Currently, the New York State midwifery law requires all midwives to have a collaborative written practice agreement (WPA) with a physician in order to practice legally in the state.
This requirement represents a significant barrier to practice for many midwives in the state as few physicians are willing to sign WPAs. It also tremendously hinders access to midwifery care for many women in New York.
The New York State Association of Licensed Midwives (NYSALM) has begun to advocate for the removal of the WPA requirement that midwives now must have with a physician to practice in NYS. The Midwifery Modernization Act, Senate Bill S5007/Assembly Bill A8117, would accomplish this goal.
While the spirit of the WPA requirement may seem like it inspires collaboration between midwives and physicians, in fact, this is not the case. Although many doctors are willing to collaborate with midwives, they are unwilling or unable to sign these agreements. Therefore, although midwives are trained as independent health care professionals, this requirement in the law prohibits them from being able to practice independently.
The WPA represents an enormous barrier to practice for midwives all over NYS.
Midwives collaborate, as necessary, with many different types of physicians (e.g., obstetricians, endocrinologists, pediatricians) with whom they have collegial relations. They very rarely have written collaborative agreements with these physicians – they simply refer their clients to see the doctors and the doctors agree to see them. This system works quite well without the requirement of a written agreement.
Importantly, when midwives cannot practice, women and families are denied access to optimal care. The WPA limits access to midwifery care to many women in communities across NYS, and often in underserved areas where this type of care is sorely needed. In many rural areas of the state there are no hospitals or obstetric providers to sign practice agreements. Removal of the WPA requirement would allow midwives to practice in areas where women currently have to travel very far to receive care.
With the closing of St. Vincent's Hospital, half of the licensed, highly trained home birth midwives serving NYC have lost their Written Practice Agreement (WPA). St Vincent's was the only Hospital in the city supportive of a woman's right to choose a home birth and willing to sign a WPA. In the weeks since it's announced closure, these midwives have reached out to hospitals and obstetricians all across the city looking for support, with no success. Please help us to save the homebirth option in New York