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Direct Entry Midwifery Permanent Administrative Rules, TXA Education and Training

Wednesday, July 5, 2023

The Board of Direct Entry Midwifery (Board) and the Health Licensing Office (HLO) filed permanent rules for direct entry midwifery with the Oregon Secretary of State's Office on April 28, 2023, and June 28, 2023. Permanent rules related to peer review and legend drugs and devices were effective on May 1, 2023. Permanent rules for risk assessment practice standards were effective on June 28, 2023.

The permanent rules will be published in the May and June 2023 Oregon Bulletin and are also available on the HLO laws and rules web page for the Board.

Tranexamic Acid (TXA) Education and Training Session
OAR 332-026-0010 has been amended to add Tranexamic Acid (TXA) to the list of drugs an LDM can administer by intravenous infusion to a birthing person as an anti-hemorrhagic to control bleeding. If an LDM chooses to purchase and administer TXA, education and training are required. The Board requested HLO develop an FAQ related to TXA. The FAQ will be available at a later date.

The Oregon Midwifery Council [1](OMC) held a live online education and training session regarding TXA on May 16, 2023.

  • The live online education and training session has been recorded, so LDMs and students who could not attend are still able to get the education and training. To obtain the recorded education and training session, you must register and pay OMC the fee listed below. Once OMC has received the payment, the education and training session will be sent by email.
  • Tickets are $25 for OMC members, $30 for non-members, and no cost to BIPOC LDMs and students.
  • For more information regarding the TXA Education and Training Session, email:


[1] The Office is sharing the information it received from OMC as a courtesy to OMC and licensees. The sharing of this information should not be interpreted as the HLO or the Board endorsing or approving the TXA education and training session. It is each individual licensee's responsibility to obtain adequate education and training before administering or purchasing any legend drug or device. 

Jaqxun Darlin, CPM, LDM, LTM, is leading the education and training session for LDMs and students who want to learn how to use TXA for postpartum hemorrhage (PPH). The education and training session reviews the research and case studies and includes a real-time demonstration of administering TXA. Other topics include prevention and management of PPH, how and when to use TXA, and when TXA should not be used. A practice protocol quick reference will be provided to participants.

For more information regarding this communication, please call Samie Patnode at (503) 373-1917, or email

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