By Gail M. Pfeifer, MA, RN, AJN news director

It seems even when doctors and nurses unite on an issue, there’s controversy. The Mississippi State Board of Medical Licensure and the Mississippi Board of Nursing (MBON) both support state bill No. 695, which would allow only certified nurse-midwives to practice midwifery in the state, according to the December 2009 issue of the state board’s magazine. Melinda Rush, executive director of MBON, wrote that there have been “incidences of death and harm to infants born in situations that were less than safe,” and urged nurses to support the bill.

I wonder though, if the board did its homework on educating the public about their concerns. One objector to the bill wrote a letter to Governor Barbour, asking him to veto the bill if it lands on his desk, because “midwives are more qualified than Drs

[sic] to deliver healthy low-risk babies.” And responses to an article on the topic in The Commercial Appeal indicate that consumers think the bill will entirely block women from having home births, literally pushing all deliveries into the hospital. Although the bill was amended to grandfather in professional non-nurse midwives with more than five years of experience, Birth Action Coalition is also urging Mississippi residents to oppose the bill, because it would “deny access” to the care of certified professional midwives.

Whether the bill finally passes or fails in the Mississippi Senate on Tuesday, it looks like both terminology and the value of nurse midwives needs clarification—and this is probably true in more places than Mississippi. My colleague Shawn Kennedy, AJN’s editorial director and interim editor-in-chief, brought up another point to consider when we discussed this issue: “I wonder why nurses are looking to limit the practice of lay midwives, unless there’s evidence about unsafe practice. Isn’t that what we rail against physicians for doing to us?”

AJN then asked Margaret Comerford Freda, professor of clinical obstetrics and gynecology and women’s health at Albert Einstein College of Medicine and Montefiore Medical Center, her opinion on the subject. In her e-mail response, Freda wrote: “I feel it would be going in the wrong direction to suggest that nurse midwives, most of whom have master’s degrees, could be replaced by individuals without the comprehensive knowledge base that nursing provides.”

Freda is also editor of MCN: The American Journal of Maternal Child Nursing. She added that midwifery education is “a very hot topic.” It sure looks that way. So, what do you think about the hoopla in Mississippi and the broader issue of midwifery regulation?

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