Midwives and doctors get along just fine

As a certified nurse-midwife, I am grateful for the attention given to midwifery by your article regarding midwives and upcoming legislation (Midwives fighting for legitimacy..., April 29). I beg to differ -- legitimacy cannot be legislated. Legitimacy grows with a reputation built on education, accountability and safe practice.

The article suggested an adversarial relationship between midwives and doctors. As certified nurse-midwives we work closely with supportive OB/GYN doctors, and the women we care for benefit from collaborative practice.

Our goal is safe and satisfying care. Most of us attend births in hospitals or birth centers, although some CNM's do homebirths.

Certified nurse-midwives are more than "...licensed nurses with additional training in midwifery." We enter our midwifery education programs with a bachelor's degree in nursing, and enter midwifery practice after extensive clinical experience and a master's degree. Our programs provide us with the pharmacology background to safely provide medications and write prescriptions.

Certified nurse-midwives are mid-level healthcare providers. We function independently at the same level as nurse practitioners and physician assistants. We care for women across their entire lifespan -- not just during pregnancy, but also for gynecological and menopausal care. CNM's are able to bill health insurance companies for the cost of care in the same way as doctors or other health professionals. Homebirth midwives are unable to bill insurance companies.

It's important that women understand the difference between certified nurse-midwives (CNM) and homebirth midwives (LM, CPM) regardless of the initials involved.

Erma Evans

Oakland

jeevans5@adelphia.net