Midwife Bill Pleases Local Practitioner

Among the nearly 100 bills signed into law by Gov. David Paterson earlier this week was one that Melanie Sumersille, a certified nurse midwife and Master of Science in nursing, finds near and dear to her heart. The bill would allow licensed midwives to deliver babies without written practice agreements with physicians.

"We have always been considered licensed, independent practitioners, and yet we always needed a supervisory agreement," said Sumersille, who is a nurse practitioner at Garden City Obstetrics and Gynecology at 877 Stewart Avenue. "This will allow midwives to function more independently. Now what it means is I don't have to necessarily speak to the supervising doctor."

Midwives are autonomous practitioners who are specialists in low-risk pregnancy, childbirth, and postpartum. Their role is to help women have a healthy pregnancy and natural birth experience.

In the past, however, they have not always been treated with the respect their expertise deserves, according to Sumersille, who is also the assistant director of risk management and OB Informatics at MediSys Health Network.

Under the bill, which passed the Senate by a vote of 61-0, New York joins 15 states that do not require licensed midwives to have written agreements with doctors to provide an alternative birthing method in homes or in hospitals.

The legislation was spurred by a hospital closing that left hundreds of pregnant women planning home births with the possibility of having no midwife care. In April, New York City's St. Vincent's Hospital closed, leaving midwives without the state-required written practice agreements.

There are an estimated 1,300 licensed midwives in New York. They perform about 15 percent of the non-cesarean deliveries. Assemblyman Dick Gottfried, a Manhattan Democrat, and co-sponsor of the bill, said: "The written practice agreement is an unnecessary restriction that blocks many midwives from serving the community."

Sumersille said midwives are not going to abuse this new-found independence.

"Every health care provider is limited by their procedures and protocols. A family practice doctor is not going to take on brain surgery and I am not going to take on a hysterectomy," she said. "There are clear cut procedures. You have to know your own limitations."

Sumersille has spent 27 years in midwifery and lays claims to one of the longest standing -- if not the longest standing, she said -- cooperative physician arrangement. She has long held an independent practice within the Garden City OBGYN. "I always saw my own caseload of patients," she said.

The new measure is good news for patients, Sumersille said, because it would allow midwives to provide their patients with quicker and more appropriate access to qualified providers. "Hopefully in the new scenario hospitals and physicians will include licensed midwives as part of the treatment team."

Some New York State doctors opposed the legislation, citing liability and emergency issues.

Sumersille said the new bill is good for midwives and patients but will require doctors to adjust. "This will take a lot of getting used to for doctors," she said. "Now they have to come to the table and talk about (patient care procedures)."