New York City Midwives Struggle To Find Hospital Support In Wake Of St. Vincent's Closure

Since last week's closure of the bankrupt St. Vincent's Hospital Manhattan, home-birth midwives in New York City are scrambling to comply with a 1992 state law that requires them to have written practice agreements with hospitals in case of emergency complications, the New York Times reports. Seven of the city's 13 home-birth midwives had agreements with St. Vincent's and have been unable to negotiate partnerships with other hospitals or obstetricians since it closed. As a result, some midwives could risk losing their medical licenses if they deliver in a woman's home, the Times reports.

The 13 midwives attend to roughly 600 births annually, and about 50 of their clients expect to give birth in the next month. According to the Times, to midwives and their clients, the option of home birth is "an affirmation of their reproductive rights" and "a reaction to the highly medicalized climate of hospital births."

Many obstetricians, on the other hand, consider home birth a "rash choice by women who refuse to believe that things can go dreadfully wrong in an instant," the Times reports. The American Congress of Obstetricians and Gynecologists in 2008 released a strong statement against home births, saying that women who opt for the method have been influenced by "what's fashionable, trendy or the latest cause celebre," the Times reports.

The ACOG statement made some obstetricians increasingly reluctant to enter into agreements with home-birth midwives. Several hospitals said this week that they are friendly to midwives but worried about the safety of home birth and the potential for malpractice lawsuits.

Pending legislation (A 8117) would abolish the state requirement for the agreements, but the measure is stalled in the Legislature, according to Assembly member Richard Gottfried (D), a sponsor of the bill. The bill memorandum notes that 15 other states allow home-birth midwives to practice without such agreements (Hartocollis, New York Times, 5/6).


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