Physicians are Responsible for Midwifery Decline

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In Mississippi, it's rare to find a Certified Nurse Midwife (CNM) in Mississippi who is actually practicing midwifery care. This is due to a state law that requires the CNM to attain a collaboration agreement with a physician, who can charge her any amount of monthly fees he/she desires.   

Essentially, state legislators are providing protection to physicians who enjoy a direct financial and competitive benefit codified into Mississippi state law, known as a “shake down,” “extortion,” and “pay to play”. 

The law does not require meaningful cooperation between the physician and the CNM. Also, the physician is not required to interact with the CNM's patients at all. Further, there is no evidence these agreements improve care coordination, quality of care, health outcomes, patient safety, or consultations between providers. However, it ensures that physicians receive profits off the labor of nurse midwives while claiming it protects the patients' safety.

But the real reason for the law is that the Mississippi State Medical Association (MSMA),  a private lobbying organization representing the professional interests of physicians, is determined to maintain the status quo of physicians running our healthcare system, even though they are associated with the ongoing maternity care crisis in the State.  

The law applies exclusively to CNMs, who are licensed and insured advanced practice nurses regulated by the Mississippi Board of Nursing. In contrast, the state has refused to establish any professional standards, credentials, and regulations for midwives who are not nurses and who deliver babies in the home.  Further, it does not require that this unregulated group of professionals, most of whom have no college degree, attain a collaboration practice agreement with physicians in order to work. This is primarily because they are not viewed as competition for physicians, but CNMs are. 

Over the last several years, I have worked with legislators to pass legislation that would exclude CNMs from this law, and all bills died in the public health committee because of physicians' adverse influence.  MSMA writes big checks to state legislators, and their physician members dress up in their white coats and travel to the state capitol to influence legislators.

If you care about this issue, please contact Representative Sam Creekmore, Chairman of Public Health and Human Services and tell him to allow members to vote on House Bill (HB) 1576. Then call Senator Hob Bryant, Chairman of Public Health and Welfare, and tell him to allow members to vote on Senate Bill (SB) 2553: 

screekmore@house.ms.gov   (662) 534-9280 (W) 

hbryan@senate.ms.gov          (601) 359-2395  or   (662) 256-9601 (W)