Looks like bill will pass. If I were an ob/gyn in NYC, I would say that if the midwives want be independent keep them as far away from my license as possible from them. There's no way in hell I would provide backup to some midwife I don't know who's now calling me because she's in over her head. You will get sucked into a lawsuit so fast it ain't even funny.
I must say that although this bill looks like it will pass ob/gyn's have one huge advantage over FP and anesthesiology regarding midlevels -- ob/gyn's can do surgery whereas midwives can't. NP's and CRNA's on the other hand claim that they can do everything that their physician counterparts can.
Midwife Reform Bill Passes Legislature
Last Update: 7/01 10:22 am
From NYS Assembly Member Richard N. Gottfried:
Licensed professional midwives would be able to practice independently under a bill that passed the Senate on Wednesday by a vote of 61-0. "This is an important step forward for women's health," said Assembly Health Committee chair Richard N. Gottfried, author of the bill, A. 8117-B, which overwhelming passed the Assembly on Monday, June 28, by a vote of 95-17. The bill now heads to Governor David Paterson to be signed into law.
Professional midwives have been licensed in New York State for decades. They provide prenatal care, deliveries, and primary gynecological care. However, they are required to have a "written practice agreement" with an obstetrician or a hospital that provides obstetric services. The bill would repeal the requirement for a written practice agreement.
"This is a major victory for women's health. The 1,300 licensed midwives in New York perform about 15% of the non-Caesarean deliveries, with exceptionally high rates of successful outcomes and patient satisfaction," Gottfried said. "The written practice agreement is an unnecessary restriction that blocks many midwives from serving the community."
When a pregnancy or delivery develops complications or becomes high risk, a midwife refers the patient to a physician. While some people associate the word "midwife" with home birth, the vast majority of midwives deliver babies exclusively in a hospital.
"Every physician commonly has to refer a patient to a specialist or a hospital, but the law doesn't bar them from practicing without a written practice agreement with specialists or hospitals," said Gottfried. Midwives currently practice in 15 states (AK, AZ, CT, DC, ID, IA, ME, MN, MT, NH, NM, OR, RI, WA, WY) without signed practice agreements.
"Too often, the written practice agreement requirement is an obstacle to midwifery care," Senator Duane said. "In some rural communities, there are no physicians available and willing to sign an agreement. The written practice agreement requirement can be an obstacle even in urban areas. When St. Vincent's Hospital closed in April in my area in Manhattan, midwives affiliated with the hospital or the hospital's physicians had to scramble for new arrangements."
In New York City, St. Vincent's was one of the only hospitals that provided written practice agreements for midwives who do home births. Hundreds of their pregnant patients were left without care when St. Vincent's closed. "Many of the home birth midwives remain without written practice agreements, causing upheaval for families who had chosen home birth in the expectation of a peaceful birth experience without medical intervention," Gottfried added.
The bill is supported by the New York State Association of Licensed Midwives, the American College of Nurse-Midwives, SUNY Downstate Medical Center, Citizens for Midwifery, National Organization for Women - NYS Chapter, New York State Perinatal Association, New York State Nurses Association, and The Nurse Practitioner Association of New York State.
"In rural Tompkins and Cortland counties, we have several midwives who are being forced to leave the community because the local physicians are not willing to sign agreements with them," said Assembly Member Barbara Lifton, who represents that area. "Their malpractice insurance company may think it adds to the physician's liability, or some of the physicians don't want the competition. But the result is a more severe health care shortage for the women of New York."
"All three of my children were delivered by a midwife," said Assembly Member Amy Paulin. "We chose home birth for two of them. I live in Westchester. The midwife was affiliated with a hospital in the Bronx, about half an hour away. If I had needed to go to a hospital, we would have gone to the nearest hospital in Westchester, not to the hospital in the Bronx. So the written practice agreement was totally pointless."
