malpractice insurance and home births - page 2

by SSUleader 4,406 Views | 17 Comments

We are a group of 4 nursing students interested in the politics of home births. We are especially interested in learning about malpractice insurance and how it relates to home births. Please reply with any information or... Read More


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    I had both of my children at home attended by lay midwives. They were former RN's that had given up their licenses to practice homebirth. I also had an apprentice at each birth. I also had private insurance which would have cost me about $50 for each birth. Instead my last homebirth was $1000 out of pocket (this was 13 years ago). My midwifes spent a considerable more amount of time with me than my physicians did with either of my pregnancies. I saw the physicians for maybe 5 minutes each visit, where the midwives, it was at least an hour. I also had great post partum care with the midwife coming to my house on day 1, 3, 5, 7 and me seeing her at her place at week 2 and week 6. I couldnt have asked for more attentive or professional care for myself or my children.
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    Many attending births at home do not carry malpractice insurance.

    When the client (patient) makes her own decisions re. care and is responsible for her own health, there is not historically as much of a need. Out of hospital midwives are rarely sued.

    Most of them, however, are not nurses, and follow a direct-entry route other than that followed by the CM.

    The malpractice insurance available costs a miniscule amount in relation to that charged to the OB.

    There has not, in the last 30 years since records have been kept, been a fetal demise as the result of an out of hospital birth. In the event of a hospital transport, the homebirth midwife still carries the statistic.

    Most out of hospital midwives do not take nurses with them to births. Instead, other midwives or apprentice midwives are taken.
  3. 0
    Quote from Penguinelane

    There has not, in the last 30 years since records have been kept, been a fetal demise as the result of an out of hospital birth. In the event of a hospital transport, the homebirth midwife still carries the statistic.
    .
    Please cite the source of this statistic.

    I personally know of a case of a non-nurse midwife in IL who attended the delivery of a stillborn infant who was "stuck" with shoulder dystocia for a prolonged period of time. Help was not summoned until the infant delivered, and could not be resuscitated.

    I am not trying to argue that similar tragedies don't occur in hospitals. They do.

    I am a proponent of informed parental choice in deliveries (home vs hospital vs birthing center).

    But, in order for parents to make an informed choice, they must have access to accurate information. I don't believe this is accurate information.
  4. 0
    I would imagine these statistics and how they are reported will vary by country and state.
  5. 0
    Quote from Jolie
    Please cite the source of this statistic.

    I personally know of a case of a non-nurse midwife in IL who attended the delivery of a stillborn infant who was "stuck" with shoulder dystocia for a prolonged period of time. Help was not summoned until the infant delivered, and could not be resuscitated.

    I am not trying to argue that similar tragedies don't occur in hospitals. They do.

    I am a proponent of informed parental choice in deliveries (home vs hospital vs birthing center).

    But, in order for parents to make an informed choice, they must have access to accurate information. I don't believe this is accurate information.
    Now I see your apparent confusion. I was speaking of my state. Thank you for allowing me to clarify.

    The source of the statistic is the President of the New Hamshire Midwifery Council, as she reported to the Commerce Committee in the New Hampshire House of Representatives in Spring 2005.

    I am familiar with the case of which you speak. The law pending legislation in Illinois is being named after the baby. The parents are outspoken in favor of the bill, and in favor of out of hospital midwifery.

    I read one article about this case in which it was stated the mother was given IM pitocin to speed her labor. The mother later stated that was untrue, and that she was given pit in response to hemmorage. Court documents, not the terribly unreliable media, the journalists contributing to which have little to no backround on the subject, should be drawn upon for the facts of the case.
  6. 0
    Thanks for clarifying!
  7. 0
    I would also like to know who out there has liability insurance for homebirths. I would like to know what state you practice in and what the average cost is per year. In my state (Oregon), homebirths attended by CPM/CNMs are legal. It's hard to get a quote from liability insurance companies since I'm still a student. Thanks for your help!
  8. 0
    From what I understand, malpractice insurance is required by certain states depending on the certification status and the rules that apply to it. Because each state has different bylaws that govern homebirth midwives, ranging from strictly managed to downright illegal, you would have to ask midwives from each state, as it is individual.

    You will always have the midwife that refuses to get insurance even when it is required, and you'll find those that have it when not required.

    Another poster said that it is rarely used by midwives, and I think they are right. There is a trust that women and families build with thier midwives so that even when the is an untoward outcome, families almost never sue.

    The state does the sueing!
    I hope this helps you with your quest!


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