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Friday, June 22, 2012

Ask a Midwife: Should midwives carry malpractice insurance?

"Ask a midwife" is a weekly series with Deb O'Connell, CNM, MS. If you have a question for her, please share it with us here. 

My midwife says malpractice insurance is too expensive and that she doesn't have access to it.  Should I only hire a midwife who carries malpractice insurance?   -- Lansing mom


We live in a litigenous society and we live in a country where medical malpractice is standard for all health care professionals.  Medical malpractice for midwives is important because it protects both the consumer and midwife.  
Most providers carry it for below reasons:
1. Protection of private assets should they be sued
2. Allows them to contract with the major 3rd party insurers (BCBS, Cigna, etc)
Consumers rely on it because should there be a claim where the provider is found to be at fault, it provides compensation to the family that has been affected. Consumers also see it as a “professional standard” for their health care provider because it tells consumers the professional they hire has met minimum standards for training, licensing, scope of practice, and professional development in order to be licensed & insured.
Some excuses midwives have given regarding malpractice insurance include:
  • “I can’t afford it.” - it depends ...she might not be able to afford it...however, a licensed midwife (CPM or CNM) can get a medical malpractice policy for as little as $4000 a year.  
  • “It’s not available.” - not true.  There are insurers that will give medical malpractice insurance to midwives (and a couple that specialize in midwifery medical malpractice products).
  • “I can’t provide care to women in poverty because after paying for the high cost of medical malpractice insurance, I'll have to raise my rates.” - This statement is ridiculous.  Carrying medical malpractice insurance has absolutely nothing to do with caring for women in poverty, in fact, the opposite is true - Medicaid providers are expected to carry medical malpractice.
Midwives are required to be licensed in the state they are practicing in order to obtain medical malpractice insurance, likely because holding a license establishes a minimum standard for education, scope of practice, and reporting of outcomes.  (Although, I must note that this isn't true in all legislation that comes forth for licensing midwives.  It should be the standard.)
It’s a sticky subject...and many providers (physicians, midwives, physical therapists, chiropractors, etc. ) wish they didn’t “have to” carry medical malpractice, but the bottom line is...it’s the standard in our country and it’s expected by the consumer.  It is the only responsible way to practice midwifery, knowing lives are at stake. 

4 comments:

  1. This is very helpful information.Thank you. It reminds me of hiring a contractor for a big, important project on my home. I wouldn't hire one who isn't licensed, bonded, insured and in good standing with the Better Business Bureau. He will be more expensive, but that is part of the budgeting for those big projects. If the work isn't inspected by a city inspector and there are problems with the work that causes significant damage to my home, my insurance might not cover the cost. Why should they? It's interesting how the emotions and beliefs regarding childbirth don't seem to apply in the same way. Shocking to me, really. After all, it's the life of you and your baby at stake - not just your air conditioning unit or bathroom shower.

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  2. Is health care a human right, as the United Methodist Church says? I don't see how. Human rights, as Americans have always understood them (beginning with Thomas Jefferson and the other Founders) are a fact of nature that cannot be rescinded by human beings Liz Woods

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  3. We live in a litigenous society and we live in a country where medical malpractice is standard for all health care professionals. Medical malpractice for midwives is important because it protects both the consumer and midwife. James Dreesen

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  4. Indeed this is a very helpful information. Now, there's no excuse for midwives to get a medical malpractice insurance.

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