A certified nurse midwife, sometimes referred to as a CNM or simply a nurse midwife, is an advanced-practice registered nurse who specializes in women's reproductive health and childbirth. Not only do they attend to women during pregnancy, childbirth, and post-birth, they also are responsible for preventive women's health maintenance.
Midwives serve a unique and essential purpose in women’s health care. And in this unique position, midwives can also be the target of malpractice claims, just like any other healthcare provider.
If you’re a midwife, you likely need midwife professional liability insurance to protect your practice and your career if something goes wrong during a birth or any type of healthcare service that you provide. A local independent insurance agent can help you find the midwife liability insurance you need.
Facts about Midwives
Here are facts about midwives from the American College of Nurse-Midwives.
- According to the American Midwifery Certification Board, as of February 2019, there were 12,218 CNMs (Certified Nurse Midwives) and 102 CMs (Certified Midwives). The majority of midwives in the United States are CNMs.
- CNMs are licensed, independent health care providers with prescriptive authority in all 50 states, the District of Columbia, American Samoa, Guam, Puerto Rico, and US Virgin Islands. CNMs are defined as primary care providers under federal law.
- CMs are licensed, independent healthcare providers who have completed the same midwifery education as CNMs. CMs are authorized to practice in Delaware, Maine, Hawaii, New Jersey, New York, and Rhode Island. CMs have prescriptive authority in New York, Rhode Island and Maine.
- In 2017, CNMs/CMs attended 351,968 births—a slight increase compared to 2016. In 2017, CNMs/CMs attended 85% of all midwife-attended births and 9.1% of total US births.
What Is Midwife Liability Insurance?
Midwives care for women who desire unique professional attention, including a natural birthing experience and attention to medical needs in a compassionate and empathetic environment. The relationship between a midwife and a patient is special, creating a closeness and confidence that may not exist in a physician/patient relationship.
Unfortunately, no matter how competent and compassionate your services, or how good your relationship is with your patients, you can be sued.
Midwife professional liability insurance helps protect against the cost of lawsuits based on the professional services you provide. Midwife liability insurance provides coverage for legal expenses and financial compensation that you must pay to others for losses resulting from your actual or alleged wrongful acts, or those of another person for whom you are legally responsible.
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Why Do You Need Midwife Liability Insurance?
Certified nurse-midwives (CNMs) and certified midwives (CMs) perform a wide range of primary health care services for women. These services include primary care, gynecologic and family planning services, preconception care, care during pregnancy, childbirth and the postpartum period, care of the normal newborn during the first 28 days of life. Midwives provide initial and ongoing assessments, diagnosis, and treatment; they conduct physical examinations; prescribe medications; admit, manage and discharge patients; order and interpret laboratory and diagnostic tests; and order the use of medical devices.
Midwives work in a variety of settings, from ambulatory care clinics and private offices to community and public health systems, homes, hospitals, and birth centers.
There are numerous reasons why midwives need midwife professional liability insurance, including the following.
- We live in a litigious society, and even the most skilled and cautious healthcare providers can find themselves involved in a lawsuit related to the care they’ve provided.
- You need to protect your practice and your personal assets. Defending a malpractice suit is expensive, even if you win. Providers often win malpractice cases, but the costs to defend the case will likely be unrecoverable. Your defense costs could include the following.
- Attorney and expert witness fees
- Payment of damages if you lose
- Court costs and other expenses
Remember, even if your coverage is offered through your employer, a facility, or as an extension of a physician’s policy, you likely still need your own policy. Your employer’s malpractice insurance is probably focused on protecting the group or the primary physician. It likely has gaps that could leave you financially devastated you’re sued for malpractice. Here are examples of additional situations.
- If you change jobs, the previous employer’s malpractice insurance may not cover you for claims made after you leave, even if the incident happened while you were still an employee.
- Your employer’s malpractice insurance coverage limits may be insufficient to cover everyone named in a malpractice suit.
- Employer coverage may not cover you for individual activities outside of the practice, e.g., if you moonlight or offer healthcare services outside of the practice as an independent contractor.
It makes sense to purchase your own midwife professional liability insurance to make sure you are protected in all circumstances and for the long term.
Keep in mind that in some states, midwives are required to have midwife malpractice insurance.
What Does Midwife Liability Insurance Cover?
Pregnancy comes with a set of risks not only to the mother and child, but to the midwife as well. Midwives may be accused of being responsible for adverse birth outcomes and any number of other negative outcomes for patients.
Any mistake or oversight that negatively impacts a patient can result in a lawsuit. A midwife professional liability policy will provide coverage for actual or alleged errors, omissions, negligence, breach of duty, misleading statements, and similar claims resulting from the performance or non-performance of professional services.
Midwife professional liability insurance typically excludes coverage for negligence due to illegal conduct, sexual improprieties, factual misrepresentations on the application for insurance, hospital or lab administration, or medical records alteration.
Every type of medical professional has different types of risks that need to be covered by their malpractice insurance. CNMs and CMs need to work closely with an insurance agent to make sure their policy fits their needs.
What Kind of Midwife Liability Insurance Should You Buy?
You can purchase midwife liability insurance with dollar limits that are appropriate for you. Most policies specify the following.
- An individual limit (the most that will be paid for any one claim)
- An aggregate limit (the most that will be paid in any policy year for all claims)
So if your policy has limits of $1,000,000/$3,000,000, this means it will pay a maximum of $1 million per claim and $3 million for all claims during a policy term.
There are two types of medical malpractice insurance policies: claims-made policies and occurrence policies. Both types of policies are very complex. You need to know how each one works and pays the claims, and then purchase the one that works best for your specialty and unique needs.
How Should You Choose Your Midwife Liability Insurance Company?
Most healthcare professionals purchase and keep the same malpractice insurance for the life of their practice. This is especially important for midwives who may change jobs several times during their career, but are still susceptible to claims that are filed years after an incident occurs.
Maintaining your own individual midwife malpractice insurance, as opposed to employer-provided coverage, is the best way to ensure you are protected for your entire career even if you change jobs or become a full-time independent contractor.
When choosing a midwife professional liability policy, be sure to select a financially strong insurance company that will be around for the life of your practice. An insurance company’s financial rating is an effective predictor of its strength and longevity.
Professional liability insurance is very important for all healthcare providers, including midwives, and also very complicated with a lot of variations. Be sure to work with an independent insurance agent who understands your needs, understands the policy you are purchasing, and understands the implications of making changes to it over time.
How Much Does Midwife Liability Insurance Cost?
Your employer may pay for some or all of the cost of your midwife liability insurance. You may be able to purchase coverage on your own and be reimbursed by your employers.
The cost of midwife professional liability insurance will vary. Your cost can depend on the state in which you practice, your years of experience, the setting in which you practice (private practice, birthing center, etc.), and the coverage limits you choose. Surprisingly, the more experience you have as a CNM may lead to higher costs for your professional liability insurance. Because birthing is a high-risk practice, the more births you attend means you have a greater risk for something going wrong and being sued.
If you’re in a group practice, you may pay less for coverage than you would by purchasing individual coverage.
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Midwives need specialized midwife liability insurance for the specific and unique risks they face. It’s important to work with an independent agent who can find insurance companies who specialize in covering your liability risks, and who sell malpractice insurance specifically designed for your specialty.
An independent insurance agent can help you find the right policy and can help you assess your options.
TrustedChoice.com Article | Reviewed by Paul Martin
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