Missouri to loosen restrictions on midwifery?

EllisDTripp · Apr 25, 2005

http://www.stltoday.com/stltoday/ne...8D7976DCAC83DFC286256FEE00107177?OpenDocument

Measure would loosen limits on midwives
By Matt Franck
Post-Dispatch Jefferson City Bureau
Sunday, Apr. 24 2005

JEFFERSON CITY- Samanda Rossi's 19-month-old son is the product of an illegal
underground movement.

Now she's hoping that the Missouri Legislature will provide her and other
mothers a sense of legitimacy.

Rossi, of Webster Groves, delivered her baby at home with the help of a
midwife. The birthing took place without a hitch, especially considering that
the midwife could have landed in prison.

Missouri law is among the most restrictive in the nation in its regulation of
midwifery. Only certified nurse midwives who partner with physicians are
legally authorized to practice. Other midwives, such as the one who delivered
Rossi's baby, face possible felony prosecution for practicing medicine without
a license.

The unlicensed midwives work within a kind of clandestine network, promoting
themselves purely by word-of-mouth. But all that would change under a bill
approved last week by the Missouri House.

The legislation, by Rep. Cynthia Davis, R-O'Fallon, would replace Missouri's
highly restrictive law with perhaps the most liberal one in the nation as it
concerns midwives.

The bill would essentially allow anyone to legally provide services as a
midwife, provided they presented mothers with information about their
experience and training.

"All I'm trying to do is stop the witch hunt so our law enforcement officers
will spend their time prosecuting meth offenders," Davis said in an interview.

But critics, including medical organizations, say the law would open the
floodgates to inferior birthing services.

"This is a dangerous piece of legislation that would literally make it possible
for anyone to hold themselves out as a midwife," said Tom Holloway, a lobbyist
for the Missouri State Medical Association.

Critics are particularly upset about a provision that would exempt midwives
from criminal prosecution, provided they worked "in good faith with a
reasonable degree of care of service." The bill also defines midwifery as
outside the realm of medical practice.

"We license everyone from wrestlers to tattoo artists, but under this bill, we
can't license people who deliver babies," said Rep. Sam Page, D-Creve Coeur.

Page, who is a physician, cites a case last year in Pittsburgh where a midwife
was charged with a felony after a baby died during a breech delivery. Under the
bill, that midwife would face no penalties, Page said.

Christine Skinner, president of Friends of Missouri Midwives, said the bill is
fundamentally about giving women choices.

"Our focus is on the rights of mothers to choose their birth attendant and
place of birth," she said. "This bill is more about consumer rights."

Skinner said the current law has all but cut off safe legal options for women
who want to deliver babies at home. It allows certified nurse midwives to
assist in home births, under a partnership with a doctor.

But Rachel Williston, of Kansas City, said she believes she's one of only three
certified nurse midwives in the state who help women give birth at home.

Williston said certified nurse midwives have a hard time partnering with
doctors, who often have concerns over insurance liability. Those fears have
made it difficult for certified nurse midwives to practice even in hospitals.

Skinner said she believes no certified nurse midwifes are providing services in
the St. Louis area, either in hospital or at home.

Supporters of the bill say it could increase the safety of home birthing in the
state. As it is, they say, unlicensed midwives might be hesitant to bring a
mother and child to the hospital during an emergency for fear of prosecution.

Davis said women who can't find trained midwives at all may be relying instead
on relatives or friends to deliver a baby at home. Under current law, those
births are legal, provided those assisting do not represent themselves as
midwives.

According to the Midwives Alliance of North America, Missouri is among about a
dozen states that prohibit midwifery other than by certified nurse midwives.
More often, states allow a broader range of midwives to practice, provided they
meet certain standards.

Illinois does not ban midwifery by statute, but the courts have limited the
practice to certified nurse midwives.

Michelle Breen, of the Coalition for Illinois Midwifery, said she believes only
a few nonnurse midwives are practicing in the state. The Illinois Legislature
failed to advance a bill that would have broadened midwife certification.

The Missouri bill, in contrast, would not require certification of any kind for
midwives. Davis said such standards would "create another large government
bureaucracy that is unnecessary." She said women should be trusted to make
informed decisions.

The legislation is backed by a curious political alliance that includes
Mennonites, Amish, conservative Republicans, as well as women whom Davis
describes as feminists. Likewise, lawmakers of both parties oppose the bill.

The measure cleared the House with the bare minimum of 82 votes needed for
approval. Page and other lawmakers say House Republican leaders played
procedural games with the bill to force it through just after midnight
Thursday. Page is now urging the Senate to defeat the measure.

In the meantime, the state's underground network of midwives continues to risk
prosecution as they welcome babies to the world.

Rossi, whose name is posted on a midwifery Web site, said she routinely
connects expectant mothers to midwives willing to help them.

Just recently, Rossi took a step aimed at protecting her own midwife. In
applying for her son's birth certificate, she listed her husband as having
supervised the baby's delivery.

The bill is HB36.

Reporter Matthew Franck
E-mail: mfranck@post-dispatch.com
Phone: 573-635-6178
Click to expand...

Rapunzel · Apr 25, 2005

*

Maggie Sugar · Apr 26, 2005

There needs to be a medium between these two sides. Not allowing midwives at all limits womyn's choices, and cuts off very good health care for many womyn. Allowing anyone who wants, no matter what their education and training to call themselves a midwife, is as dangerous as hell. Midwives, whether nurses or direct entry, should be trained, educated, given hands on learning and certification or licsensure. THIS would make childbirth safer than either outlawing midwivery totally, or letting anyone who wants practice it, without training or education.

Maggie Sugar · Apr 26, 2005

I live in IL. There are unlicensed, non-nurse midwives practicing here. I have had a few clients who have used them. I don't recommend people who don't have certification or licensure to anyone. I had a client whose "midwife" fled a birth where the placenta wouldn't deliver. The parents were forced to go to a local hospital, and it took more than a year to get a birth certificate for the baby, as the "midwife" (who, from what I saw from the baby missed a InterUnterine Growth Restriction (baby was WAY too small, and preterm like for her dates,) and a severe sucking disorder in the baby, as well as couldn't handle a stubborn placental birth.) The midwife told the parents not to tell the hospital she did the delivery, and the hospital knew something was wrong and DCFS got involved, and they couldn't get ahold of the licenced midwife who had left the unlicenced one in charge while she was on vacation, and neither would sign a birth certificate. It was a mess. (As was my client, from loss of blood, and her baby, from an undiagnosed growth restriction.)

Luckily, most of the midwives I know, whether nurse or direct entry, are very responsible (would never leave a womyn in labor or in distress) very capable and wonderful people.

Log in or Sign up

Missouri to loosen restrictions on midwifery?

EllisDTripp Green Secessionist

Rapunzel Member

Maggie Sugar Senior Member

Maggie Sugar Senior Member

Log in or Sign up

Missouri to loosen restrictions on midwifery?

EllisDTripp Green Secessionist

Rapunzel Member

Maggie Sugar Senior Member

Maggie Sugar Senior Member

Useful Searches