自然疗法助产 - 自然疗法医生法 - 商业与专业 - CA

Section § 3650

这项法律规定，自然疗法医生如果完成了额外培训并获得了委员会颁发的专业证书，就可以协助分娩。

自然疗法医生如果已完成额外培训并获得委员会颁发的专业执业证书，则可以进行自然疗法分娩助产。

自然疗法医生分娩助产额外培训

Section § 3651

要在加州获得自然疗法分娩助产的专业执业认证，自然疗法医生需要通过与助产相关的特定考试，并证明他们符合特定的教育要求。他们必须完成一个类似于美国护士助产士学院认可项目的助产学或产科专业课程，或者拥有来自其他州且符合加州标准的类似教育和执照。这种培训涵盖母婴健康、沟通技巧以及其他相关医学知识等领域。

In order to be certified for the specialty practice of naturopathic childbirth attendance, a naturopathic doctor shall obtain a passing grade on the American College of Nurse Midwives Written Examination, the American College of Naturopathic Obstetricians Examination, or a substantially equivalent examination approved by the board, and shall establish, to the board’s satisfaction, compliance with one of the following requirements:

(a) Successful completion of a certificate of midwifery or naturopathic obstetrics specialty from an approved naturopathic medical education program consisting of not less than 84 semester units or 126 quarter units that substantially complies with the following educational standards and requirements:

(1) The curriculum is presented in semester or quarter units under the following formula:

(A) One hour of instruction in theory each week throughout a semester or quarter equals one unit.

(B) Three hours of clinical practice each week throughout a semester or quarter equals one unit.

(2) The program provides both academic and clinical preparation that is substantially equivalent to that provided in a program accredited by the American College of Nurse Midwives. The program includes, but is not limited to, preparation in all of the following areas:

(A) The art and science of midwifery, one-half of which shall be in theory and one-half of which shall be in clinical practice. Theory and clinical practice shall be concurrent in the areas of maternal and child health, including, but not limited to, labor and delivery, neonatal well care, and postpartum care.

(B) Communications skills that include the principles of oral, written, and group communications.

(C) Anatomy and physiology, genetics, obstetrics and gynecology, embryology and fetal development, neonatology, applied microbiology, chemistry, child growth and development, pharmacology, nutrition, laboratory diagnostic tests and procedures, and physical assessment.

(D) Concepts in psychosocial, emotional, and cultural aspects of maternal and child care, human sexuality, counseling and teaching, maternal and infant and family bonding process, breast feeding, family planning, principles of preventive health, and community health.

(E) Aspects of the normal pregnancy, labor and delivery, postpartum period, newborn care, family planning, or routine gynecological care in alternative birth centers, homes, and hospitals.

(3) The program integrates the following subjects throughout its entire curriculum:

(A) Midwifery process.

(B) Basic intervention skills in preventive, remedial, and supportive midwifery.

(C) The knowledge and skills required to develop collegial relationships with health care providers from other disciplines.

(D) Related behavioral and social sciences with emphasis on societal and cultural patterns, human development, and behavior related to maternal and child health, illness, and wellness.

(4) Instruction in personal hygiene, client abuse, cultural diversity, and the legal, social, and ethical aspects of midwifery.

(5) Instruction in the midwifery management process which shall include all of the following:

(A) Obtaining or updating a defined and relevant database for assessment of the health status of the client.

(B) Identifying problems based upon correct interpretation of the database.

(C) Preparing a defined needs or problem list, or both, with corroboration from the client.

(D) Consulting, collaborating with, and referring to, appropriate members of the health care team.

(E) Providing information to enable clients to make appropriate decisions and to assume appropriate responsibility for their own health.

(F) Assuming direct responsibility for the development of comprehensive, supportive care for the client and with the client.

(G) Assuming direct responsibility for implementing the plan of care.

(H) Initiating appropriate measures for obstetrical and neonatal emergencies.

(I) Evaluating, with corroboration from the client, the achievement of health care goals and modifying the plan of care appropriately.

(b) Successful completion of an educational program that the board has determined satisfies the criteria of subdivision (a) and current licensure as a midwife by a state with licensing standards that have been found by the board to be substantially equivalent to those adopted by the board pursuant to this article.

自然疗法分娩美国护士助产士学院自然疗法产科

Section § 3651.5

获得助产认证的自然疗法医生必须保持其新生儿复苏和心肺复苏的最新认证。他们还需要向委员会提交一份计划，说明他们将如何与其他医疗保健提供者进行会诊，在一切正常时如何在受过产科培训的监督医生指导下工作，以及如何处理紧急情况，包括在需要时将母亲和婴儿转运到医院。

获得自然疗法助产专业执业认证的自然疗法医生应履行以下两项职责：

(a) 保持新生儿复苏和心肺复苏的当前认证。

(b) 向委员会提交一份关于以下事项的书面计划：

(1) 与其他医疗保健提供者会诊。

(2) 在分娩进展符合公认正常标准的情况下，由具有产科当前执业经验或培训的执业医师和外科医生进行监督，以协助产妇分娩。该计划应规定，所有并发症应立即转诊给医师和外科医生。

