John Maszinski
Office: 312-580-6440
Statement of ISMS on Direct-Entry Midwives
Statement of ISMS on Direct-Entry Midwives
Provided to WBEZ (91.5 FM, Chicago)on August 19, 2013.

The Illinois State Medical Society supports the collaborative relationship that currently exists between physicians and certified nurse midwives, but is strongly opposed to the licensure of "certified professional midwives."  OB-related emergencies can happen in a matter of seconds.  That's when medical training really matters.  Substituting under-trained, unsupervised individuals for physicians and advanced practice nurses greatly increases the risks to the mother and infant.

Legislation repeatedly introduced in Illinois would license direct entry midwives as "certified professional midwives." These midwives are not required to hold a nursing degree, or even a bachelor's degree. They do not consider obstetrical care to be medical, yet their legislation would allow them to perform histories and physicals, provide prenatal care, dispense drugs, treat hemorrhages and other emergencies, and treat the infant and woman postpartum. All these activities are medical in nature and should only be performed by medical professionals

The high educational standards met by physicians and certified nurse midwives are in stark contrast to the minimal training proposed for "certified professional midwives:"

  • Physicians must complete four years of medical school and two years of residency training before practicing independently. OB/GYNs complete four years of residency training that includes nearly 800 deliveries. This rigorous training prepares the physician for those 10% of deliveries that involve an unanticipated problem putting mother and infant at risk.
  • Certified nurse midwives are advanced practice nurses who hold graduate degrees and have also completed accredited nurse-midwifery education programs.  In the context of a collaborative agreement with a physician, their training prepares them to attend births, prescribe medications, and provide other services.
  • In contrast, the majority of a "certified professional midwife's" training is an apprenticeship that requires only that a candidate attend a certain number of home births with a preceptor - someone already "recognized" as a midwife. Proposals for licensure require only that individuals receive minimal education in science and first aid, be credentialed as a certified midwife and be in good standing with the North American Registry of Midwives.

The bills introduced on behalf of direct-entry midwives have varied, but tend to share some alarming traits:

  • They would allow at least some direct entry midwives to practice independently, without physician collaboration or supervision;
  • They would allow midwives with minimal pharmacology training to administer drugs; and
  • They would allow these midwives with no hospital admitting privileges to supervise home births, endangering mothers and children who may experience life-threatening emergencies.

ISMS is a professional membership association representing 11,000 physicians practicing in all medical specialties statewide.

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