In our last post, we began looking at the issue of home birth safety, particularly the impact of midwife care on home birth safety. As we began pointing out, not all midwives receive the same level of training and have the same level of competence.
There are a variety of designations that can apply to midwives. For instance, one basic distinction is between certified professional midwives and certified nurse midwives. The latter receive significantly more training than the former, and yet the former are most often the ones assisting at home births. There are other types of midwives which receives different training as well.
Different states handle midwifery practice differently, with some imposing significant regulations and others having no regulation at all in place. According to Safer Midwifery For Michigan, Michigan is among the states that currently have no regulation of most types of midwives. This means that, for most types of midwife in Michigan, there are no rules regarding the scope of practice of midwifery, no practice guidelines for assessing risk factors, and no established rules regarding transfer of care. Unfortunately, this means that it is impossible in many cases to hold a negligent midwife professionally responsible when something goes wrong in childbirth.
The only type of midwife that is licensed in the state of Michigan is certified nurse midwives. CNMs have a defined scope of practice laid out in the Public Health Code. CNMs are licensed and regulated by the state Board of Nursing. The rules, however, are not specific to midwifery and so do not specifically address out-of-hospital birth. That being said, CNMs can be held professionally responsible when they act negligently in the course of a home birth.
In our next post, we’ll continue looking at this topic and the importance of working with an experienced attorney when something goes wrong with a home birth.