Certified nurse midwives (CNM) not only perform routine health screenings and reproductive management for women, but they also care for women during the perinatal period and care for both mother and newborn in hospital settings or birth centers. As with any healthcare provider, malpractice cases threaten even the most cautious advanced-practice nurse.

Depending on the organization or facility the CNM is employed, malpractice insurance may or may not be required. Some organizations provide malpractice insurance for its providers, and therefore, additional coverage is not necessary for employment. However, many would argue the benefits of carrying additional coverage because employer-paid coverage may not be adequate in covering financial losses, and representation may be lacking in quality.

The cost of malpractice insurance can vary. Cost can depend on the state of employment, years of experience, setting, and the coverage chosen. CNMs tend to pay more the more years of experience they have (more deliveries mean more potential for lawsuits). The cost can be as low as $5,000-$6,000 per year or exceed $20,000 per year. CNMs in a group practice may pay lower rates depending on how many providers they are in practice with. Additionally, some physicians who are engaged in a collaborative agreement with a CNM due to states' scope of practice laws may even be charged fees by the CNM's malpractice insurance company.

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In a study done in 2008 among 145 CNMs, seven reported going without coverage. Of those, five stated that it was extremely difficult to obtain coverage. Most of the respondents (126 of 145) said they were covered through an employer. Additionally, the study found that the CNMs in the study were practicing "defensively"- in other words, ordering unnecessary tests or procedures out of fear of malpractice suits. Unfortunately, this can drive healthcare costs up as well as open the CNM to potentially more malpractice cases because of the complications or side effects of unnecessary tests/ procedures.

We, unfortunately, live in a litigious society and in healthcare, there is no room for error. However, errors do occur, and healthcare providers should consider carrying malpractice insurance to protect their assets, homes, and financial well-being.

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