Midwife Conversation: Positive Birth Stories, Value Of Practice, Educational Requirements, Need For More Midwifery Practitioners

Staten Islander previously published a conversation Senator Sanders had with a midwife in Vermont.  Their practice requirements are very different from those in New York, as they offer a direct-entry pathway, which does not require a Master’s Degree.  

– Is physiologic birth the absence of all interventions (epidural, pitocin, episiotomy, c- section, etc)?

Physiologic birth refers to birth as a natural process with minimal to no interventions such as amniotomy, use of medications for induction/augmentation, etc

– Is this the goal of the midwives practicing at NYU Langone (to have as close to a physiologic birth as possible)?

Yes, the purpose of the midwives at NYU is to help facilitate physiologic births for all low risk patients in our practice

– Are the midwives in her practice often achieving this goal? 

I believe we are achieving this goal which is proven by our C-section rate of 24% which is below the national average.

Staten islander News sat down with Shawna Paul, licensed midwife in New York, working at NYU Langone in Brooklyn at their family health center.  They provide care for women from puberty to menopause, including assisting them with delivering their babies safely and with minimal interventions.  Below are some of the requirements for becoming a midwife in New York, as well as the Midwife Practice Act of 2010, and some of the changes that are being proposed in the current legislative session for the Senate and Assembly.  

About The Citywide Doula Initiative, referenced in the video,  we can provide the following information:

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The program referenced is the Adams Administration’s signature “Citywide Doula Initiative,” expanding access to doula services in disinvested neighborhoods. The program has seen no maternal deaths among participating patients, with lower rates of C-section and preterm births.

These doulas are provided to residents of underserved neighborhoods, along with those in homeless shelters and foster homes.

1984 law:  

Definition of a midwife and necessities for practice: 

The practice of the profession of midwifery is defined as the management of normal pregnancies, child birth and postpartum care as well as primary preventive reproductive health care of essentially healthy women, and shall include newborn evaluation, resuscitation and referral for infants. A midwife shall have collaborative relationships with (i) a licensed physician who is board certified as an obstetrician-gynecologist by a national certifying body or (ii) a licensed physician who practices obstetrics and has obstetric privileges at a general hospital licensed under article twenty-eight of the public health law or (iii) a hospital, licensed under article twenty-eight of the public health law, that provides obstetrics through a licensed physician having obstetrical privileges at such institution, that provide for consultation, collaborative management and referral to address the health status and risks of his or her patients and that include plans for emergency medical gynecological and/or obstetrical coverage. A midwife shall maintain documentation of such collaborative relationships and shall make information about such collaborative relationships available to his or her patients. Failure to comply with the requirements found in this subdivision shall be subject to professional misconduct provisions as set forth in article one hundred thirty of this title

Education requirements (which have not changed), according to New York midwives association:

To obtain a NYS license, midwives must hold at least a Master’s degree, and pass the American Midwifery Certification Board licensing exam. More information about additional licensure requirements can be found here

According to the NYS Department of Education:  To meet the education requirements for licensure as a midwife in New York State, you must present evidence of completion of a master’s or higher degree program in midwifery or a related field that is:

registered by the Department as licensure qualifying; or

accredited by the Accreditation Commission for Midwifery Education*; or

determined by the Department to be equivalent of such a registered** or accredited program.