(3) 将婴儿或产妇（或两者）紧急转运和运送至适当的医疗保健机构，并获得新生儿重症监护室、产科病房或其他患者护理区域的使用权。

自然疗法助产新生儿复苏心肺复苏

Section § 3652

如果您持有自然疗法分娩执业证书，该证书将与您的自然疗法医生执照同时到期。要续签此证书，您需要支付费用并提供30小时在分娩、助产或产科等领域的继续教育证明。其中，15小时可以计入所有自然疗法医生所需的总教育学分。如果您的执照受到任何纪律处分，除非另有明确说明，否则也会影响您的分娩执业证书。但如果问题仅涉及您的分娩执业，他们可能只会限制您工作的这一部分，而不是您的整个执照。

(a) 自然疗法分娩助产专业执业证书应与持证人的自然疗法医生执照同时到期。

(b) 该证书可在提交委员会设定的续期费并提供令委员会满意的、完成30小时自然疗法分娩、助产或产科继续教育学分的证据后续期。其中15小时可计入自然疗法医生所需的60小时继续教育学分。

(c) 委员会或司法机关的执照或纪律处分应被视为对颁发给持证人的自然疗法分娩专业执业证书具有同等效力，除非执照或纪律处分中另有规定。当执照或纪律处分的主题专门涉及持有专业证书的持证人从事自然疗法分娩执业时，该处分可以，而非影响持证人执业的整个范围，仅暂停、撤销、附加条件或限制持证人在专业证书下的权限。

自然疗法分娩专业证书继续教育

Section § 3653

本法律规定，自然疗法助产士在分娩中不能使用某些医疗程序，例如产钳分娩、全身麻醉或脊髓麻醉、剖宫产，或进行会阴侧切术，除非他们符合特定的监督要求。此外，他们不允许处理与妊娠相关的并发症，并且必须将此类病例转诊给产科医生或其他合格的医生。

(a) 自然疗法助产不包括使用或实施以下任何一项：

(1) 产钳分娩。

(2) 全身麻醉或脊髓麻醉。

(3) 剖宫产分娩。

(4) 会阴侧切术，除非其符合第2746.52条规定的相同监督要求。

(b) 自然疗法助产不包括对妊娠、分娩、生产或新生儿期并发症的管理。所有并发症均应酌情转诊给产科医生或其他执业医师和外科医生。

自然疗法助产产钳分娩全身麻醉

Section § 3654

这项法律允许持有分娩助产认证的自然疗法医生使用与产妇和新生儿护理相关的特定药物和设备。他们可以施用产后止血药、抗生素、维生素K和RhoGAM等。他们还被允许使用多普勒（胎心仪）、注射器、复苏工具和吸乳器等特定设备，以协助分娩和产妇护理。

除第3640条规定外，持有自然疗法分娩助产专业证书的自然疗法医生可以施用、开具或执行以下任何事项：

(a) 产后止血药。

(b) 预防性眼科抗生素。

(c) 维生素K。

(d) RhoGAM。

(e) 局部麻醉药物。

(f) 静脉输液，限于乳酸林格氏液、5%葡萄糖乳酸林格氏液，以及用于静脉锁的肝素和0.9%氯化钠。

(g) 用于产妇过敏性休克，等待紧急转运的肾上腺素。

(h) 用于非免疫、非妊娠妇女的麻疹、腮腺炎和风疹（MMR）疫苗。

(i) 根据当前疾病控制中心指南，用于乙肝母亲所生新生儿的HBIG和GBV。

(j) 根据当前疾病控制中心指南，用于B族β溶血性链球菌（GBBS）产时预防的抗生素。

(k) 自然疗法分娩实践附带设备，具体而言，多普勒（胎心仪）、注射器、针头、静脉采血设备、缝合线、导尿管、静脉输液设备、羊膜穿刺钩、气道吸引装置、新生儿和成人复苏设备、血糖仪和离心机。

(l) 产妇护理附带设备，具体而言，弹力袜、孕妇托腹带、吸乳器、阴道隔膜和宫颈帽。

自然疗法分娩助产产后止血药预防性眼科抗生素

Section § 3655

如果自然疗法医生持有在家分娩助产的专业证书，他们必须向每位客户提供书面信息。这包括他们的资质详情、紧急情况计划的副本、在家分娩程序和风险的描述，以及他们的责任保险状况。客户必须签署这份表格，然后将其归档，并向客户提供一份副本。

(a) 持有自然疗法分娩助产专业证书的执业者，应当以书面形式向每位客户披露以下信息：

(1) 自然疗法医生的资质和资历。

(2) 用于咨询、紧急转诊和运送的书面计划副本。

(3) 在家中或医院以外环境分娩的程序、益处和风险的描述。

(4) 执业者从事自然疗法分娩助产业务的责任保险状况。

(b) 该表格必须由客户签署，归档在客户病历中，并向客户提供一份副本。

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