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Bill to sever doctors from certified nurse midwives moves ahead in NC House

RALEIGH A bill to relieve certified nurse midwives from the requirement that they have formal supervision agreements with physicians has gone to the N.C. House health and human services committee.

Four primary sponsors were joined by 23 co-sponsors on the bill, which has drawn criticism from the N.C. Medical Board.

“The medical board feels that a physician needs to be involved,” said Jean Fisher-Brinkley, board spokeswoman.

Alex Miller, a lobbyest for the N.C. College of Nurse-Midwives, said requiring a formal agreement with a supervising doctor has discouraged midwives from serving isolated parts of the state, where physicians are scarce. Some 30 percent of North Carolina counties are without any type of physician, and more than 70 are considered medically underserved by the U.S.Department of Health and Human Services.

A joint subcommittee of the N.C. Medical Board and the Board of Nursing oversee the credentialling of certified nurse midwives. Physicians who agree to supervise nurse midwives are overseen by the medical board.

Miller said some nurse midwives have had to close their practices suddenly when physicians terminated their agreements. In some of those cases, the nurse midwives were informed that medical board investigators had concerns about the physical distance between the physician’s practice and that of the nurse midwife.

Fisher-Brinkley said she was not at liberty to discuss the nature or outcomes of board investigations.

Another obstacle for certified nurse midwives is the expensive liability coverage physicians must carry on behalf of the midwives they supervise, Miller said.

He said a Senate version of the bill, titled Update/Modernize Midwifery Practice Act, is expected to be filed in the next few days.

Elder: 919-829-4528

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