For centuries, midwives have helped women through the birthing process. A midwife attends childbirth, provides support during labor and delivery, and supervises the general care of women and children directly after birth. Midwives can assist women in giving birth either in the hospital or at home. Midwives who work within a hospital setting are called nurse-midwives and must be trained and licensed. Each state has its own laws regarding licensing of nurse midwives. Other midwives, called lay midwives, are not necessarily medically trained. Most states have statutes limiting the type of patient that can be under the care of a lay midwife. What happens, however, when the midwife is assisting a home birth and there is a problem with the baby? Can a midwife be faulted for failure to perform extraordinary measures to save a baby when the necessary equipment is only available in the hospital?
Midwives can be held liable for medical malpractice. However, they are not held to the same standard of care as an obstetrician. They owe the patient the duty to act as a reasonable midwife. A big area of potential liability for midwives is the failure to consult a physician. For example, in one case a midwife was found liable for failing to refer a patient to an obstetrician after the patient experienced high blood pressure. Both the patient and the unborn child died after the patient developed preeclampsia. In another case, a midwife was found liable for failing to refer the patient to the hospital for a caesarian delivery. The patient underwent a long labor, resulting in fetal distress to the child. The child was born with severe brain damage.
Midwives can limit their potential exposure to medical malpractice suits by obtaining the patient’s informed consent. Patients should be made aware of the extent and nature of the midwife’s education and training. Likewise, patients should be informed of how the midwife plans to deal with any problems that may arise during the pregnancy or the delivery and inform patients of their right to transfer their care to an obstetrician at any point.
Statistics show that births attended by certified nurse midwives are just as safe as those attended by obstetricians. In addition, births attended by nurse midwives have a much lower caesarian rate. The safety rate of births attended by lay midwives is not well documented.
Copyright 2011 LexisNexis, a division of Reed Elsevier Inc.