I was the only consumer advocate at the Lobby Day today hosted by the NC American College of Nurse Midwives (NCACNM) to support House Bill 204 to update and modernize the Midwifery Practice Act. This is just one of three midwifery bills in discussion in the legislature.
I tagged along with the nurse-midwives as a way to listen in and support them by sharing my personal experience of their quality of care. The first group I was with met with Representative William D. Brisson – a down home southern farmer that understood old school midwifery and was interested in hearing how it plays out in today’s world. He spoke a lot about his family, grandchild and his overall interest in supporting children.
According to the NCACNM, currently 31 of North Carolina’s 100 counties have no practicing OB/Gyn. Lack of access to qualified care has been cited as the main reason North Carolina is 44th in the nation in infant mortality and 37th in maternal mortality. Brisson represents areas in the rural coastal plain and he understood the lack of access to quality prenatal care in those areas. The second group I was with met with Senator Shirley B. Randleman, a senate sponsor of the companion senate bill who also represents rural folks. She was very supportive and knowledgeable, and keen on addressing the shortage of physicians.
I learned a lot about the midwive’s positive personal experiences with working in hospital settings, working at Camp Lejune (where nurse-midwives don’t need a physician’s signature because it’s not required federally), and from midwives-in-training that were hoping to serve their communities though are currently working as RNs as they await the removal of the barrier to practice.
In order to practice as a nurse-midwife in North Carolina, midwives need the signature of a supervising physician. This is additional physician oversight, as their certification already provides oversight from a joint committee of the Board of Nursing and the Board of Medicine. I learned about this barrier the hard way – just 8 weeks after Ten was born and I was having trouble healing and with breastfeeding – the supervising physician for my midwives dropped his backing, forcing the practice to close. I had to go to the birth center for additional care, which I am fortunate to have nearby. My heart went out to those that were pregnant at the time and were left without options that fit their hopes and needs.
According to the NCACNM, 44 states do not require physician supervision of nurse-midwives. House Bill 204 bill would replace this requirement with a mandate for collaboration and consultation with physicians as dictated by the needs of the patient.
Collaboration and consultation is nothing new – it’s what happened when my blood tests came back showing that my thyroid went nutso during early pregnancy, so I was referred right away to a specialist. They communicated and collaborated with my midwives so I was able to have a healthy pregnancy. I was also referred to a specialist after the birth when I had trouble healing.
I look forward to hearing the report back from NCACNM and hope to find and share ways in which consumer advocates can get involved.