RE “THE high cost of caesareans’’ (oped, June 28): The authors rightly point out the concern many obstetricians have regarding our national caesareans section rate. However, there are many factors contributing to this rate, including the obesity epidemic, the number of women delaying childbearing (and the associated increase in medical risk factors for abdominal delivery including diabetes and hypertension), and the litigious society in which we live.
The Legislature is not the appropriate body to direct medical care, however. The current bill in Massachusetts attempting to “expand access to midwifery care’’ is not the solution. Our state has wonderful, well-trained, competent certified nurse midwives and certified midwives who provide exceptional care to women in the Commonwealth.
This bill would license certified professional midwives, formerly called “lay midwives,’’ who don’t even have to have a high school diploma to attain certification. This could also potentially cost the state millions of dollars during difficult economic times.
Yes, we all care about the caesareans rate and need to develop strategies to improve access to care by qualified providers in safe settings. However, licensing individuals without adequate training is a dangerous proposal and not the answer to challenges in the health care system.
Gabe Cohn, MD and Erin E. Tracy, MD
The writers are chairman and vice chairwoman, respectively, of the Massachusetts section of the American College of Obstetricians and Gynecologists.