The State Board Of Nursing And The State Board Of Healing Arts v. Ruebke

913 P.2d 142 (1996)

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Nature of the Case

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Facts

Ps alleged that D held herself out as a certified midwife; had been offering prenatal, labor, and delivery services to pregnant women in Kansas; and had been functioning as a registered professional nurse and/or a practitioner of the healing arts. The hearing on Ps' motion for a temporary injunction revealed that D acts as a lay midwife comprehensively assisting pregnant women with prenatal care, delivery, and post-partum care. D is president of the Kansas Midwives Association and follows its promulgated standards, which include a risk screening assessment based upon family medical history; establishing prenatal care plans, including monthly visitations; examinations and assistance in birth; and post-partum care. D works with supervising physicians who are made aware of her mode of practice and who are available for consultation and perform many of the medical tests incident to pregnancy. D is available to members of her church, friends, and Christians who hear about her by word of mouth. She delivers babies throughout the state and has supervising physicians in many different regions. D does not charge for her services and considers them to be a ministry. Some families have given her money, others goods, and many have given her nothing. D follows a consent decree dated November 15, 1984, from the District Court of Finney County, Kansas, in State ex rel. Board of Healing Arts v. Hitchcock: “Defendant shall be permitted to engage in the practice of midwifery in the State of Kansas, and such practice shall not be considered the practice of healing arts or the practice of medicine and surgery, so long as she utilizes a licensed physician in the vicinity who has agreed to be available in case of complications and to be available for consultation and examination, and so long as she will provide such physician with her prenatal records of the patient in the event the physician so requests prior to delivery.” Dr. Debra L. Messamore, an obstetrician/gynecologist, testified that the prenatal assessments made by D were obstetrical diagnoses and the standard of care relating to post-delivery conditions of the mother and baby involved obstetrical judgments. She reviewed the birth records of the Butterfield birth and testified that obstetrical or medical judgments were reflected. Although admitting that many procedures at issue could be performed by a nurse rather than a physician. Ginger Breedlove, a Kansas certified advanced registered nurse practitioner, and nurse-midwife testified that nursing functions were involved. The trial court held that provisions of both acts were unconstitutionally vague, D's midwifery practices did not and were not intended to come within the healing arts act or the nursing act, and her activities fell within exceptions to the two acts even if the acts did apply and were constitutional. Ps appealed.