These articles are intended to inform the best practices of certified nurse-midwives/certified midwives and the unique liability challenges that they face in clinical practice. The information provided will include, but is not limited to, standards of practice, midwifery liability challenges, hospital systems failures, professional conduct, avoiding litigation, cultures of care in corporate healthcare systems, and various legal considerations associated with safe practice.
Responsible certified nurse-midwife (CNM)/certified midwife (CM) practice, and optimal legal representation of midwives, requires realistic information pertaining to the profession of midwifery, specific standards of practice for various midwifery designations, and how specific standards guide practice. Attorneys specializing in medical negligence need to understand the potential liability issues unique to the practice of CNMs/CMs, including a basic familiarity with the practices of other classifications of midwives in the community. The ability to distinguish individual midwifery practice is not possible for most people. This lack of knowledge matters, especially for women selecting a maternity care provider.
Negative attitudes of hospital administrations, misinformed medical and legal providers, corporate healthcare culture, and knowledge deficits within society have allowed the professional profiles of all types of midwives to suffer. Practicing midwives deserve to understand how midwifery is currently viewed in the context of malpractice litigation. Consumers of midwifery care need to understand the education, background, and legislative boundaries imposed upon different types of midwives.
Information provided will primarily feature Certified Nurse-Midwife/Certified Midwife working environments which harbor overt and hidden legal risks. Certified Nurse-Midwifery practice is changing. In hospital corporate practice, role expectations for CNMs have become more fluid and legally precarious. Many attorneys involved in midwifery malpractice litigation frequently lack basic knowledge of the diversity of practice among defendant midwives. This has the potential to diminish the effectiveness of legal representation in medical negligence cases. Attorneys, physicians, and midwives require an awareness of the liability burdens that are unique to each designation of midwife and the environments where they work. In order to establish whether a midwife has met or breached an applicable standard of care in a negligence lawsuit, attorneys can only effectively prosecute or defend their clients if there is basic comprehension of the character and foundation of the individual midwifery practice and the specific standards of care which apply.
Among practicing midwives, there are critical differences. From a legal standpoint, midwifery practice must be evaluated in the context of educational degree, certification, individual practice standards, and setting.
For practicing CNMs/CMs, exposure to pertinent legal concepts, and strategies to prevent malpractice, should favorably affect individual practice through heightened awareness, confidence and, hopefully, reassurance.
Along with general discussions of legality and risk, the content presented is a focused examination of hospital CNM practice and its unique legal challenges. Select articles will also address decades of mythology, folklore, and random hysteria that have negatively impacted the delivery of midwifery care in America.
Despite a narrow focus on Certified Nurse-Midwives in hospital practice, it is my hope that this information will benefit all professional midwives so they may be recognized for the positive contributions they have made, from antiquity to the present, to safe maternal/child care and the childbirth experience.
Martha E. Merrill-Hall JD MS CNM
http://www.midwivesoncall.com