.Here is what I know of the situation. I don't think it's necessary to know the details of the complication to take a stance here. LMs are highly trained and all follow protocols within their legal scope of practice. (and these can vary based on their MD back-up and local hospital support). Hope this helps
'THE SITUATION
In 2016, I served as the primary midwife for an experienced mother. I wanted to provide the mother the in-home experience she desired, and also wanted to ensure that we were fully supported for the birth. I did the responsible thing, and retained another licensed midwife to serve as an additional birth assistant.
A serious complication arose (though NOT as a result of negligence) and the hospital where I transferred the patient filed a complaint against myself and my birth assistants who were present at the labor. My birth assistants were another licensed midwife (LM) and a registered nurse (RN). While the nursing board quickly dismissed the complaint against the RN, the Washington State Department of Health initiated a formal disciplinary action against the LM, alleging that she engaged in unprofessional conduct when she “failed to intervene, or provide any guidance, advice or comments…”
Though the Department of Health did initiate a proceeding against me (which I intend to fight), that proceeding was of lesser severity than the proceeding it initiated against the LM birth assistant!
PRACTICAL EFFECTS
This aggressive prosecution by the DOH against a birth assistant is believed to be the first time the Department has taken this type of action against a birth assistant working with a licensed midwife. The departments action impacts midwives and birth assistants across Washington State!
The DOH demonstrates a profound lack of understanding of the midwifery standards, culture and practice. It is possible that the DOH is not fully informed or aware of this dangerous precedent, which underscores the need for a separate midwifery Board or Commission at the DOH – one comprised of members who truly understand and support the profession they are regulating. Ideally, this Board or Commission would include a majority of Licensed Midwives.
More importantly, this DOH action creates a profound disincentive to midwives to serve as birth assistants, if assistants will now be disciplined for the supposed mistakes of the lead midwife. Additionally the DOH action creates an unprecedented and unwarranted risk of disciplinary action for service as a birth assistant. Understandably, the facts of this case has already led licensed midwifery providers to consider stopping this long-held practice of assisting at births.
More knowledge in the birth room is a benefit to the family and outcomes. If midwives are unable to secure licensed providers as birth assistants, there can be a risk of decreased safety for those in Washington State desiring an out of hospital birth. Ironically, if not corrected, the results of this DOH action will place the DOH in violation of its own mission and values. The action in this case is beyond the extent in which the health department serves the community.
WHO DOES THIS IMPACT?
Each and Every Member of the Midwifery Profession and their ability to:
- FIND a birth assistant
- SERVE as a birth assistant
- OBTAIN malpractice insurance at a reasonable cost
- BE ASSURED proper autonomy in their own practice
- FACILITATE safe and secure out of hospital births
It also impacts ANY WASHINGTON STATE CITIZEN WHO SHARES THE MISSION OF THE WASHINGTON STATE DEPARTMENT OF HEALTH TO PROTECT AND IMPROVE THE HEALTH OF ALL PEOPLE IN WASHINGTON STATE
THE CULTURE OF MIDWIFERY
Midwifery is an ancient profession with its own culture. Part of this culture is to commonly work together at births. Having two trained care providers at a birth can increase the safety should an unlikely obstetrical emergency occur. In the state of Washington, midwives are autonomous providers. An alternative to hospital based providers who follow hospital protocol, each midwife has independent and unique practice guidelines to guide their decisions and practice. When a midwife is called to assist another, they take a secondary role and defer to the primary midwife’s practice.'