The Role of Litigation in Midwifery Practice in the United States: Results from a Nationwide Survey of Certified Nurse-Midwives/Certified Midwives

Authors

  • William F. McCool CNM, PhD,

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      University of Pennsylvania School of Nursing, 420 Guardian Dr., Philadelphia, PA 19104. E-mail: mccoolwf@nursing.upenn.edu
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    • William F. McCool, CNM, PhD, FACNM, is currently the Director of the Midwifery Graduate Program at the University of Pennsylvania and in Midwifery practice at the Hospital of the University of Pennsylvania, Philadelphia, PA.

  • Mamie Guidera CNM, MSN,

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    • Mamie Guidera, CNM, MSN, is a member of the faculty at the University of Pennsylvania and in Midwifery practice at the Hospital of the University of Pennsylvania, Philadelphia, PA.

  • Sarah Hakala SNM, BSN, BA,

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    • Sarah Hakala, SNM, BSN, BA, is a graduate of the University of Michigan and received her BSN from the University of Pennsylvania School of Nursing. She is currently enrolled in the Midwifery Graduate Program at the University of Pennsylvania, Philadelphia, PA.

  • Erica J. Delaney WHCNP, MSN, BA

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    • Erica J. Delaney, WHCNP, MSN, BA, is a graduate of Harvard University and received her MSN from the University of Pennsylvania School of Nursing, where she completed studies as a Women's Health Care Nurse Practitioner.


University of Pennsylvania School of Nursing, 420 Guardian Dr., Philadelphia, PA 19104. E-mail: mccoolwf@nursing.upenn.edu

Abstract

Professional liability litigation is playing an increasing role in the practice of women's health care in this country. Although the impact of litigation on obstetricians' practices has been widely documented, data on the effect of litigation on midwifery practice are scant. The authors conducted a nationwide Web-based survey of American College of Nurse-Midwives (ACNM) members about the experience of being involved in litigation. The survey was completed by 600 midwives (17.5% response rate). Of those midwives completing the survey, 152 (25.3%) had been named in a lawsuit at least once during their midwifery careers. The litigation cases had been resolved for 114 (75%) of these respondents at the time of the survey. Forty-one (36%) reported being dropped from the case, even though the litigation continued without their involvement. Another 54 individuals (47.4%) were involved in cases that were settled before going to court, and an additional 10 cases (8.8%) were dropped without a settlement. Of the nine lawsuits (7.9%) that went to court, four favored the plaintiff (3.5%) and five (4.4%) favored the defendant. Future surveys are needed to better define the relationship between the practices of midwives and medical malpractice litigation.

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