If you want to, what stops you?

laney1733 · Apr 1, 2006

Hi, I'm not a CNM yet, still in nursing school but working toward it! I had this conversation with my own CNM though and she stated that she doesn't because of fear of litigation and malpractise issues. Our area is very conservative.

midwife2b · Apr 5, 2006

If there was support (read: backup) from even ONE OBGYN in my area I might consider a home birth practice. Despite the evidence that suggests homebirth is safe, it is underground here. Most women have successful homebirths but it is the one bad outcome that makes the docs not want to be a backup.

Yes, its a liability issue but also a social and cultural issue. There is such a thing as a community standard of care; frequently I read of practices (such as cytotec IOL, for example), that are very common in some parts of the country but not others. A very conservative community such as mine would label a physician who backs homebirth midwives. Any adverse outcome (even minor ones) would be criticized and the physician labeled "rebellious" or worse.

This summer I read an article about an OB who had a very low C-Section rate, had babies who were larger than "average", low incidence of episiotomies, 3rd and 4th degree lacs. Now doesn't that sound like a physician you might trust for your birth experience? She was advised by the Medical Staff of her hospital to increase her C-Section rate within 2 standard deviations of what the average was for all the other physicians in the community. The reason? Malpractice claims were implied (big babies, increased risk of shoulder dystocia/nerve complications). She claims that she was "bullied" because she practiced more like a midwife than a doctor.

Sadly she left her practice and her patients.

Her stats are what is expected of a CNM, yet she was ostracized by the medical community. It just doesn't make any sense to me.