Safeguarding modern midwifery

About the Author

Uniting clinical expertise and legal perspective to reveal how midwifery is interpreted—and often misinterpreted—across courts and hospitals.

Martha E Merrill-Hall portrait
Martha E Merrill-Hall JD MS CNM

Martha has led CNM practice across private, Indian Health Service, hospitalist, and critical access settings while litigating personal injury and professional malpractice cases.

Today she researches verdict trends, policy shifts, and licensure actions from the Rocky Mountains—equipping midwives, patients, and counsel with grounded legal insight.

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Why midwives & counsel read

Dual license perspective

Decades of private, IHS, hospitalist, and critical access CNM practice pair with JD work representing both plaintiffs and defendants in professional malpractice.

  • Pro bono defense of advanced practice providers facing board actions.
  • Expert witness experience in midwifery negligence claims.

Where I've practiced

Licensed across Colorado, Montana, Nebraska, Iowa, New Mexico, California, and beyond—spanning CNM hospitalist teams, Indian Health Service care, and cardiology/critical care nursing roots in Vermont and Maine.

Today I research verdicts, legal seminars, and policy shifts from the Rocky Mountains.

What Martha hopes readers gain

  • Historical context for how CNMs/CMs secured hospital privileges and where culture still lags clinical reality.
  • Plain-language breakdowns of licensure boundaries, malpractice myths, and courtroom expectations.
  • Validation for midwives, attorneys, and patients who need equitable framing of the profession’s contributions.
  • Strategies to translate courtroom narratives back into safe bedside practice.

August 10, 2024

Legal Standard of Care, Part 2

Updated January 12, 2026

Legislation and Standard of Care

            Another example of legislative language describing standard of care can be defined as thedegree 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 or labor and delivery unit.  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.

       An additional example of statutory language and one of my favorites:

“That degree of care or competence that a reasonably competent midwifery professional practicing in the same field as the defendant and in the same area as the defendant would do under the circumstances that defendant was facing with respect to the care and treatment of the patient”. Whew.

     Based on this legislative language, establishing whether the applicable legal requirements are met in court will require the testimony of exceedingly focused and good-humored expert witnesses, retained by both plaintiff(s) and defendant(s). The prospective experts selected for this challenging task will be required to argue whether a defendant care provider complied with, or breached, the standard.

http://www.midwivesontrial.com