[Midwives].

Abstract

The American College of Obstetrics and Gynecology, the Nurses Association of the College, and the American College of Nurse Midwives believe that improved maternity care and health services for women in the U.S. can be achieved by the cooperative efforts of teams of physicians, nurse-midwives, and obstetric registered nurses. Yet the Massachusetts Medical Society opposed House Bills 848 and 2200 authorizing the practice of midwifery in licensed facilities by a certifed nurse-midwife who functions as a member of a team that includes an obstetrician-gynecologist. The opposition was on the grounds that the use of midwives will dilute quality medical care. Does this mean the Society cannot recognize the deficits in availability and quality of maternity care in the U.S. and does not believe the reports of lower infant and maternal mortality rates in European countries using midwifery than in the U.S.? Or does it reflect the tendency of the physician to consider pregnancy and labor as illness? The American Medical Association and the American Academy of Pediatrics have endorsed the use of pediatric nurse associates and physician assistants in health care. The Massachusetts Medical Society should endorse the use of midwives in health care with a physician being called in to provide diagnosis and therapy where a condition incompatible with health is detected.