Bill to give midwives more autonomy passes in Albany

A reform bill that would allow midwives to practice independently without written agreements with doctors has passed both houses of the State Legislature and now heads to the governor's desk.

Under current law, midwives are required to have a "written practice agreement" with an obstetrician or hospital. The bill would repeal the need for a written document, allowing midwives more professional latitude.

"The agreement we have in place now requires us to have the signature of a collaborating physician as a kind of contract that is filed with the state and with the institutions where we obtain privileges," Barbara Charles, a Huntington midwife, said.

"This is a wonderful step forward, and oh, what a relief," added Charles, who said she will continue to consult with physicians and refer tough cases to them. "The only thing that will change," she said, "is that I won't need to sign that [document] in order to practice."

Passed 61-0 in the State Senate Wednesday night after a 95-17 vote in the Assembly Monday, the measure's supporters are calling it a victory for the state's 1,300 licensed midwives, who perform about 15 percent of the state's non-Caesarean deliveries.

The bill, by Assemb. Richard Gottfried (D-Manhattan), is supported by a range of professional groups, including the New York State Association of Licensed Midwives and the Nurse Practitioner Association of New York State. Nurse practitioners have a similar measure awaiting action in the Legislature that would eliminate the need for a written agreement with physicians.

Midwives practice in 15 states without signed physician agreements, Gottfried said, noting "the written practice agreement is an unnecessary restriction."

The bill is opposed by some physicians who say freeing midwives from a written agreement endangers lives. The New York chapter of the American Congress of Obstetricians and Gynecologists lambasted it Thursday, saying the bill would expose midwives to higher malpractice insurance costs.

"These written agreements exist for a reason," said Donna Montalto, executive director New York's division of the congress. If a midwife is faced with a high-risk birth, the agreement ensured a doctor would be immediately summoned, she added.

Susan Brockmann, a Malverne midwife and vice president of the state's licensed midwives, said midwives do not handle high-risk births and most perform deliveries in hospitals. "A lot of doctors didn't want to sign the agreements. There was this fear of lawsuits," she said, adding doctors did not like having to compete for the business.

It's not known when or whether the governor will sign the bill.