In reality, the obstetricians are FORCED to take on the patients as a condition of medical staff appointment.

So the midwife with the complication turns over the patient to the hospital, and the unlicky obstetrician on duty that day inherits the risk.

Having seen many such cases over the years, the midwife always skates off responsibility. The patient has been fed the anti-doctor line, to even be in the doctor’s care is sort of an insult to them, the midwife does not see any responsibility.

And heck, I’m in primary care. And even I’ve seen this. The other thing with mid-levels is the request for “co-management” and “collaboration” which really means when there’s trouble, the response is “I’m just the nurse” and the search is on for a doctor to take the blame.

You are right on the money! Midwives probably have a unfair advantage when it comes to malpractice insurance because the physicians backing them up probably take the heat most of the time for bad outcomes, I would suspect. So as you say, if they can now practice without supervision, their malpractice rates would likely go up, thus leveling the playing field a little.

Kevin has already posted a wealth of articles about why C section rates are up.. hello, anybody say “John Edwards”??

And to the midwife who posted… if you take the VAST MAJORITY of pregnancies, and hand them to midwives, then where in the world do you think you can procure a vast number o OB’s from??? What would we need them for. But oops, if there’s ashortage, I guess we’ll just have to suck it up.

Why doesn’t anyone come to their senses about this midlevel stuff already?

As our friend from the North, Dr. Quisling-Hamsen, Oh, I mean Isberg, points out–U.S. obstetrics is the stray datapoint, way out of international norms as far as invasive procedures.

There are risks to going to a midwife; there are risks to going to a doctor. No one knows which is better. People should be able to chose; that’s what this law did. That’s good–and doctors are dastardly to oppose it.

I am not naive or an idiot; I am well aware that many midwives consider MD’s to be the worst evil in the medical world, or that the midwife can do things as well or better as an MD. (and yes, I have heard them talk). But I also believe that many times, Obstetrics has gotten too much like an illness and too little like a normal event.

I had high risk pregnancies and used an OB. I have cared for many women and had wonderful, safe deliveries and many women who ended up needing medical interventions for one reason or another.

I really believe that midwives and physicians can work together and tricks like this one are wrong.

One last thing: I have read many of the debates regarding MD vs midwife, home birth vs hospital. If you look at many European countries where women DO deliver at home, with a midwife, you see that many do just fine. However, here in the US we don’t have the infrastructure to do that safely. You can’t compare those apples and oranges.

Many midwives have great statistics. However, if you compare them to a MD ONLY COMPARING SIMILAR PATIENTS (drop all the high risk patients the MD has), I think most doctors would show the same great statistics.

Undoubtedly, midwives go to doctors when there’re complications. As they should. And, no doubt, it’s a stressful challenge . . . uh . . . but that’s your job and why you get the big bucks.

However, for the vast majority of normal cases, cutting-happy doctors, with their drugs and unnecessary procedures, may not be the best choice.

If you were really concerned about women’s health, you’d accept this.

Yeah, okay. Midwives have better outcomes than OB’s. Does anyone in their freaking mind believe this garbage???

How many midwife deliveries have these dingbats actually attended where the thing goies HORRIBLY wrong and the doctor must step in? I HAVE I HAVE!!! And I’m sure there aren’t ANY Wwhere an OB said “Please Midwife, help meeeeee!!!”

To those whi crave all these superior midwife outcomes, please, do all OB’s afavor and NEVER DARKEN THEIR DOORSTEP!!! They won’t miss you, believe me.
Of course, most Americans have snese and wouldn’t choose such a thing.

In fact, for the minute-clinics that the undereducated masses are screaming for, the mid-levels doling out antibiotics & viagra should NOT have supervision by an MD off-site, and should bear the full responsibility of treating their patients, especially when the treat that “cold” with a z-pak when it was really a CHF or COPD exacerbation.