Missouri has lost 11 hospital maternity wards since 2009, and state rules on certified nurse-midwives are leading some providers to practice across the state line in Kansas, according to reporting by KCUR and St. Louis Public Radio. Among the closures is the maternity unit at Research Medical Center in Kansas City, Missouri.
Missouri requires certified nurse-midwives to sign a collaborative practice agreement with a physician. The report counts Missouri among 11 states with this kind of requirement. Kansas and Iowa let nurse-midwives practice without a physician agreement.