Archive for 27 July 2010

URGENT Action Alert: Please post to all lists!!!

Dear Midwifery Supporters,

Good news!!!  We are steps away from getting the midwifery bill—that so many of us have worked on for so long—passed this legislative session, which ends THIS SATURDAY, 31 July.

Even if you have already done so, please call and/or email your OWN Mass Rep. and Senator today, tomorrow, or day you can this week, and ask your own representative to reach out to Speaker DeLeo, asking him to bring the bill to the House floor for a vote and to help the bill pass THIS SESSION. Note that the bill is now known as House 4810:  An Act Relative to Certified Professional Midwives and Enhancing the Practice of Nurse-Midwives.

Who’s your rep?  You can find them at the following link: http://www.wheredoivotema.com/bal/myelectioninfo.php

Text of the bill can be found at the following link:  http://www.mass.gov/legis/bills/house/186/ht04/ht04810.htm

Thank you again to the whole coalition for all of your excellent work.  We could not have come this far without everyone’s expertise, experience, passion, and all the good work you are already doing to address this critical issue.

Keep the pressure on!!!

Best,

Ann Sweeney
MFOM
617-901-2777

P.S.  We’ve recently heard that there is a surprising amount of misinformation about the midwifery bill among many representatives, especially regarding the items below, so please share/forward this email to your representatives or their staffers who might help correct the record for other Representatives.

1.       The Mass Medical Society strongly objects to CNMs functioning without direct MD supervision, yet has articulated no sound basis for this objection. Nationally, ACOG already supports the elimination of direct supervision of CNMs by physicians, acknowledging that it is not required for safe practice, and 44 other states no longer have such requirements. This requirement is the reason full-scope CNM services are not now accessible in high-need Massachusetts communities such as Lawrence and Worcester. Requiring such supervision creates excessive and unnecessary liability for physicians, so it is even more puzzling to witness the continued opposition of the Massachusetts ACOG chapter to this feature of the bill.

2.       Some legislators have been led to believe that the bill would provide new prescription writing privileges for nurse-midwives, when this is not really the case. Nurse-midwives already have prescription writing privileges but can now exercise these privileges only if an MD is technically providing supervision, which amounts merely to a review of sample prescriptions on a quarterly basis. Because of hospital accrediting rules, this clause prevents CNMs from admitting patients in labor under the midwives’ own names, prevents them from serving on hospital committees which determine maternity care policies, and bars them from any control of their own practice environment. This undermines the ability of CNMs to provide the most effective care. (By the way, CNMs already have independent prescription authority in most other states, for example: NM, NH, WA, AK, OR, and the District of Columbia.)

3.       Although the legislation has already been rewritten to accommodate concerns about the age at which a midwife could begin training (it was changed from 18 years to 21 years), legislators are still being misled about this fact. (There are, by the way, no such age requirements that we have been able to find in the Massachusetts statutes with respect to the education of nurses.)

4.       Another objection is that the bill does not require a midwife to carry malpractice insurance. In almost all states, malpractice insurance is not required by statute, and it would be unfair to single out one professional group in this regard. Some would argue that such a requirement would violate equal protection clauses. Because the ‘risk pool’ of homebirth midwives across the country is small, malpractice insurance has never been available for homebirth midwives, despite the concerted efforts of national and local organizations over several decades. Requiring CPMs to adhere to a standard that is impossible is another mechanism to restrain trade and prevent access to home birth midwives. Childbearing women who want to be protected by malpractice insurance have the option of delivery in facilities, where such insurance coverage is required.  Moreover, the Massachusetts legislature could, like a few other states, make disclosure of this absence of malpractice insurance coverage part of a required informed consent procedure. The malpractice insurance issue is NOT a credible objection to this bill.

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27 July 2010 at 12:17 pm Leave a comment


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