Varying Opinions on Midwifery Licensure

As an organization, Citizens for Midwifery supports the Big Push campaign and is also a partner in the MAMA campaign. However, I think it important to acknowledge that there are strong differences of opinion within the "birth world" about legislative "solutions" in midwifery. I frequently post updates and alerts from various campaigns to this blog. However, there are women who caution that licensing and legislation have unforeseen consequences and I think it is both fair and important to listen to their voices too.

Carla Hartley and Gloria Lemay are women that I admire and respect and both of them have recently voiced their concerns via their blogs about licensing midwives.

Gloria made a thoughtful post titled Licensing, registering and certifying midwives–at what cost?

And Carla has made a couple of quick posts about licensing and also re: malpractice insurance.

My personal feelings about midwifery legislation were deeply shaped by the experiences of living in Missouri for my entire life, in which until last year, the practice of midwifery was a felony. A felony is a serious thing and our intense legislative efforts in Missouri were able to remove that obstacle. There are those who expressed concern about taking a legislative approach, feeling that it was better to leave things as they were and cautioning that legislation has its own risks. I think it certainly is important to be mindful of risks, but I also feel (and felt) very strongly that leaving midwifery a felony was the worst possible tactic to take. I take an, "anything is better than midwives being FELONS!" perspective. Additionally, I felt strongly that it was unethical, impractical, and illogical to assume and trust that another woman would be willing to break the law for me and my family by attending my births--that is a LOT to expect from another woman and from her family, who is by extension also put at significant risk. I couldn't ethically continue to expect that. I do not claim to know for certain if pushing for licensure is the correct answer for every state, however, and I find it important to listen to both sides of the issue. There are a lot of very informed people working on legislative campaigns and I place a great deal of trust in their wisdom and expertise! I also believe that they have the best interests of the consumer at heart.

--
Molly
CfM Blogger

Grassroots Network: Missouri Supreme Court rules Moms and Midwives win!

Dear Friends,

As we reported previously, in Missouri an amendment included in a big insurance bill that was passed last year would give CPMs legal, unregulated status in Missouri, but was challenged by the Medical Association. When the first court upheld the ruling, midwives and midwifery advocates appealed to the state supreme court. Now, finally, the supreme court has ruled: they essentially threw the case out on the basis that the Medical Association did not have any standing in the case! The Medical Association has 10 days to petition for a re-hearing, so there could still be a reversal, but this is unlikely.

The meaning: Once the 10 days are up (on July 4, Independence Day!), if a re-hearing is not granted, CPMs will be free to practice legally in Missouri!!

Here is a brief news account and another.

You can read the opinion and summary here.

Here is a press release from Friends of Missouri Midwives.

The appeal involved attorneys that cost money. If you are excited about this amazing victory, consider a donation to help with the remaining $33,000 still owed. You can go to Free the Midwives to make a donation -- every little bit counts!

As you are likely aware, midwifery advocates in Missouri have fought very long and hard to achieve legal status. They were extremely close to passing licensing legislation this spring, only to fall victim to hardball tactics by the medical lobbyists in the final hours of the legislative session.

Legal, unregulated status will allow midwives to practice openly and thus increase the pool of midwives and home birth advocates, a very positive development for midwives and mothers in Missouri!

Kudos to all in Missouri, who worked very hard, pushed through discouraging times, and never gave up!

Sincerely,

Susan Hodges, “gatekeeper”

Grassroots Network: ACOG and the Massachusetts Bill for a Board of Midwifery

Dear Friends,

Many of you already know of the bill wending its way through the MA legislative process: a bill developed by CNMs, CPMs, CMs and consumers, working together. The gist of the bill is that it would create a single midwifery board that would license CNMs, CMs and CPMs, with slightly different licenses that reflect differences in training, and includes prescriptive privileges for CNMs/CMs and administration of emergency and state mandated meds for CPMs.

Of course, ACOG (American College of Obstetricians and Gynecologists) is opposed, as they are opposed to any bill that would license CPMs and allow for legal midwife-attended home births.

Now you can read exactly what ACOG is saying about the bill, and how they are urging their members to actively work to stop passage of this bill. You can read their latest statement here.

I am sure you will recognize the many errors and misinformation, starting with the novel idea that CPMs are what used to be called lay midwives absolutely not true!

Whether you are involved with state legislation for CPMs or not, in MA or elsewhere, it is worthwhile to be aware of what ACOG is telling its members. You never know when you will have a chance to enlighten a physician or other person who has been misled by ACOG's statements!

Sincerely,
Susan Hodges, gatekeeper

Of Midwives and Laws

There has been news lately from advocates in both Maine and Missouri regarding the licensure bills that they were attempting to pass this legislative session. In Maine, the licensing bill was rejected, but approved a new law allowing CPMs to carry and use certain medications (such as pitocin). You can read more about this on the Midwifery World blog.

In Missouri, valiant attempts to pass a bill licensing CPMs was thwarted in the last hours of the legislative session. The bill managed to make it through the Senate (a first in years), but with only hours left in the session it was not heard in the House and thus did not make it to fruition. Hopes have turned to the Supreme Court case regarding the bill from 2007 and a decision is expected on June 10. You can read more in this St. Louis Post-Dispatch article. (The article uses the term "lay midwives", though the bill was actually about Certified Professional Midwives.) There is additional information on the Midwifery World blog as well.