The American Congress of Obstetricians and Gynecologists, District II
CONTACT: Sue Nigra, Director of Communications
email@example.com; (518) 436-3461
ACOG District II Statement on
Midwife Bill Passing Legislature
Albany, NY, July 1, 2010 - The New York State Chapter of the American Congress of Obstetricians and Gynecologists, (ACOG District II) remains in opposition to the Midwifery Modernization Act (S.5007/A.8117), which has passed the New York State Legislature.
The bill does not recognize the difference between homebirth midwifery and hospital-based midwifery and as such would eliminate the written collaborative practice agreement between all licensed midwives and obstetrician-gynecologists. ACOG believes that because this legislation does not differentiate between the two forms of midwifery, the legislation is ill advised, and will put patients at risk. ACOG is urging Governor David Paterson to veto this legislation.
ACOG District II recognizes the unique relationship between obstetrician-gynecologists and licensed midwives who perform deliveries in a hospital. Midwives play an integral role in the delivery of women's health care. ACOG firmly believes that our relationship is enhanced by collaborative practice agreements that prevent ambiguity, especially in regard to high-risk births.
Patient safety will exist with the elimination of the written collaborative agreements between ob-gyns and hospital-based midwives because the hospital setting is the safest place to have a baby - and in the case of an obstetrical emergency, clinical responsibilities are assured. However, this legislation eliminates the written plan for homebirth midwives and if it becomes law, New York will have no patient safety system in place to handle situations in which an advanced level of maternity care is urgently needed.
- If there is no prior physician-patient relationship through a written collaborative agreement for homebirth midwifery, more obstetric emergencies and poor outcomes may arise.
Homebirth midwives are not accountable to the public. Patients cannot look up the credentials and/or malpractice on a public website like they can for physicians.
Patients need to be informed about:
o Whether any licensed midwife, but particularly home birth midwives
have hospital privileges.
o Whether any licensed midwife has medical liability insurance coverage
and the policy limits of such coverage.
o A protocol for home-birth emergencies, including transportation to a
hospital, particular to each patient.
In a 2002 joint statement of practice relations that was published by ACOG and the American College of Nurse Midwives (ACNM), it was further stipulated that when ob-gyns and midwives collaborate, they should concur on a clear mechanism for consultation, collaboration and referral based on the individual needs of each patient. It is ACOG's fear that this legislation will erode this structure and jeopardize patient safety.
ACOG District II strongly opposes S.5007/A.8117 and urges its defeat.
The American Congress of Obstetricians and Gynecologists, District II (ACOG) represents the board certified obstetrician-gynecologists in the state who deliver health care to New York's women. Our Albany office offers the New York State Legislature its resources as a scientific and educational organization dedicated to quality health care for women. If you have questions on this or any other state legislative proposal, please contact our office at 518-436-3461.