Midwife says unfair policy threatens career

Sharon Foster, a certified midwife nurse, says she had to quit her job because she couldn't find a doctor to sign a collaborative practice agreement, giving her the green light to handle home births.

Foster's clinic posted her story on Facebook Wednesday. Nearly 200 people shared the post and called the KWCH 12 newsroom, asking Eyewitness News to do a story to dig up answers and bring the root of this problem to the surface.

"It's frustrating. It's sad," Foster says. "I have a lot of patients that are being forced to change. One lady was due any time."

Foster is a certified nurse midwife. In her position, she needs a doctor's approval to practice each year. This is unlike Deidre Degrado, a certified professional midwife. Her title is similar, but Degrado does not need that formal approval from a doctor.

However, she also does not have the advanced-learning degree like Foster.

"The playing field needs to be leveled, and the certified nurse midwives, many like (Foster) who have a tremendous amount of experience and high level of education are basically required to be held to a higher standard than the CPM's are," Degrado says.

Degrado said CNMs have collaborated agreements in Kansas City, Manhattan, Lawrence and other cities. She also knows hospitals in Topeka employ midwives in their hospitals and birth centers. She said Wichita hospitals don't have midwives.

A few days ago, Foster quit her job because she couldn't find a doctor to sign for her. And she wants to know why.

OBGYN Jonathan Scrafford says it comes down to liability and safety.

"Probably the two most common reasons OBGYNs are not willing to sign collaborative agreements for home births are either due to concerns about safety which usually draws from just the idea that home births are not safe, and there is some backing for that within the American college of OBGYNs. The ACOG does consider home births to have a higher rate of complications than planned hospital delivers, so some of that draws from safety," said Scrafford.

He said it also comes down to liability.

"My understanding is typically vicarious liability is not upheld in a court of law in these cases because the physician does not have a direct interaction or supervision with the mid-wife," Scrafford says. "But the idea of signing collaborative agreement often times puts the fear of liability in the heart of an obstetrician."

Scafford said Wichita is the largest market in the country without midwives delivering at accredited medical facilities, and he believes it would benefit women if that changed.

For Foster, the concern comes with what she says is a lack of options for women in the community.