Friday, December 08, 2006

Midwives and malpractice

It is convential wisdom that midwives are hardly ever sued owing to their better relationship with patients and the fact that their patients are low risk. Therefore, I was surprised to find the following statistics in the National Practitioner Data Bank's most recent report (2004).

In that year, there were 459 monetary judgments against CNMs. There were many more malpractice suits, but 459 resulted in a win for the plaintiff and payment of money. The average payout for a strictly obsetrics related claim was approximately $532,000. It is difficult to interpret the information for the size of monetary damages because the CNM results are lumped together with the results for labor and delivery nurses. In comparison, obstetricians had 1361 claims with an average payout of approximately $505,000.

There is much less information for direct entry midwives since they are under no obligation to report malpractice claims or judgments. The National Practitioner Data Bank received voluntary reports from DEMs in 5 states about 12 suits filed against them. There is no information about the results of these lawsuits.

What this suggests to me is that as midwifery moves into the mainstream, midwives are becoming subject to the same pressures as obstetricians. If they have a bad outcome, they will be sued and they will lose. It will be interesting to see if the increasing number of successful lawsuits will modify midwifery practice.

Correction: The statistics for 2004 show that there were 459 monetary judgments CUMULTIVELY in the years 1990 to 2004. In the year 2004, there were 58 monetary judgments specifically against CNMs for purely obstetrical causes. The payouts ranged from $1500 to $3,450,000.


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