Medical Malpractice
Midwifery involves providing obstetrical care, including childbirth. Midwives deliver babies in hospitals, birth centers, and in the birth mother’s home. Midwives have long been defendants in birth injury lawsuits alleging medical malpractice that caused permanent injury or death to the child or mother.
Maryland Law
Historically, midwives have played a large role in providing obstetrical care. In rural Maryland in the 19th Century, most midwives learned the craft through apprenticeship and the school of hard knocks. Midwives were not regulated in Maryland until 1898.
Maryland law defines nurse-midwifery in COMAR 10.27.05.01 as the healthcare “management of newborns and clients throughout their reproductive life cycle.” Under 10.27.05.01, nurse-midwifery includes the healthcare management of newborns and patients throughout their reproductive life cycle. Maryland does not permit unlicensed or lay midwives to practice. A midwife must be:
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A registered nurse
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Certified by the American College of Nurse-Midwives Certification Council
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Approved by the Maryland Board of Nursing
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Affiliated with a physician
COMAR 10.27.05.02 outlines the requirements for certification as a nurse-midwife. A midwife must not only be a registered nurse but must also have a current certification as a nurse-midwife by the American College of Nurse-Midwives. The midwife must also be affiliated with a medical doctor.
If these requirements are completed, COMAR 10.27.05.06 allows a midwife to perform “independent management of clients appropriate to the skill and knowledge of the certified nurse midwife and the nurse midwife’s agreement and protocols” and “management, in collaboration with a physician, of clients with medical complications.”
So in Maryland today, there are not the “old granny” midwives of yesteryear. Midwives are no longer women without education whose formal training was serving as an apprentice for another midwife. Today, Maryland midwives are registered nurses with advanced specialized training in midwifery.” The overwhelming majority (approximately 98%) of midwife-attended deliveries occur in hospitals, with one percent in birth centers, and one percent in the client’s home setting.
Are Midwives Safe?
Does this mean that it is safe to have a midwife deliver your baby? Our opinion is not a medical opinion but rather one based on seeing how difficult it is to manage complications during the birthing process. We think you are better off going to a great hospital and getting a great OB.
So why even allow midwives in the first place? That is a great question. It is simply not as safe as having a good OB/GYN. It is mostly because some people are going to have their babies at home or underwater or however they want to do it. Midwives deliver 12.1% of all vaginal births in this country. The state will not be able to stop it. So the thinking is we should at least allow some regulation and some hope that generally accepted procedures will be utilized.
There are good midwives. The problem our lawyers have is that midwifery care is primarily intended for healthy women. So when complications develop, midwives typically refer the mother-to-be to other health care providers. The problem is we often do not know who is healthy and who is not healthy until it is too late.
Midwives and Birth Injuries
Midwives can also make the same medical malpractice mistakes that can cause birth injuries as obstetricians. Why don’t you hear about $20 million verdicts against midwives in birth injury cases? Because in birth injury cases, the key is to find negligence on the part of the deep-pocket hospital that has the coverage and assets to satisfy a judgment. It is rare to find a midwife who has more than $1 million in coverage. Meritorious birth injury cases against the midwife alone usually result in the insurance company offering the full insurance policy pretty quickly. Parenthetically, this is all why the Internet has a hundred thousand pages to attract birth injury lawsuits, but few mention midwives who are delivering so many babies.
Most birth injury cases against midwives stem from when they see or should see signs of trouble, like an abnormal fetal heart monitoring strip, and do not abort the mission and get to an obstetrician. If there is a sign that the mother or the baby is in trouble, this is a higher risk case that requires a more comprehensive obstetrics team.
Suing a Midwife vs. Suing the Hospital
When a birth injury occurs during midwife-managed labor, one of the first questions is who is legally responsible.
The answer depends on the setting and the structure of the care team.
If the midwife was practicing inside a hospital, the hospital may share responsibility under agency, supervision, or credentialing theories. If the midwife was affiliated with a physician group, that practice may also be named in the lawsuit.
