Obstetrics Consultations and Midwifery Liability
Campaigns against midwifery, starting at the beginning of the 19th century, set the table for strained relationships between physicians and midwives, persisting to the present time. Anti-midwifery sentiments, enhanced by the attitudes of J. Whitridge Williams (1912) and Joseph Bolivar DeLee (1915)*, ushered in an age of obstetrics and scientific medicine which were considered the only modern and realistic choice for safe and healthy childbirth in America.
Legal Standard of Care, Part 2
Another example of legislative language describing standard of care can be defined as the “degree of care and skill of the average CNM, taking into account the medical/midwifery knowledge available to her based on customary practices of the average CNM”. It is obvious that statutory legal terms exist to be argued about in court. A CNM provider will never hear this language in any graduate school midwifery classroom. Certified Nurse-Midwives do not acquire knowledge of the science, skills, ethics, and competencies of midwifery based on legislative standards. “Available knowledge” for a CNM/CM will be based on her education from an accredited midwifery education program.
Elements of Negligence
To be negligent is to act or fail to act in a way that causes injury to another person. Accidents happen, but what separates an unintentional accident from a negligent act is the standard of care. By neglecting the applicable and proper standard of care pertaining to a particular incident, an individual may be found liable for any resulting injuries. Negligence is a legal theory in civil law. The concept of negligence is closely related to determination of standard of care. Medical malpractice is considered a specific entity within the domain of negligence.
Legal Foundations For Certified Nurse-Midwifery Practice
CNMs and CMs must demonstrate compliance with the Core Competencies for Basic Midwifery Practice of the ACNM upon completion of their midwifery education programs and must practice according to the ACNM Standards for the Practice of Nurse-Midwifery. The Core Competencies define baseline midwifery practice; the collection of skills which every Certified Nurse-Midwife must have. American College of Nurse-Midwife competencies and standards are consistent with or exceed the global competencies and standards for the practice of midwifery as defined by the International Confederation of Midwives. To maintain the designation of CNM or CM, midwives must be recertified every five years through the American Midwifery Certification Board (AMCB) and must also meet specific continuing education requirements.[1]
Mid-level Mortification Part 2
“I really hate it when a nurse-practitioner is called a mid-level provider”. Mid-level provider is not a legal or academic term. It is slang developed to demean or minimize a health professional who is not an MD. The term “mid-level provider” is aimed at nurse-practitioners (NP’s), as well as physician assistants (PA’s), and certified nurse-midwives. It is insulting to health professionals as well as to the patients that they serve. Mid-level implies that he or she provides middle-of-the-road or average care. Who then delivers high-level care? It must be the MD, of course. So who delivers the lowest level of care? Nurses?
Statutory Constraints and Certified Nurse-Midwifery Scope of Practice
Scope of practice refers to the legally permissible boundaries of Certified Nurse-Midwife/Certified Midwife practice which are defined by State statute and regulation and, to a lesser degree, educational accomplishment, and certifying organization. 1 The 10th Amendment of the U.S. Constitution delegates professional regulation to the States for the health, safety and welfare of citizens.
Nurse-Midwifery Scope of Practice
DEFINITION OF MIDWIFERY AND SCOPE OF PRACTICE OF CERTIFIED NURSE-MIDWIVES AND CERTIFIED MIDWIVES Midwifery as practiced by certified nurse-midwives (CNMs) and certified midwives (CMs) encompasses the independent provision of care during pregnancy, childbirth, and the postpartum period; sexual and reproductive health; gynecologic health; and family planning services, including preconception care
Graduate Level Midwifery Education
Along with other misconceptions regarding nurse-midwifery practice, is the idea the CNMs/CMs are inadequately educated when compared with physicians. Historically, in the medical world and with the medicalization of normal women experiencing normal childbirth, anything short of a traditional medical school education was considered inferior. As previously mentioned, certified nurse-midwifery education has not been designed to confer skills specific to a medical model of care, although there is expected overlap between models for certain aspects of care.
Profiles of Nurse-Midwifery Practice and Obstetrical Practice in Maternity Care
Models of care define how health care services are delivered and the underlying philosophies which dictate how these services are provided. Nurse-Midwifery and medical models of care are based on each profession’s perspective and training in pregnancy and birth.
All Midwives Are Not The Same
Consumers and attorneys need to understand differences between midwives and the unique aspects of each practice. For instance, a CPM or a Lay midwife will be judged by a different standard of care than CNMs or CMs.
Diversified Midwifery Practice in the United States
As defined by the American College of Nurse-Midwives (ACNM), midwifery as practiced by CNMs and Certified Midwives (CMs) encompasses a full range of primary health care services for women from adolescence to menopause.
Awareness of Legal Risk in Midwifery Practice
When any of us embark on a career, especially as healthcare professionals, we do not expect to spend time in a courtroom, someday, accused of negligence and forced to defend the care we have provided.