Martha Merrill-Hall 7/7/25 Martha Merrill-Hall 7/7/25

Foreseeability Of Risk: A Tragic Clinical Summary

Martha Merrill-Hall 6/30/25 Martha Merrill-Hall 6/30/25

Mean Girls: Midwifery/Obstetrical Issues and Practice

Bullying and incivility in midwifery, nursing, and obstetrical practice have been the subject of several articles in the past few years. In 2008, JCAH published a sentinel event alert requiring all hospitals with their accreditation to have a policy in place for the confidential reporting of bullying without fear of repercussions.

Martha Merrill-Hall 6/27/25 Martha Merrill-Hall 6/27/25

Responsible Documentation of Patient Care IV

Some of the most frequently requested documents from health care institutions in preparation for litigation are Policies & Procedures. An example: Pitocin dosage and management, nursing protocols, electronic fetal monitoring, VBAC, shoulder dystocia, mag and pre-e, preterm labor, oxygen administration and neonates, AND Chain of command. Plaintiffs’ attorneys will compare relevant policies and procedures to the care provided and how it was documented.

Martha Merrill-Hall 6/25/25 Martha Merrill-Hall 6/25/25

Responsible Documentation of Patient Care: Avoiding Legal Risk III

Avoid comments in your documentation that can be considered “blaming” e.g. “I gave the order to the nurse but she never seems to listen to anything I say”. Generally avoid recording any negative conversations or disruptive team member behavior. This scenario will make any plaintiffs’ attorney jump fpr joy.

Martha Merrill-Hall 6/23/25 Martha Merrill-Hall 6/23/25

Responsible Documentation of Patient Care: Avoiding Legal Risk Part II

Affirmative Duty Documentation:

- Complications and emergencies requiring management by the health care team, if one exists.

- Timely and appropriate action of the care team.

- Identification of personnel contacted, their title, data reported, changes in patient status, what was requested, and outcome.

Martha Merrill-Hall 6/19/25 Martha Merrill-Hall 6/19/25

Responsible Documentation Of Patient Care: Avoiding Legal Risk: Part I

If you began your midwifery journey in Nursing School, you are familiar with documentation; paper and electronic. Although medical, nursing, and midwifery documentation was strictly paper for many decades, the current recording of patient care is with the electronic record aka EMR.

Martha Merrill-Hall 6/17/25 Martha Merrill-Hall 6/17/25

Common Legal Claims Against Midwives, Part II

During the course of a vaginal birth, a baby's shoulder can get caught on the mother's pubic bone, preventing the body of the baby to proceed down the birth canal for delivery. When this occurs, it is the result of shoulder dystocia.

Martha Merrill-Hall 6/11/25 Martha Merrill-Hall 6/11/25

Common Legal Claims Against Certified Nurse-Midwives and Certified Midwives - Part 1

All events that are associated with a shoulder dystocia must be carefully recorded in the medical record. Appropriate documentation allows an accurate record of what happened during the delivery, especially for attorneys and experts to review retrospecitvely, but also for reviewing your own experience.

Martha Merrill-Hall 6/9/25 Martha Merrill-Hall 6/9/25

Nurses On Trial: Malpractice Issues in OB Nursing

Aside from the field of Obstetrics, no other specialty in medicine or nursing must attend to two patients at once; one or more contained within the body of the other.

Martha Merrill-Hall 6/4/25 Martha Merrill-Hall 6/4/25

Shoulder Dystocia Maneuvers: The One Medicine Leaves Out

In the midst of a profusion of shoulder dystocia papers and publications, there is a notable absence of discussions regarding what is arguably the most effective, and least damaging, maneuver to relieve shoulder dystocia.

