Abstract
Intensive interviews with licensed lay midwives in one of ten states that have recently reactivated and revised legislation legalizing such alternative practitioners for low risk clientele revealed a number of obstacles to their practice. The obstacles stem from the same rules and regulations developed by medical practitioners that made their homebirth service legal. Even after surmounting the difficulties of obtaining a license, the midwives find widespread unwillingness among private physicians to provide the required prenatal screening examination and medical back-up. The opposition of physicians to the licensed midwifery program is voiced in terms of concern about the safety of homebirths, particularly those attended by nonphysicians. Yet, the outcomes from the first 4 years of the program give no support for such concerns. Physician reluctance to cooperate with the legal program, combined with restrictions prohibiting the licensed midwives from sulturing minor tears and administering a single dose of an antihemorrhagic drug in an emergency transfer, do compromise the overall quality of midwifery care. While accepting their subordinate position to medical practitioners, the midwives are struggling to establish the continuum of care for homebirth women implied in their licensure law.
| Original language | English (US) |
|---|---|
| Pages (from-to) | 1189-1196 |
| Number of pages | 8 |
| Journal | Social Science and Medicine |
| Volume | 19 |
| Issue number | 11 |
| DOIs | |
| State | Published - 1984 |
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ASJC Scopus subject areas
- Economics and Econometrics
- Public Health, Environmental and Occupational Health
- Social Psychology
- Development
- Health(social science)
Cite this
Obstacles to the practice of licensed lay midwifery. / Sullivan, Deborah A.; Weitz, Rose.
In: Social Science and Medicine, Vol. 19, No. 11, 1984, p. 1189-1196.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Obstacles to the practice of licensed lay midwifery
AU - Sullivan, Deborah A.
AU - Weitz, Rose
PY - 1984
Y1 - 1984
N2 - Intensive interviews with licensed lay midwives in one of ten states that have recently reactivated and revised legislation legalizing such alternative practitioners for low risk clientele revealed a number of obstacles to their practice. The obstacles stem from the same rules and regulations developed by medical practitioners that made their homebirth service legal. Even after surmounting the difficulties of obtaining a license, the midwives find widespread unwillingness among private physicians to provide the required prenatal screening examination and medical back-up. The opposition of physicians to the licensed midwifery program is voiced in terms of concern about the safety of homebirths, particularly those attended by nonphysicians. Yet, the outcomes from the first 4 years of the program give no support for such concerns. Physician reluctance to cooperate with the legal program, combined with restrictions prohibiting the licensed midwives from sulturing minor tears and administering a single dose of an antihemorrhagic drug in an emergency transfer, do compromise the overall quality of midwifery care. While accepting their subordinate position to medical practitioners, the midwives are struggling to establish the continuum of care for homebirth women implied in their licensure law.
AB - Intensive interviews with licensed lay midwives in one of ten states that have recently reactivated and revised legislation legalizing such alternative practitioners for low risk clientele revealed a number of obstacles to their practice. The obstacles stem from the same rules and regulations developed by medical practitioners that made their homebirth service legal. Even after surmounting the difficulties of obtaining a license, the midwives find widespread unwillingness among private physicians to provide the required prenatal screening examination and medical back-up. The opposition of physicians to the licensed midwifery program is voiced in terms of concern about the safety of homebirths, particularly those attended by nonphysicians. Yet, the outcomes from the first 4 years of the program give no support for such concerns. Physician reluctance to cooperate with the legal program, combined with restrictions prohibiting the licensed midwives from sulturing minor tears and administering a single dose of an antihemorrhagic drug in an emergency transfer, do compromise the overall quality of midwifery care. While accepting their subordinate position to medical practitioners, the midwives are struggling to establish the continuum of care for homebirth women implied in their licensure law.
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U2 - 10.1016/0277-9536(84)90369-1
DO - 10.1016/0277-9536(84)90369-1
M3 - Article
C2 - 6523160
AN - SCOPUS:0021669162
VL - 19
SP - 1189
EP - 1196
JO - Social Science and Medicine
JF - Social Science and Medicine
SN - 0277-9536
IS - 11
ER -