Nurse Midwives Are Trained, Lifesaving Professionals. Why Are We Holding Them Back?

Alieza Durana exposed the red tape stopping nurse-midwives from solving America’s maternal care crisis for the Better Life Lab blog on Slate.

At a time when maternal mortality rates are decreasing worldwide, they more than doubled between 2000 and 2014 in the U.S. and particularly affected women of color. A simple solution to the skyrocketing costs and scarce access to maternal care is at our fingertips: nurses. Jessica Henman got her master’s and license as a certified nurse midwife in 2010, but when she went to practice in the St. Louis area, she hit a wall. She needed to establish a legal “collaborative agreement” with a doctor who would review her charts, approve prescriptions, and be held liable for her work. But because Missouri doctors are limited in the number of advanced practice nurses they can collaborate with (three), she had a hard time finding one. “I contacted over 100 physicians and couldn’t find a collaborator,” recounts Henman. In Missouri, a doctor needs to review the work of advanced practice nurses; if that doctor gets hit by a bus and isn’t able to practice, Henman can’t practice. Ironically, Henman went back to get a lesser degree as a certified professional midwife so she could practice without a collaboration agreement. For her first two years as a midwife, Henman operated under a lesser certification and only took low-risk pregnancies of mothers able to pay out of pocket.