Non-Tri Entry-- Political View Regarding Obstetrics

Sent to MA State Representatives:
I have been practicing obstetrics and gynecology in Massachusetts for over 15 years. I have worked with certified nurse midwives during my residency (training) and I have served as a back up for CNMs as a board certified obstetrician-gynecologist. I have great respect for the philosophy and practice given by CNMs who have completed post-graduate training in a credentialed program. CNMs are extremely capable of handling uncomplicated obstetrical care. I have also seen how despite best intents and efforts of a certified nurse midwife, a mother's health can easily be jeopardized without a physician's extensive knowledge and surgical expertise as back up. Obstetricians are held to a high standard-- after medical school we enter competitive 4- year residency, and we are required to re-certify every 6 years (as compared to 10 years for orthopedists, internists and others, for example). It is a field that, rightly so, requires close oversight as the health of a women is greatly threatened during pregnancy, delivery and postpartum. The lack of sufficient training and oversight for "certified professional midwives" and lay midwifery is most concerning for assuring women's health.

I am a mother as well and I am forever grateful for the superb care by an obstetrician when I was pregnant with my first-born son. I had an infection, which endangered my son's health, leading to a premature delivery. Now he is turning ten years old, soon to be entering 4th grade and he is healthy and I am healthy and for that I am beyond grateful.

I am deeply concerned regarding MA Senate Bill 2341
An Act RELATIVE TO CERTIFIED PROFESSIONAL MIDWIVES AND ENHANCING THE PRACTICE OF NURSE-MIDWIVES.

As a highly regarded colleague states,
"The most alarming thing about this bill is the following statement in the bill,
'The practice of midwifery shall not constitute the practice of medicine, certified nurse-midwifery, or emergency medical care to the extent that a midwife advises, attends, or assists a woman during pregnancy, labor, natural childbirth, or the postpartum period.'

As obstetrician/ gynecologists we are fully aware that while labor is a physiologic process, there are a myriad of potential complications a woman might endure during her pregnancy or postpartum period. This bill would essentially say women’s health care falls outside the realm of medical care, and the licensed practitioners wouldn’t be subject to the same degree of oversight other providers of women’s health care are."

I would strongly urge you to consider defeating this bill for the safety of women.
Sincerely yours,
Kitsa Catherine Kondylis-deBlois, MD, FACOG