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The new commentary, article by article, explores the importance of the legal practice agreement.
Despite many successful applications in practice, agreement regarding design criteria has not been reached.
So to Ms. Paulin, New York's requirement that midwives have a "written practice agreement" with a doctor or hospital seems like an unnecessary hurdle.
Suppose a woman is giving birth in a hospital, attended by a midwife without a practice agreement, and the woman starts to hemorrhage, Donna Montalto, executive director of the New York division of the congress of obstetricians, said Thursday.
(Most states still require nurse practitioners to work with physicians under a written practice agreement). The bill's authors contend that mandatory collaboration with a physician "no longer serves a clinical purpose" and reduces much-needed access to primary care.
But the requirement for a so-called written practice agreement had been a particularly high hurdle for midwives who assist at home births, which are often outside mainstream practice, and for those in rural counties where doctors are scarce.
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The hospital had practice agreements with 7 of New York City's 13 home-birth midwives.
Though in theory the ITU works by majority vote, in practice agreements are almost always reached by consensus.
So-called written practice agreements with hospitals or doctors have been a condition for all midwives to practice in New York State since 1992.
For example, in the newly privatised general practice agreements, the government has fragmented previously integrated services into core, additional and enhanced services.
Midwifery organisations are scrambling to persuade other hospitals to take over St Vincent's role by signing the so-called "written practice agreements" the midwives need to be legal.
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