Another question about mid wives

Specialties Ob/Gyn

Published

I was reading the other thread about midwives, and didn't want to hijack the thread with my questions. I was wondering what the liability situation is for midwives and home birthing. I know that many of the precautionary (defensive medicine) measures in hospital births are due to fear of lawsuits, and I also know that avoiding these practices is the goal of many women who choose to do home-birthing. Do midwives carry insurance, or is their some sort of contract with the mother not to sue?

Also, I was wondering what the requirements are for being a home-birth candidate (i.e. pregnancy hx, general health, etc.), as well as what type of fetal monitoring is done prenatally (ultrasound, prenatal checkups, etc). I hope my questions aren't too dumb, but I don't know a whole lot about midwifery and I was just curious. Thanks

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Specializes in OB, lactation.

You might get good answers here (especially about the liability questions... I know CNM's have to have it but I'm not sure how direct entry midwives usually do their insurance arrangements):

http://www.midwiferytoday.com/forums/

Requirements for prenatal care and homebirth vary but they are generally quite conservative, hence the good safety record for home births in general.

Here's one page of stuff from one midwife but I'm sure they are individual to the practitioner:

HOME BASED MIDWIFERY ...protocol for acceptance into care

http://hometown.aol.com/Midgewife/protocol1.html

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You might get good answers here (especially about the liability questions... I know CNM's have to have it but I'm not sure how direct entry midwives usually do their insurance arrangements):

http://www.midwiferytoday.com/forums/

Requirements for prenatal care and homebirth vary but they are generally quite conservative, hence the good safety record for home births in general.

Here's one page of stuff from one midwife but I'm sure they are individual to the practitioner:

HOME BASED MIDWIFERY ...protocol for acceptance into care

http://hometown.aol.com/Midgewife/protocol1.html

Thanks for the resources!:)

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My preceptor is not insured. She is very up front about her training, experience, and lack of licensure. When newly pregnant couples come for an initial consult, they are given her informed consent packet which outlines in detail things such as the status of midwifery in our state, her education, her philosophies about births, as well as her limits and boundaries in regards to risk. There is a page that lays out the fee and the services provided, and there is a release of liability.

She is very conservative about whom she will take on, and her success record reflects that. She's cared for me through two pregnancies, and I haven't gotten the firm green light for homebirth until the very end of both because of my anemia. I work hard to brings my levels up, because the responsibility is mine, and I know she'll ship me off to the OB who does dual care with me, lol.

She does the standard 13 (or more for postdates) prenatal appointments and can order labwork and ultrasounds. At prenatals, we monitor all the usual: heart tones, weight, urine, fundal height, blood pressure, etc. About the only thing we don't do is the lady partsl exams doctors require during the last trimester. She'll do a lady partsl exam if it's warranted (preterm labor, 41+ weeks), but otherwise, no.

Sarah

Wife to Aaron, Mom to five, Doula/Apprentice Midwife

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Specializes in OB, lactation.
About the only thing we don't do is the lady partsl exams doctors require during the last trimester. She'll do a lady partsl exam if it's warranted (preterm labor, 41+ weeks), but otherwise, no.

FYI, one of my OB/GYN's wouldn't do vag exams either. :) Another only did it because I asked for it.

stsdoc, you're welcome! :)

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Very interesting stuff. My wife had expressed some interest in home-birth (when we get to that point:chuckle) after watching numerous shows about it on Discovery Health. From what you guys have posted, it seems like a safe option for uncomplicated pregnancies and that a good amount of screening takes place. Thanks again everyone.

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My preceptor is not insured. She is very up front about her training, experience, and lack of licensure. When newly pregnant couples come for an initial consult, they are given her informed consent packet which outlines in detail things such as the status of midwifery in our state, her education, her philosophies about births, as well as her limits and boundaries in regards to risk. There is a page that lays out the fee and the services provided, and there is a release of liability.

She is very conservative about whom she will take on, and her success record reflects that. She's cared for me through two pregnancies, and I haven't gotten the firm green light for homebirth until the very end of both because of my anemia. I work hard to brings my levels up, because the responsibility is mine, and I know she'll ship me off to the OB who does dual care with me, lol.

She does the standard 13 (or more for postdates) prenatal appointments and can order labwork and ultrasounds. At prenatals, we monitor all the usual: heart tones, weight, urine, fundal height, blood pressure, etc. About the only thing we don't do is the lady partsl exams doctors require during the last trimester. She'll do a lady partsl exam if it's warranted (preterm labor, 41+ weeks), but otherwise, no.

Sarah

Wife to Aaron, Mom to five, Doula/Apprentice Midwife

Just an FYI. There are many OB's out there now who do NOT do exams during the last weeks of pregnancy. Most of ours where I work do NOt do them. trends have changed in that arena.

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Just an FYI. There are many OB's out there now who do NOT do exams during the last weeks of pregnancy. Most of ours where I work do NOt do them. trends have changed in that arena.

Not in my area, lol. Most women don't bat an eye either!

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You might get good answers here (especially about the liability questions... I know CNM's have to have it but I'm not sure how direct entry midwives usually do their insurance arrangements):

http://www.midwiferytoday.com/forums/

equirements for prenatal care and homebirth vary but they are generally quite conservative, hence the good safety record for home births in general.

Here's one page of stuff from one midwife but I'm sure they are individual to the practitioner:

HOME BASED MIDWIFERY ...protocol for acceptance into care

http://hometown.aol.com/Midgewife/protocol1.html

DEM do have the possibility to carry an in most states...

As of the CNM and CM it is now problematic.. We had an insurance until 2 years ago coveriig home birth but the carrier has changed and the new one does not cover homebirth, The ACNM comitee has been looking into it. "

May be we'll ahve some news in JUne at the ACNM convention in W. DC.

The informed consent does not cover the MW in court if mac happens during the birth.. :crying2:

Ginny

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