The Board-Approved Informed Consent Form – Direct Entry Midwifery is the written informed consent that a Licensed Direct-Entry Midwife (LDEM) in Montana obtains before accepting a woman into care. It is published by the Montana Board of Alternative Health Care, part of the Department of Labor and Industry's Business Standards Division. The patient initials six disclosure items, and both the patient and the LDEM sign and date it. On FillingPDF you can fill out the form online and download or print the completed PDF; the Board publishes the official PDF at the link shown on this page.
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What is Informed Consent – Montana?
The Board-Approved Informed Consent Form – Direct Entry Midwifery is the Montana Board of Alternative Health Care's written consent document, which a Licensed Direct-Entry Midwife (LDEM) completes with a patient to record that the patient has read and understood the key facts about midwifery care.
The form rests on Title 37, Chapter 27 of the Montana Code Annotated. Under MCA 37-27-311, an LDEM must first obtain written informed consent before accepting a woman into care. The form is described as the LDEM's own words on informed consent for midwifery care, and the patient initials each of six sections:
- the LDEM's educational background, the nature and scope of care, and the possibility of and procedure for transport to a hospital;
- the available alternatives to the LDEM's care;
- the risks of home birth, mainly conditions that may arise during delivery;
- the advice to consult a physician at least twice during pregnancy;
- whether the midwifery services are located more than 50 miles from the nearest hospital;
- the limit on a health care provider's liability for good-faith emergency care to an LDEM's patient, which covers damages caused by gross negligence or by willful or wanton acts or omissions.
The form's preamble also states that LDEMs must file birth certificates and follow recommended blood screening tests for mother and newborn, and that they are not required by law to carry malpractice insurance. The form has a place for additional information to be attached.
Who needs to file Informed Consent – Montana?
Licensed Direct-Entry Midwives (LDEM) in Montana use this form. Before accepting a woman into care, an LDEM must first obtain written informed consent under MCA 37-27-311, and this is the Board-approved form for that consent.
The patient or client is the other party. She reads the form, initials each of the six sections to show she has read and understood them, and signs and dates it. The LDEM also signs and dates it and enters a license number.
The form applies to care by a Licensed Direct-Entry Midwife. It describes direct-entry midwifery as not being the practice of medicine, certified nurse-midwifery or emergency medical care when the midwife advises, attends or assists during pregnancy, labor, natural childbirth or the postpartum periods and the pregnancy is not a high-risk pregnancy. The form does not say that anyone may sign for the patient.
When to file Informed Consent – Montana
Complete the form before the LDEM accepts the woman into care. The form states that, prior to accepting a woman into care, a Licensed Direct-Entry Midwife shall first obtain written informed consent per MCA 37-27-311. The form prints no due date or renewal period of its own, and the printed revision date is 01/2024.
How to fill out Informed Consent – Montana
Read the introductory statements
Review the Board's opening text, which cites MCA 37-27-311, the scope of LDEM practice and the filing and screening duties of LDEMs. The patient should read it before initialing anything.
Initial the care and transport section
Initial the first line, covering the LDEM's educational background, the nature and scope of care, and the possibility of and procedure for hospital transport.
Initial alternatives and home birth risks
Initial the line on the available alternatives to the LDEM's care and the line describing the risks of home birth, mainly conditions that may arise during delivery.
Initial the physician and distance items
Initial the line stating that the patient was advised to consult a physician at least twice during pregnancy. Then initial the line on whether services are located more than 50 miles from the nearest hospital.
Initial the liability limitation
Initial the last line about a health care provider's liability for good-faith emergency care to an LDEM's patient, limited to damages caused by gross negligence or by willful or wanton acts or omissions.
Add any additional information
If the LDEM wants to give more information, attach or include it, as the form allows.
Sign and date for the patient
The patient or client signs on the Patient/Client Signature line and enters the date.
Sign, date and add the license number
The LDEM signs on the LDEM Signature line, enters the date and writes the license number on the License # line.
Review and download the completed PDF
Check that all six sections are initialed and both signatures and dates are present. Download or print the completed PDF from FillingPDF and keep it as the written consent.
How to submit Informed Consent – Montana
The form prints no filing channel, portal or mailing address for returning it; it is a written consent that the LDEM obtains from the patient before accepting her into care. For questions about the form, the Montana Board of Alternative Health Care lists these contact details on it:
- Mail: 301 South Park, 4th Floor, PO Box 200513, Helena, Montana 59620-0513.
- Phone: (406) 841-2394.
- Email: [email protected].
- Website: www.althealth.mt.gov, where the complete rules and regulations are posted.
FillingPDF lets you fill out and download the PDF; submission follows the channels above.
Common mistakes to avoid
- Leaving one of the six sections without the patient's initials; the form asks the patient to initial each section as read and understood.
- Having the form signed after the woman has already been accepted into care; the LDEM must first obtain written informed consent.
- Omitting the date next to the patient or LDEM signature.
- Leaving the LDEM's License # line blank at the bottom of the form.
- Skipping the 50-mile item; the form asks whether the midwifery services are located more than 50 miles from the nearest hospital.
- Treating the form as proof that the midwife carries malpractice insurance; the form says LDEMs are not required by law to carry it.
- Leaving out extra information the LDEM wants to give; the form says additional information may be attached or included.
Frequently asked questions
What is the informed consent form for direct-entry midwifery in Montana?
It is the Board-Approved Informed Consent Form – Direct Entry Midwifery from the Montana Board of Alternative Health Care. A Licensed Direct-Entry Midwife uses it to obtain the written informed consent that MCA 37-27-311 requires before accepting a woman into care.
Who has to sign the informed consent form?
Both the patient or client and the Licensed Direct-Entry Midwife sign and date it. The patient also initials each of the six sections, and the LDEM enters a license number at the bottom of the form.
When must the LDEM get informed consent?
Before accepting the woman into care. The form states that an LDEM shall first obtain written informed consent per MCA 37-27-311. It prints no separate deadline or renewal period.
What does the patient initial on the form?
Six items: the LDEM's background, scope of care and hospital transport; alternatives to LDEM care; home birth risks; the advice to see a physician at least twice; whether services are over 50 miles from a hospital; and the limit on provider liability in good-faith emergencies.
Can I fill out the informed consent form online?
Yes. You can fill out the PDF online on FillingPDF and download or print it. FillingPDF is an independent service, not the Board, and does not file or send the form; the signed consent stays with the parties as the form describes.
Does the midwife need malpractice insurance under this form?
The form states that Licensed Direct-Entry Midwives are not required by law to carry malpractice insurance. It also says they must file birth certificates and follow recommended blood screening tests for mother and newborn.
Where can I find the Board's rules for direct-entry midwives?
The form says the complete rules and regulations are on the Board website at www.althealth.mt.gov. You can also contact the Board at (406) 841-2394 or [email protected], or write to PO Box 200513, Helena, Montana 59620-0513.
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