Accountability Committee Update
The NARM Accountability process provides a forum for families who choose CPMs as their care providers and states who utilize the CPM for legal recognition to have complaints addressed.
Previously, NARM Complaint Reviews were conducted by a committee of CPMs in the community of the midwife under review. The disadvantage has always been that it can be challenging to recruit enough midwives to process complaints on a local level. The shift to virtual Complaint Review during the past three years revealed the benefits of drawing from a larger pool of midwives to evaluate competency and professional conduct.
During the past year, NARM created a process to train CPMs from across the nation to serve on a standing national Accountability committee. The goal is to provide consistent Complaint Reviews with well trained CPMs. This committee was assembled from midwives who responded to the invitation sent to all CPMs in November 2023.
Additionally, the committee will recruit local midwives to participate in Complaint Reviews to offer insight into local community standards as well as challenges faced regionally. We anticipate the shift to a standing committee will improve and expedite the process for the growing community of CPMs.
The NARM Accountability Committee will begin reviewing complaints in January 2024.
Ask NARM: What Counts as an Initial Prenatal Exam?
One of the questions addressed to NARM is, “what counts or doesn’t count as an Initial Prenatal Exam?” In practice, CPMs may perform some of the physical exam skills over several visits or not at all in some circumstances. To reflect actual practice, NARM has updated the definition of The Initial Prenatal Exam to separate the physical exam skill requirements from the Initial Prenatal Exam. NARM still requires all of the Maternal Health Assessment skills to be performed by student midwives, but they are not all required to be performed during the Initial Prenatal Exam.
Initial Prenatal Exam: The Initial Prenatal Exam should be performed by the student midwife at their first encounter with the client over no more than two visits for the purpose of screening suitability for out of hospital birth. It includes an intake interview, history (medical, gynecological, family), and physical assessment. The client must be offered all the assessments listed in Skills Verification Form 201a, Maternal Health Assessment, “Performs a physical examination.” NARM respects the right of the client to decline the physical exam as a whole or in part. When the client exercises this right of refusal, this should be noted in their chart, and the Initial Prenatal Exam may still count on Form112b even without a full physical examination.
This policy update was approved in November 2023, and the CIB and website have been updated to reflect these changes.
eBlast emailed December 30, 2023