Safety first in midwifery rules

March 6, 2013 

Yes, it’s 2013, and we’re supposed to be in North Carolina, which has long prided itself on being a more progressive Southern state. And yet some 30 of our 100 counties have no obstetrician. Expectant mothers have to travel for counseling and treatment before, during and after delivering their babies.

Many do. Many don’t. And many worry that by living in rural areas they won’t have quick access to medical help when the time comes.

But the solution to easing that worry isn’t found in a couple of bills now simmering in the General Assembly, bills that would ease requirements on midwives in the name of having accessible care for more mothers-to-be.

One measure would drop a requirement that certified nurse midwives, who have considerable training and at least master’s degrees in midwifery, also be under a supervisory agreement with a board-certified physician. That rule, given the shortage of doctors, is difficult to meet, say advocates for midwives. And North Carolina is only one of six states that have the requirement.

Still, the N.C. Medical Society believes these highly trained midwives still need that connection to a physician, but a look at how other states operate without the rule would be worthwhile.

Also on the legislative agenda are proposals that would set up a licensing procedure for non-nurse midwives that would allow them to practice legally again in North Carolina. The Medical Society opposes these ideas strongly, arguing that these midwives lack the training that would be necessary in a medical emergency.

Certainly it’s true that women should have the freedom to choose whether to have their babies in a hospital or at home. But the state has a right to protect the health of mothers and children with reasonable regulation, and the current regulations, especially considering the state’s relatively high infant mortality rate, seem reasonable.

The state, perhaps in cooperation with medical schools, should endeavor to take more obstetrics care to underserved areas.

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