In some cases, the midwife’s failure to recognize and escalate fetal distress is the central issue. In others, the breakdown involves hospital systems — delayed cesarean response times, unclear escalation protocols, or poor communication between the midwife and the supervising obstetrician.
Evaluating a midwife negligence case requires careful review of:
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Fetal monitoring strips
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Timing of physician notification
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Transfer decisions
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Communication records
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Hospital escalation policies
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Credentialing and supervision agreements
That evidence determines whether the claim is against the midwife alone, the hospital, or both. When in doubt, we err on the side of suing only the hospital. Why? Because if the hospital accepts responsibility for the midwife, we would rather sue the hospital or the physicians’ group than blame an individual. Why, then, is the hospital willing to do this? Because they want to protect their healthcare providers. This can be a rare case where everyone wins.
Midwife Birth Injury Settlements and Verdicts
When a birth injury occurs under the care of a midwife, families often ask the same questions: Can midwives be sued for negligence? Do I have a birth injury lawsuit against a midwife? Was this simply a tragic outcome, or was there negligent hospital staff and a failure to escalate care? Midwives can be defendants in medical malpractice claims just like obstetricians. The key issue in any midwife negligence case is whether warning signs during labor were recognized and whether timely physician involvement occurred. Below are recent midwife negligence cases, including verdicts and settlements, showing how courts evaluate claims involving midwife malpractice and hospital collaboration failures.
Midwife negligence verdicts and reported settlements are far less common than hospital or OB-GYN malpractice outcomes. That does not mean claims are rare. It means many midwife cases resolve quietly. Certified nurse midwives often carry lower malpractice insurance limits than hospitals or physician groups, and when liability is strong, insurers frequently tender policy limits early. In other cases, the hospital or supervising physician is also named, and the case is reported under the hospital’s name rather than the midwife’s. As a result, public verdicts against midwives represent only a fraction of midwife negligence claims that are actually filed and resolved.
Here are some of these settlements and verdicts:
Jennings v. Cox (Wisconsin 2025) $29,070,051: A woman in labor experienced a sudden and significant drop in her baby’s fetal heart rate while under the care of a certified nurse midwife. The midwife allegedly failed to timely contact an on-call obstetrician or arrange for emergency intervention despite concerning tracings. The baby suffered hypoxic brain injury and was later diagnosed with cerebral palsy requiring lifelong care. The family sued, alleging negligent monitoring and failure to escalate care. A St. Croix County jury returned a verdict of $29,070,051.
Anonymous v. Midwife and Einstein Medical Center (Pennsylvania 2023) $5.6 million: A mother under midwife-led labor management experienced complications that allegedly were not timely escalated to a supervising obstetrician. The child sustained neurological injury during delivery. The lawsuit claimed negligent monitoring and delay in obtaining appropriate physician intervention. A Philadelphia jury awarded approximately $5.6 million.
Anonymous v. Anonymous (Florida 2020) $12 million: During a midwife-managed labor, signs of fetal distress allegedly were not properly addressed and transfer to physician-led care was delayed. The newborn suffered permanent neurological injury. The family sued the midwife for negligent labor management and failure to timely intervene. A Florida jury awarded approximately $12 million in damages.
Anonymous v. Anonymous (Massachusetts 2016) $1.5 million: A certified nurse midwife allegedly failed to properly respond to abnormal fetal heart rate monitoring during labor and delayed contacting an obstetrician. The baby suffered brain injury consistent with oxygen deprivation. The family filed a malpractice lawsuit alleging failure to recognize and act upon fetal distress. The case resolved through mediation for $1.5 million before trial.
Suing a Midwife
Have you suffered a hospital injury due to the negligence of a midwife? Miller & Zois can help you. Call us at 800-553-8082. You will speak with a nurse attorney who will understand what has happened to you and can explain to you what your options are and answer any questions you may have. You can also get an online case review.