Malpractice Liability Burden in Midwifery: A Survey of Michigan Certified Nurse-Midwives

A statewide survey was conducted among 282 nurse-midwives in Michigan to examine the extent of their current medical liability burden. Two hundred ten responses were received for an adjusted response rate of 76.9%. Data from 145 certified nurse-midwives (CNMs) who were currently engaged in clinical...

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Bibliographic Details
Published in:Journal of midwifery & women's health 2008-01, Vol.53 (1), p.19-27
Main Authors: Xu, Xiao, Lori, Jody R., Siefert, Kristine A., Jacobson, Peter D., Ransom, Scott B.
Format: Article
Language:English
Subjects:
Burden
Certification
certified nurse-midwives
Clinical medicine
Female
Health insurance
Humans
Insurance, Liability
Liability
malpractice
Malpractice - legislation & jurisprudence
Medical malpractice
Michigan
Midwifery
Midwifery - legislation & jurisprudence
Nurse Midwives
Nurses
Nursing
Obstetrics
Pregnancy
Professional Practice - legislation & jurisprudence
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Summary:A statewide survey was conducted among 282 nurse-midwives in Michigan to examine the extent of their current medical liability burden. Two hundred ten responses were received for an adjusted response rate of 76.9%. Data from 145 certified nurse-midwives (CNMs) who were currently engaged in clinical practice in Michigan were used for this analysis. Sixty-nine percent of CNMs reported that liability concerns had a negative impact on their clinical decision making. Most CNMs (88.1%) acquired malpractice insurance coverage through an employer, whereas 4.9% were practicing “bare” due to difficulty in obtaining coverage. Thirty-five percent of the respondents had been named in a malpractice claim at least once in their career, and 15.5% had at least one malpractice payment of $30,000 or more made on their behalf. CNMs who purchased malpractice insurance coverage themselves or were going bare were significantly less likely to include obstetrics in their practice than their counterparts covered through an employer (70.6% versus 87.2%; P = .04). These findings among Michigan CNMs call for further investigation into the consequences of the current malpractice situation surrounding nurse-midwifery practice and its influence on obstetric care, particularly among women from disadvantaged populations.
ISSN:1526-9523
1542-2011
DOI:10.1016/j.jmwh.2007.10.003