Liability insurance in midwifery education: faculty and student needs versus academic realities

The objective of this study was to examine faculty and student liability claims and insurance problems in midwifery education. The American College of Nurse-Midwives Professional Liability Section and Division of Education developed and administered an Internet survey to 45 midwifery programs. Of the 39 programs that responded to the survey, 28 (72%) were previously involved in a liability claim, yielding a maximum claim incidence of 1%. Liability coverage was provided to midwifery faculty and students by a variety of mechanisms, including sovereign immunity, organizational trust funds, and private insurance. The costs of annual liability coverage ranged from $1,500 to $7,000 for faculty and from $1,000 to $1,800 for students. Six of 31 program directors (19%) knew a student who did not enroll because of the cost of liability insurance. Thirty of the 39 directors (77%) reported difficulty with obtaining clinical placements as a result of liability-related preceptor concerns. Midwifery student involvement in liability claims is low; however, liability insurance is required by hospitals for clinical practice and many clinical preceptors. The price of private liability insurance is a disincentive for students to study midwifery and for clinical preceptors to work with students. Midwifery program directors and academic administrators must advocate for affordable liability coverage.