MIDWIFERY: Law Unenforceable, Regulators Say
California's law regulating home births may be falling short, according to midwives, doctors and policymakers, the AP/Orange County Register reports. Although the state's midwifery law is intended to protect women and their infants by requiring physicians to supervise home deliveries, regulators assert that it is unenforceable and leaves many midwives unsupervised, even those who "beg for even an informal relationship with a doctor they can consult." Deputy Attorney General Mara Faust said, "Right now, anything goes. We have a law that's just not enforceable -- it's just not working." Both sides in the debate say the law "works fine" for hospital-based certified nurse midwives who work under a doctor's supervision, but lay midwives and hospital-trained certified nurse midwives who want to perform home deliveries contend that few doctors will provide the supervision required by the law. Even doctors who support home deliveries say they fear that consultation with midwives, "no matter how remote, will open them to legal liability should something go wrong." Dr. Steven Polansky, a board member of the California Association of Obstetricians and Gynecologists, argues that certified nurse midwives should practice only in hospitals and that lay midwives "should not be allowed to practice at all." Like many physicians, Polansky maintains hospital births are safer than those performed at home. State Sen. Liz Figueroa (D) is hoping to change California's law, which is "more strict than any other state that regulates planned home births." Figueroa is considering new language to require physicians' "collaboration" rather than "supervision" and to mandate that midwives have malpractice insurance to help protect physicians who assist them. Meanwhile, a regulatory ruling allows midwives to "operate on their own despite the law, so long as they make good-faith efforts to line up a doctor." Faith Gibson, director of the California College of Midwives, said, "Midwives want to be licensed; we want to be part of regular life. We don't want to be thought of as on the fringe" (Thompson, AP/Orange County Register, 4/23).This is part of the California Healthline Daily Edition, a summary of health policy coverage from major news organizations. Sign up for an email subscription.