http://khn.org/news/california-doctors-and-hospitals-tussle-over-role-of-nurse-midwives/?utm_campaign=KHN%3A+Daily+Health+Policy+Report&utm_source=hs_email&utm_medium=email&utm_content=32615438&_hsenc=p2ANqtz-8ImMNfbaboVFE98SiaPvCTZ4yTpxm1jcBnGL_CYvqxvYvZwPQNFNecHArS_UOxcmh7DeSB55A1rlnC8y5IjYTjPqcSTg&_hsmi=32615438

A California bill that would allow certified nurse-midwives to practice independently is pitting the state’s doctors against its hospitals, even though both sides support the main goal of the legislation.

The California Hospital Association and the California Medical Association, which represents doctors, agree that nurse-midwives have the training and qualifications to practice without physician supervision.

But they differ sharply over whether hospitals should be able to employ midwives directly — a dispute the certified nurse-midwives fear could derail the proposed law.

The bill would override an existing law that requires certified nurse-midwives to practice under the supervision of medical doctors. California is one of only six states that requires full supervision. Several other states mandate other forms of collaboration, such as in prescribing medications.

The American College of Nurse-Midwives has been chipping away for decades at state laws that require physician supervision, and it has finally passed the tipping point nationally, said Jesse Bushman, director of federal government affairs for the organization. Nurse-midwives aren’t seeking permission to go off and do whatever they want without consulting anyone, Bushman said. “They’re just asking to be able to do what they are trained to do.”

In states where nurse-midwives can practice independently, there is more access to care, he said, citing a recent report published by the George Washington University’s Jacobs Institute of Women’s Health.

There are more than 11,200 nurse-midwives around the nation, including about 1,200 in California. They provide maternity care, family planning services and other primary care for women.