BILL NUMBER: S5007
TITLE OF BILL :
An act to amend the education law, in relation to the definition of
the practice of midwifery
PURPOSE OR GENERAL IDEA OF BILL :
To eliminate the requirement for a written practice agreement.
SUMMARY OF SPECIFIC PROVISIONS :
This legislation amends subdivision 1 and 2 of section 6951 of the
Education Law by eliminating the requirement for a written practice
This bill will amend the Education Law to eliminate the requirement
for a written practice agreement. This bill will not expand the scope
of practice of licensed midwives.
Midwives are an integral part of our health care system. Although
midwives have been educated in universities for over fifty years, the
Midwifery Practice Act was not passed until 1992. To date, more than
1300 midwives have been licensed by the New York State Education
Department for practice in a variety of settings, including private
offices, public health clinics, hospitals, birth centers and homes.
Midwives attend approximately 10% of all births (15% of all vaginal
births) in New York State every year and are proud of the lower
cesarean rates, shorter hospital stays and higher breastfeeding rates
among the women they serve. Midwives provide management of normal
pregnancies, child birth and postpartum care as well as primary
preventive reproductive health care of essentially healthy women,
including newborn evaluation, resuscitation and referral for infants.
New York State licensed midwives also provide health care to
pre-adolescent, adolescent and adult women throughout their life span,
including primary well woman health care, gynecologic care and care
during and after pregnancy. In addition, licensed midwives prescribe
medications, order laboratory tests and refer to other health care
providers. Midwives have been and continue to be a vital component of
our health care delivery system in New York State.
Under the Midwifery Practice Act, the New York State Board of
Midwifery outlines rigorous educational requirements and regulations
for the practice of midwifery. Pursuant to their scope of practice, as
well as their professional and ethical obligations, licensed midwives
provide services to their clients, with referral, collaboration and
consultation. By removing the requirement for a "written practice
agreement," this bill will promote and enhance access to health care
services, especially in rural and lower-income urban areas, and
increase the quality of care for those women who choose midwifery
Midwives currently practice in 15 states (AK, AZ, CT, DC, ID, IA, ME,
MN, MT, NH, NM, OR, RI, W A, WY) without signed practice agreements.
Like these and many other states, New York is experiencing a shortage
in its health care workforce, especially Ob-Gyns and primary care
providers. According to the New York Department of Health ("NYDOH"),
the North Country region's primary care physician supply decreased by
8% between 2001 and 2005 and, in the nine-county Southern Tier region,
the number of OB/GYNs declined by 28%. In addition, NYDOH statistics
for 2004-2006 show that there was late or no prenatal care in almost
7% of all births in Cattaraugus County and in over 8% of all births in
Queens County. Access to quality prenatal and post-partum care is
essential to achieve good health outcomes, and have healthy mothers
and healthy babies. For many women in New York's rural and
lower-income urban areas, licensed midwives are their only source of
health care and point of access to the health care system.
Licensed midwives need to be recognized as full partners in New York's
health care delivery system in order to ensure that women in New York
have access to comprehensive and quality health care services. Too
often, however, the written practice agreement requirement stands as
an obstacle to midwifery care. For example, in certain rural
communities, there are no physicians available to sign an agreement.
Moreover, even when a midwife is able to secure a written practice
agreement, it has served as the basis for limiting the practice of
midwifery by wrongly implying that midwives require direct supervision
and interfering with effective coordination of care.
As health care professionals that serve and care for the needs women
and babies, including those in New York's underserved areas, licensed
midwives play a vital role in our health care system. The requirement
for a written practice agreement restricts access to care and the
choice of a licensed midwife as a health care provider for women in
New York State. Safe, quality health care can best be provided to
women and their infants when policymakers develop laws and regulations
that foster midwives' ability to provide midwifery care within their
scope of practice while encouraging consultation, collaborative
management, and seamless referral and transfer of care when indicated.
PRIOR LEGISLATIVE HISTORY :
FISCAL IMPLICATIONS :
EFFECTIVE DATE :
Open Legislation comments facilitate discussion of New York State legislation. All comments are subject to moderation. Comments deemed off-topic, commercial, campaign-related, self-promotional; or that contain profanity or hate speech; or that link to sites outside of the nysenate.gov domain are not permitted, and will not be published. Comment moderation is generally performed Monday through Friday.
By contributing or voting you agree to the Terms of Participation and verify you are over 13.