Midwifery Bill

We need your help now!

Mass Midwifery Supporters–you ROCK!!!

Thanks to your calls, Rep. Spiliotis has lifted her hold on the Midwifery Bill!

Against all the odds, the bill is on the move again and headed toward the finish line at the eleventh hour, so KEEP THE CALLS TO THE SPEAKER’S OFFICE COMING.  If you have the time, please forward this message to all of your family and friends here in the Commonwealth, asking them to reach out, too!

Call, email, or fax the Speaker and the State House today (Saturday) in support of the Midwifery Bill, House 4180. The legislature is still in session so please keep the calls coming!!!

Speaker DeLeo’s number is:
Telephone: 617-722-2500
Facsimile: 617-722-2008
E-Mail: Robert.DeLeo@state.ma.us

Even if you’re not a constituent, please call him as he serves as Speaker for the State and is responsible to all residents of the Commonwealth.

Please keep the phones lit and keep spreading the word!!!

Thanks so much for your continued support!!!  We’re almost there!!!

Keep the pressure on!!!


Ann Sweeney

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.

Supporting documents you can to email to you representative are:

a.     Full text of bill

b.     Bill fact sheet

c.     Evidence-Based Maternity Care Report (AKA The Milbank Report)

When you’ve contacted your representative or his/her aide, please send us an email letting us know their response at info@mfom.org

Many, many thanks for your help.

What is the midwifery bill?

The bill is to establish a board of midwifery in Massachusetts that regulates all midwives. Although a pretty dry “regulatory” bill, this is an important improvement for many reasons. First, there are about 400 certified nurse midwives catching babies in the state hospitals and two birth centers in Massachusetts who are currently regulated under the state nursing board. Unfortunately, nurse midwives are less than 4% of the state’s nurses, and their regulations have not been updated since the late 1980’s. Massachusetts is one of only six states that still defines the relationship between CNMs and physicians as “supervisory” rather than “collaborative”. This hinders nurse midwives’ abilities to manage thier own freestanding birthing centers, for example, so that the state has none. Currently, many Massachusetts moms to drive to New Hampshire for this type of birthing option. It also makes Massachusetts a less desirable place for nurse-midwives to seek employment compared to other states.

There are approximately 40 certified professional midwives who have received national certification from the North American Registry of Midwives who would receive licensure  to catch babies at home by this board. This ensures that families who choose home birth can have confidence in the standardized training of CPMs, ensure that CPMs have access to necessary emergency medicines, and are practicing legally.

The bill establishes a board comprised of nurse midwives, homebirth midwives, physicians, nurses, and consumers who can improve the choices, safety, and access of midwifery services by offering a far more specialized oversight invested in seeing midwifery flourish in Massachusetts.

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