Midwifery Legislative Updates

The Big Push For Midwives, launched on January 24, is a coordinated campaign to advocate for regulation and licensure of Certified Professional Midwives (CPMs) in all 50 states and the District of Columbia. The website includes a page with links to news articles related to midwifery-related legislative efforts, and a map of states where licensure is available or where legislation is pending. Licensure is currently available to CPMs in 22 states.

Here's what's going on - at least, what's been in the news lately. Not a comprehensive list, but hopefully I'll get these updates out more often.

Alabama - SB240 and HB 314 establish a State Board of Midwifery. Link: Bill would allow home childbirth, a healthy option.

Idaho - HB 488 would provide for voluntary licensure for CPMs. Link: Idaho midwives want licensing option, ability to offer meds.

Maryland - HB 1407 would end the requirement that nurse-midwives practicing in Maryland have a written agreement with a doctor. Get the info from VBACFacts.com.

Missouri - Home birth supporters return with new midwifery measure:

Last year, lawmakers unwittingly approved a lay midwifery law after [Senator John] Loudon inserted an obscure medical term into a broader health insurance bill during the legislative session's frantic final days. The measure was signed by Gov. Matt Blunt but has since been overturned by a Cole County judge. An appeal to the state Supreme Court is pending.

Senate President Pro Tem Michael Gibbons responded to Loudon's tactics by removing him as chairman of the Small Business, Insurance and Industrial Relations Committee. He earned the job back by promising to push a bill repealing the law allowing those with private "tocological certification" to offer pregnancy-related care.

Tocology is a synonym for obstetrics, coming from the Greek root word of childbirth.

On Wednesday, the Senate Pension, Veterans' Affairs and General Laws Committee considered two Loudon bills - one to repeal the midwifery law, and the other to create a state licensing board to monitor midwives - but took no action.

The Missouri bills are HB 1600, SB 1021 and SB 870.

New Hampshire - The NH legislature has passed a bill, SB131, which requires insurance companies to cover midwife-attended home births in that state:

The bill builds on New Hampshire's long history of supporting alternatives to hospital birth. For more than 20 years, the state has permitted "lay midwives" who do not have medical or nursing degrees to practice in the state once they obtain proper training. Two years ago, it approved a measure that required health insurers to pay for deliveries in birthing centers run by midwives.

The newest bill does not change much other than the range of places where a woman can deliver her baby, but that choice is critical, many of the bill's advocates said.

"This gives women a real choice," said Rep. Jim Martin of Sanbornville, a Republican who was one of the bill's sponsors.

link: Backing at-home births.

North Carolina - Midwives seek state sanction:

Rep. Charles Thomas, R-Buncombe, submitted language to legislative bill drafters last year but never turned it into a bill. He said the supporters didn’t meet with doctors and trial lawyers seeking common ground, as he had encouraged.

So Rep. Ty Harrell, D-Wake, won legislative leaders’ agreement to form a commission to study the issue. The panel includes medical professionals as well as Thomas, Harrell and other lawmakers, and is co-chaired by Rep. Bobby England, a doctor and Democrat from Rutherford County.

After the panel’s first meeting, Thomas was skeptical of the proposal he called “an end run around medical school” but said a compromise might be reached if concerns about safety and liability are met.

Ohio - Legalizing Birth: Ohio criminalizes midwives wanting to help women deliver at home:

Ohio law only recognizes nurse midwives, who are registered nurses with a master's degree in midwifery, according to Stephanie Beck Borden, chair of Ohio Families for Safe Birth.

"In Ohio, nurse midwives are not independent practitioners" but rather have a "written collaborative agreement with an obstetrician to practice," she says.

But CPMs or direct-entry midwives like Helwig, who care for women giving birth in their homes, lack official approval.

"Direct-entry midwives are at risk of legal prosecution for practicing medicine," Beck Borden says. "In Ohio there is no protection, no regulatory body for direct-entry midwives. (They can be) prosecuted for practicing advanced-practice nursing without a license or practicing medicine without a license, which is a felony."

South Dakota - Senate Bill 34, which allows Certified Nurse-midwives to attend home births, passed both the House and the Senate by wide margins. House Bill 1155 which would license and regulate Certified Professional Midwives, is struggling. See also Home Birth Midwifery "Smoke Out".

Midwifery Legislative Update

A lot going on. Let's get right to it.

Federal (US) - The Midwifery Care Access and Reimbursement Equity Act of 2007 (HR 864/S.507) would "amend title XVIII of the Social Security Act to provide for reimbursement of certified midwife services and to provide for more equitable reimbursement rates for certified nurse-midwife services."

Illinois - SB 385 would provide for the licensure of direct-entry midwives. I'm not hearing a lot of buzz about this one.

Indiana - A Midwifery Licensure Bill, HB 1238, is scheduled to be heard by the Committee on Public Health on Monday morning. Quick! Contact your legislator!

Missouri - SB 303 and HB 503 provide for the licensure of direct-entry midwifery. The bill defines "direct-entry midwife" as one licensed as a Certified Professional Midwife by NARM. Currently, the unlicensed practice of midwifery in Missouri is a felony.

North Dakota - SB 2377 was originally a bill making it a Class B Misdemeanor for a person to provide obstetrical services without a license; however it now appears to be a bill providing for a legislative council study "of the provision of obstetrical services by laypeople."

South Dakota - HB 1207, the bill to regulate direct-entry midwifery seems to be dead. HB 1267 would remove the requirement that Certified Nurse-Midwives have a written collaborative arrangement with a physician, which would in effect allow CNMs to attend homebirths.

Utah - SB 243 would amend Utah's Direct-Entry Midwife Act by defining what constitutes a “normal” pregnancy, labor and delivery; and clarify when consultation or transfer is required. Opponents of the bill say that the language is too restrictive, and would effectively end homebirth in the state for all but a handful of women. The Mommy Blawger thinks that legislators, the vast majority of whom have neither given birth nor delivered a baby, are not qualified to define "normal" birth by any stretch of the imagination.

Know of any legislation that I've missed? Shoot me a comment or an email.