Seven nurse midwives lose physician supervision; expecting moms left looking for birthing care

Supervising OB left them no alternative

kgarloch@charlotteobserver.com June 3, 2012 

Seven nurse midwives abruptly closed their practices last week when a doctor told them the N.C. Medical Board will no longer allow him to oversee nurse midwives outside his own practice.

Medical board officials said Friday that they have taken no action in connection to this doctor, and the Observer could not establish the reasons behind his actions.

In North Carolina, licensed nurse midwives are required to be supervised by a physician. Dr. Henry Dorn, a High Point obstetrician, had done that for seven nurse midwives in Hickory, Durham, Fayetteville and Wilmington.

When he withdrew his backup Wednesday, the midwives said their licenses became invalid, and their patients – dozens of expectant mothers planning to give birth at home – were left without health care providers.

Dorn could not be reached for comment.

But Jean Fisher Brinkley, spokeswoman for the medical board, said Friday that no restrictions have been placed on Dorn’s license, and any decision about supervising the midwives was his own. She would not say whether an investigation is pending. Medical board files show that Dorn has had no disciplinary action against him.

Karen Benfield, one of the nurse midwives affected, said Dorn told them “not go public until he’d actually received the formal sanction via certified mail.”

But Benfield, based in Hickory, and the other nurse midwives immediately began contacting their patients, and the news quickly surfaced on websites and Facebook pages.

“I’ve been scrambling like crazy to get coverage for my patients,” Benfield said. “Within the next four weeks, I had three women due.”

One of her patients, whose baby is due Wednesday, got an appointment with nurse midwife Marcia Ensminger at the Natural Beginnings Birth and Wellness Center in Statesville.

“A lot of (obstetricians’) offices will not accept transfers after 36 weeks (of pregnancy),” Ensminger said. “We’re accepting any patients that have been affected by this.”

Ensminger’s group delivers babies at their birthing center, but she supports home births.

“I think it should be up to the woman as to where she wants to have her baby,” Ensminger said. “If you’re a low-risk pregnancy with a trained provider, it’s safe to have a baby at home.”

Heard about investigation

Ashley Marshall, one of three nurse midwives at Carrboro Midwifery in Durham, said she had heard about a medical board investigation earlier this year.

“We knew this was coming,” she said. “My certification is still valid with the American Midwifery Certification Board, but in the eyes of the law in North Carolina we’re not recognized as nurse midwives.

“I caught a baby three days ago (but now) I can’t touch any of our patients.”

The state has about 300 licensed nurse midwives, but most deliver babies in hospitals.

Marshall said there’s nothing in state law that prevents a doctor from supervising nurse midwives in several locations.

She said she and her partners have a written protocol with Dorn, and they meet once a year for “chart review” of complex cases, where mothers ended up being transferred to a hospital because home delivery became unsafe. Local doctors have accepted their patients and “treated us with respect, like colleagues,” Marshall said.

Want law changed

Both Marshall and Benfield, who has attended home births in Charlotte, support a proposed change in state law to allow licensed nurse midwives to “collaborate” with an obstetrician instead of being supervised.

Rebekah Hawes of Durham said she had her 1-year-old son at home after giving birth to her 4-year-old in a Georgia hospital.

“I would not consider any other option than a home birth with Carrboro Midwifery,” she said. “I am a low-risk mother, and it is safe for me to deliver at home. Our choices should not be taken away from us.”

Garloch: 704-358-5078

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