312

LAWS OF MARYLAND

Ch.8

As to subsection (b)(2) through (6) of this
section, the attention of the General Assembly is
called to the fact that the current practice of
licensed nurse midwives is broader than the
practice delineated in this law. Specifically,
licensed nurse midwives frequently select and
administer drugs from a medical directive
established by a physician. Since it is often
impossible to predict when a pregnancy or
childbirth becomes or will become abnormal,
licensed nurse midwives do, in emergency and
similar situations, undertake charge of abnormal
cases of pregnancy and attend women in abnormal
cases of childbirth. Also, it sometimes is
almost impossible to draw a line between the
"normal" pregnancy or childbirth and the
"abnormal" pregnancy or childbirth. In addition,
since "disease" can encompass common problems
such as anemia, licensed nurse midwives under
certain circumstances undertake charge of
administering care for a disease that relates to
childbirth.

In subsection (b)(4) and (5) of this section, the
prohibitions of present Art. 43, § 87 are revised
as scope restrictions to clarify that these
illegal acts are not part of the practice of
midwifery.

In subsection (b)(5) of this section, the phrase
"except under the personal direction and
supervision of a physician", is new language
added to clarify that a licensed nurse midwife
has the same scope of action as an unlicensed
individual. This addition is called to the
attention of the General Assembly.

In subsection (b)(6) of this section, the phrase
"prophylactic against gonococcal ophthalmia
neonatorum" is added to clarify the duty of a
licensed nurse midwife under Art. 43, § 38B of
the Code.

The last clause of present Art. 43, § 85, which
prohibits a licensed nurse midwife from using a
designation that implies that the licensed nurse
midwife may take an action outside of the
authorized scope of practice, is deleted as
unnecessary.

The first clause of present Art. 43, § 85 now
appears in § 7-609 of this subtitle.

The balance of present Art. 43, § 87 now appears
in §§ 7-606 and 7-610 of this subtitle.