Abstract:Lawsuits among midwives were significantly related to exposure to births over time. Practice patterns and job security were not greatly affected by the experience of a lawsuit. Future cyclic surveys are needed to track the frequency of litigation and the outcomes that lead to lawsuits and to better define the relationships between midwifery practice and medical malpractice litigation.
“…In the first national survey of CNMs/CMs regarding their involvement in malpractice lawsuits, more than 25% of respondents stated that they had been involved in at least one lawsuit as a result of practicing as a midwife . Five years later, in a second national survey of CNMs/CMs, the percentage had increased to 32%, nearly a third of midwife respondents . Another survey that focused on practicing midwives in one state (Michigan) revealed that 35% of respondents had been named in a malpractice claim …”
Section: Review Of the Literaturementioning
confidence: 99%
“…Litigation following adverse outcomes in clinical practice is commonplace in the United States, and certified nurse‐midwives/certified midwives (CNMs/CMs) are not exempt from this process . Most often, the last step in litigious courses of action are closed claims , which are lawsuits that have come to an end either because: 1) the case has been dropped without any judgment put forth; 2) a settlement has been reached between the parties involved, commonly referred to as the plaintiff who initiated the suit and the defendant against whom a litigious claim has been made; or 3) a decision has been rendered in a civil law proceeding, such as a trial or an arbitration hearing .…”
Recommendations for improving clinical practice and avoiding litigation based on findings from the closed claims analysis include, but are not limited to, the need for thorough and accurate documentation in practice, appropriate and timely consultation and collaboration, and the presence of practitioners whose clinical skills match the level of care assessed to be necessary for each woman for whom care is offered.
“…In the first national survey of CNMs/CMs regarding their involvement in malpractice lawsuits, more than 25% of respondents stated that they had been involved in at least one lawsuit as a result of practicing as a midwife . Five years later, in a second national survey of CNMs/CMs, the percentage had increased to 32%, nearly a third of midwife respondents . Another survey that focused on practicing midwives in one state (Michigan) revealed that 35% of respondents had been named in a malpractice claim …”
Section: Review Of the Literaturementioning
confidence: 99%
“…Litigation following adverse outcomes in clinical practice is commonplace in the United States, and certified nurse‐midwives/certified midwives (CNMs/CMs) are not exempt from this process . Most often, the last step in litigious courses of action are closed claims , which are lawsuits that have come to an end either because: 1) the case has been dropped without any judgment put forth; 2) a settlement has been reached between the parties involved, commonly referred to as the plaintiff who initiated the suit and the defendant against whom a litigious claim has been made; or 3) a decision has been rendered in a civil law proceeding, such as a trial or an arbitration hearing .…”
Recommendations for improving clinical practice and avoiding litigation based on findings from the closed claims analysis include, but are not limited to, the need for thorough and accurate documentation in practice, appropriate and timely consultation and collaboration, and the presence of practitioners whose clinical skills match the level of care assessed to be necessary for each woman for whom care is offered.
“…Current midwifery educators are finding it increasingly difficult to provide adequate opportunities for students to learn how to offer effective care for women with normal pregnancies in clinical placements [1,2]. Several factors impact this issue: the increased risk(s) of interventions for pregnant women over the age of 35 [3], societal awareness of women's rights and concerns about litigation [4,5], and decreased birth rates [6]. As health professionals, midwives are responsible for making important clinical decisions regarding positive childbirth experiences for pregnant women.…”
Background: Clinical decision-making skills are essential for providing high-quality patient care. To enhance these skills, many institutions worldwide use case-based learning (CBL) as an educational strategy of pre-clinical training. However, to date, the influence of different learning modalities on students' clinical decision-making processes has not been fully explored. This study aims to explore the influence of video and paper case modalities on the clinical decision-making process of midwifery students during CBL. Methods: CBL involving a normal pregnant woman was provided for 45 midwifery students. They were divided into 12 groups; six groups received the video modality, and six groups received the paper modality. Group discussions were video-recorded, and focus groups were conducted after the CBL. Transcripts of the group discussions were analysed in terms of their interaction patterns, and focus groups were thematically analysed based on the three-stage model of clinical decision-making, which includes cue acquisition, interpretation, and evaluation/ decision-making. Results: The students in the video groups paid more attention to psychosocial than biomedical aspects and discussed tailored care for the woman and her family members. They refrained from vaginal examinations and electric fetal heart monitoring. Conversely, the students in the paper groups paid more attention to biomedical than psychosocial aspects and discussed when to perform vaginal examinations and electric fetal heart monitoring. Conclusion: This study clarified that video and paper case modalities have different influences on learners' clinical decision-making processes. Video case learning encourages midwifery students to have a woman-and familycentred holistic perspective of labour and birth care, which leads to careful consideration of the psychosocial aspects. Paper case learning encourages midwifery students to have a healthcare provider-centred biomedical perspective of labour and childbirth care, which leads to thorough biomedical assessment.
“…This survey was a revision of the 2009 survey based on respondent feedback, recommendations from the ACNM Professional Liability Committee, and a pilot survey of ACNM region VI Utah Affiliate members. Items describing a midwives' scope of practice and reasons or categories for claims were derived from prior surveys, 2,3 with inclusion of high-frequency responses submitted as open ended, and the 2015 closedclaims analysis, which identified the most frequent reasons for midwifery litigation. 4 Specific practice changes due to litigation or affordability of malpractice insurance were derived from the ACOG survey to allow comparison.…”
Section: Methodsmentioning
confidence: 99%
“…9 It is presumed that similar resources will be effective. In the 2009 ACNM survey, 3 the most frequently identified sources of support or coping were practice partners and professional colleagues (62%). Counseling or psychotherapy was used by 8% of midwives.…”
Introduction: This is the third national survey about the incidence of midwifery involvement in malpractice litigation, case outcome, methods of coping, and the influence of fear of liability or actual litigation on midwifery practice and professional liability insurance. Incidence of disciplinary action was also included.
Methods:A link to a web-based survey was sent to all American College of Nurse-Midwives members with an active email address in January 2018. Students and associate members were excluded from analysis. Logistic regression was used to identify predictors of involvement in lawsuit.Results: Of 6199 email links sent, 880 midwives responded (14%). One-third of participants (n = 280, 32%) have been named in at least one lawsuit after a median of 7 years in practice. Claims most often involved intrapartum hospital-based care and resulted from fetal heart rate interpretation. The most common outcome of a case was settlement prior to court or arbitration (n = 117, 42%). Significant predictors of litigation included older age of the midwife and region of practice (increased in Northeastern states, decreased in Midwestern states). Midwives' most common source of emotional support was their attorney. Only 6% (n = 53) of participants experienced disciplinary action against their state license. Half of the actions by a state governing board were unrelated to a lawsuit. Discussion: Midwives may experience litigation the longer they are in practice, but there has not been a significant change in the incidence since the previous survey in 2009. More resources and education are needed for midwives to provide adequate peer support to colleagues following adverse events or when named in a lawsuit. Continued education is also needed for midwives regarding types of professional liability insurance, affordability, and how policy terms and limits influence clinical practice.
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