Martha Merrill-Hall 6/1/25 Martha Merrill-Hall 6/1/25

HIPAA - Health Insurance Portability and Accountability Act of 1996

HIPAA

When viewing this article, you may have the urge to skip it altogether and I can relate to your motivation. Anyone who has practiced or been employed in healthcare since 2003, has been thoroughly indoctrinated in HIPAA and what it represents. Either as a patient, or as a provider, HIPAA blurs our vision with its complex, legislative demands and potential penalties if we falter. Without delving too deeply into its complexities or inducing catatonia, the basics of HIPAA do deserve review in order to remind us all of the importance of this legislation and its relevance to midwifery practice.

Martha Merrill-Hall 6/1/25 Martha Merrill-Hall 6/1/25

News Briefs: Midwifery Issues and Practice For Consumers, Attorneys, Physicians and More . . .

A couple whose baby was taken away by the state after they chose to have their midwife treat the child for jaundice instead of taking it to the hospital filed a lawsuit against the Texas Department of Family and Protective Services.

Martha Merrill-Hall 5/26/25 Martha Merrill-Hall 5/26/25

Midwifery Profile and EMTALA - Part 4

Variations are appreciated and expected when encountering competing research findings. Women will always labor outside of research expectations, despite best practices and the predictions of labor models.

Martha Merrill-Hall 5/23/25 Martha Merrill-Hall 5/23/25

CNM/CM Legal Exposure in Triage - EMTALA Part 3

In the midst of enthusiasm and medical society endorsements for the data of Jun Zhang et al, the Friedman data do remain scientifically viable and legal for triage evaluation purposes. Admitting a patient at 4 cm is very unlikely to expose a triage midwife to an EMTALA violation, or even a civil claim for negligence, as long as a proper screening or labor evaluation is performed and documented.

Martha Merrill-Hall 5/21/25 Martha Merrill-Hall 5/21/25

News Briefs: Midwifery Issues and Practice For Consumers, Attorneys, Physicians and More. . .

In June of 2024, hearings concluded in a lawsuit against a 2019 law that established strict guidelines for midwifery care in Hawai’i. The suit challenged restrictions placed on the type of licensure midwives in Hawai’i needed in order to practice.

Martha Merrill-Hall 5/20/25 Martha Merrill-Hall 5/20/25

Double Jeopardy in OB Triage - EMTALA Part 2

In American criminal law, Double Jeopardy protects a defendant from being punished twice for the same offense.1 In civil law, which governs malpractice in healthccare, defendant midwives can be punished twice for the same offense. Although the criminal version of Double Jeopardy does not apply in civil cases, the term is defined as “a risk or disadvantage incurred from two sources”

Martha Merrill-Hall 5/15/25 Martha Merrill-Hall 5/15/25

Emergency Medical Treatment and Active Labor Act - Part I

EMTALA is the Federal Statute, enacted in 1986, that eliminated the historic, common-law precept of “no duty to treat”

Martha Merrill-Hall 5/12/25 Martha Merrill-Hall 5/12/25

News Briefs: Midwifery Issues and Practice For Consumers, Attorneys, Physicians and More. . .

Martha Merrill-Hall 5/12/25 Martha Merrill-Hall 5/12/25

Vaginal Breech Birth Training, Hospital Credentialing, and Informed Consent

Experienced support and availability for competent breech birth providers is a sticking point in many hospital review processes. Clearly, those who support breech delivery must convene a dedicated team who are willing to be available at all times. For medical-legal purposes, availability means that there are experienced OB’s, midwives, neonatal nurse-practitioners, neonatologists, and labor and delivery RN’s who are trained and experienced in vaginal breech delivery.

Martha Merrill-Hall 5/6/25 Martha Merrill-Hall 5/6/25

Midwifery, Vaginal Breech Delivery, and The Lawyers - Part III

Advertising for clients to bring claims following vaginal breech birth (VBB) mishaps is easy to find, just check billboards, phone directories, TV, and online articles. Although distasteful, directing some attention to these advertisements is important for your practice. Breech deliveries are regaining support and acceptance in the obstetrical/midwifery community.