Do not choose a nurse midwife for your pregnancy or labor and delivery until you read this!

What should you know about midwives and their services? Midwifery is defined as the management of normal pregnancy, childbirth and post-partum care by a licensed midwife. Midwives tend to have a high level of success with childbirth simply because they are only supposed to handle cases involving uncomplicated, low risk pregnancies and labor and delivery.

A midwive should never handle a high risk pregnancy or a labor and delivery that has complications.  A midwife does not have the training or experience to handle complications that often arise in high risk pregnancies, and he/she cannot perform a cesarean section if an emergency arises during labor and delivery. Midwives often discourage cesarean sections for mothers who encounter difficulties during labor and delivery, such as persistent, non-reassuring fetal heart strips.  This is a mistake, as a qualified obstetrician should make the determation whether a cesarean section is indicated.

Midwives do not have a medical degree and they have not attended medical school.  Further, many midwives do not have a nursing license since a license in nursing is not a prerequisite to licensure as a midwife in New York State. A licensed midwife must only maintain a current midwifery registration to practice as a midwife in New York State.  There is no formal continuing education requirement in midwifery and the New York State Education Law does not require a midwife to purchase malpractice insurance.

If you have any complications during your pregnancy or labor and delivery, you should not have a midwife handle your case!

What is the relationship between midwives and physicians? Licensed midwives are independent practitioners, who collaborate with physicians and consult with them if complications arise during the childbearing process.

New York State law does not require supervision by a physician.  Rather, the law provides that licensed midwives must establish a collaborative practice and maintain a written practice agreement with a physician or hospital in accordance with that agreement. New York State law requires licensed midwives to practice pursuant to a written practice agreement at all times. Such agreements provide for physician consultation, collaboration, referral and emergency obstetrical coverage and include written guidelines and protocols.

The written practice agreement between a midwife and a physician also includes guidelines for identification of pregnancies which are not considered normal and the procedures that are to be followed in such cases.  This provides that the judgment of the collaborating physician will prevail as to whether the pregnancy, childbirth or post-partum care is normal and whether the woman is essentially healthy, unless otherwise provided in the practice protocol.

Written practice agreements with physicians must be maintained and made available upon request by the State Education Department.  Both the licensed midwife and the physician must maintain the agreement for a minimum of 10 years after the amendment or termination of the agreement.