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​Direct Entry Midwifery Proposed Administrative Rules

Thursday, March 2, 2023

The Board of Direct Entry Midwifery, under the Health Licensing Office, has filed proposed rules with the Oregon Secretary of State. 

The proposed rules:

  • Amend the peer review requirements to clarify that licensed direct entry midwives (LDMs) who “attend" births must present at least two peer review cases per year with an Oregon midwifery peer review organization or midwifery quality improvement organization that maintains a charter and standards for peer review.
  • Adds “fetal growth restriction" to indication for consult during pregnancy (antepartum). There has been confusion in the midwifery community that the indication to transfer during pregnancy (antepartum) regarding abnormal fetal surveillance testing, including but not limited to, biophysical profile, non-stress test, and auscultated acceleration testing, includes “fetal growth restriction." The Rules Advisory Committee (RAC) determined that there are enough variables regarding “fetal growth restriction" that it should be separate from abnormal fetal surveillance testing and added to the indication to consult, which requires the LDM to either transfer care or consult with an Oregon licensed health care provider, communicate to the birthing person all recommendations, obtain informed consent, and make a plan for the birthing person. Consultation information must be documented in the birthing person's record of care.
  • Adds Tranexamic Acid (TXA) to the list of legend drugs for maternal use by DEMs to stop bleeding. 

The proposed rules will be published in the March 2023, Oregon Bulletin

You are invited to review the proposed rules and submit comments from March 1, 2023, through 12 p.m. (noon) on March 28, 2023. To submit your comments by email, send them to Samie Patnode at:

Written comments can also be submitted by postal mail to:

Attn: Samie Patnode Health Licensing Office 1430 Tandem Ave. NE, Suite 180 Salem, OR 97301-2192 

A public rule hearing has been scheduled for March 16, 2023, from 9 to 10 a.m. Stakeholders can participate:

  • In person at the Health Licensing Office board room, 1430 Tandem Ave. NE, Suite 180, Salem, OR 97301; or
  • By telephone conference call by calling 503-934-3605 and entering participant code 530340.

Comments will not be accepted, nor considered, if received after 12 p.m. (noon) on March 28, 2023. For more information or to request alternative formats, please call Samie Patnode at (503) 373-1917 or email

Permanent administrative rules are anticipated to become effective on May 1, 2023.

This email will be made available in an accessible alternative format upon request. Please contact April Fleming at, or by calling (503) 509-5127; or Derek Fultz at, or by calling (503) 373-1915. All relay calls are accepted.