Midwives of New Jersey Restricted from Providing Homebirth Services!
This past summer, our physician consultants were restricted from providing back-up for homebirth clients by their new practice management company. Their concern is the doctors’ liability for the Midwives who are assisting birth in such a “dangerous” setting. We were able to secure another physician for this role for a brief time but because we were unable to meet that doctor’s requirement to do 4 births a month in her birth center, we have lost her support. As of December 7th, we are unable to provide homebirth services. We do have OneCare OB/GYN (formerly One to One Female Care) for our consultants when we are delivering babies in the hospital and birth center.
We want to fight for our right to provide and your right to choose legal, safe homebirth services in New Jersey without the permission of a doctor. Nearly all physicians disagree with homebirth, excluding Dr.Garfinkel who has provided. Because of this and the perceived liability, you cannot deliver at home despite the fact that homebirth is legal, Midwives have specific regulations regarding the provision of homebirth services, and it is a covered benefit by most insurance companies.
The American College of Obstetricians and Gynecologists (ACOG) has amended their position on homebirth over the years from a strong recommendation against birth at home to the current stance (2017) that says:
Although the American College of Obstetricians and Gynecologists believes that hospitals and accredited birth centers are the safest settings for birth, each woman has the right to make a medically informed decision about delivery. Importantly, women should be informed that several factors are critical to reducing perinatal mortality rates and achieving favorable home birth outcomes. These factors include the appropriate selection of candidates for home birth; the availability of a certified nurse–midwife, certified midwife or midwife whose education and licensure meet International Confederation of Midwives’ Global Standards for Midwifery Education, or physician practicing obstetrics within an integrated and regulated health system; ready access to consultation; and access to safe and timely transport to nearby hospitals.
The Midwives of New Jersey have been attending homebirth very safely and successfully under the exact conditions ACOG recommends above since 2008. We would love to continue offering homebirth to our clients. This change has greatly impacted several families planning a homebirth in the next couple of months. We are asking the state of New Jersey Board of Medical Examiners to grant Midwives of New Jersey an Emergency Waiver of this portion of the New Jersey Administrative Code that deals with consulting physicians:
13:35-2A.6 CONSULTING PHYSICIANS; CLINICAL GUIDELINES Prior to beginning practice as a midwife, a
licensee shall enter into a consulting agreement with a physician who is licensed in New Jersey and who:
1)Holds hospital privileges in operative obstetrics/gynecology;
2) Has a binding agreement with a physician who holds operative privileges in operative obstetrics/gynecology; or
3) Holds hospital privileges in gynecology, if a licensee limits his or her practice to nonobstetrical. The licensee shall establish written clinical guidelines with the consulting physician which outlines the licensee’s scope of practice.
Please send us a letter written in support of the Midwives of New Jersey providing Midwifery services in our specific scope of practice without physician signature or approval. We will gather all the letters into one PDF and submit to the Midwifery Liaison Board on Monday 1/3. They have a scheduled meeting on 1/4.
Here is a sample letter for your convenience.
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Thank you for your ongoing support of Moms, Babies and Midwives in New Jersey.
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