限制性法规而阻碍获得挽救生命和肯定生命的避孕措施。对于美国大多数社区助产士和直接入职助产士来说,情况尤其如此,因为她们历来不能合法地提供有效的避孕方法。最近,华盛顿州的持证助产士在全美率先获得了处方权,使她们的客户能够直接获得避孕药具,并获得治疗产前和产后常见疾病的药物。华盛顿州助产士协会通过在州议会的持续宣传努力,与立法者和政府机构建立了长期关系,从而实现了这一长期目标。我们介绍了一个由助产士主导的成功创新案例,该案例为执业权力受限于限制性法律的持证助产士实现了范围扩张。我们还介绍了所吸取的经验教训,并提出了一些策略,以帮助其他地区希望改善健康公平和避孕机会的助产士及其倡导者。助产士完全有能力为生活在服务不足的农村和城市地区的个人以及来自历史上被边缘化的社区的人提供这种必要的护理,但她们这样做的能力受到了限制性法律的限制。
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来源期刊
CiteScore
3.60
自引率
7.40%
发文量
103
审稿时长
6-12 weeks
期刊介绍: The Journal of Midwifery & Women''s Health (JMWH) is a bimonthly, peer-reviewed journal dedicated to the publication of original research and review articles that focus on midwifery and women''s health. JMWH provides a forum for interdisciplinary exchange across a broad range of women''s health issues. Manuscripts that address midwifery, women''s health, education, evidence-based practice, public health, policy, and research are welcomed
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