Midwives oppose home-birth bill

by Associated Press

Published: March 1,2010

Tags: childbirth, healthcare, Legislature, midwives

JACKSON — Renata Hillman has been birthing babies in Mississippi for more than two decades, delivering some 500 children by her own count.

Hillman, a certified professional midwife or CPM, said she became concerned about a bill in the Legislature that would put restrictions on who can perform home births. So Hillman, some traditional midwives and midwifery advocates organized and unleashed a barrage of calls and e-mails on lawmakers, urging them to kill the bill.

“What they don’t understand is that if they take away the home birth midwives, they’re going to make it more dangerous,” Hillman said. “Families will have their babies unassisted.”

She does, however, believe there should be some law in place, making certified professional midwives like herself the standard.

The 2008 death of a child in Pearl River County is what led to Mississippi’s bill, which would only allow certified nurse midwives or midwives who could prove they’ve practiced for five years to deliver babies. Anyone who performed births who didn’t meet those requirements could face criminal penalties.

Midwifery legislation also is pending in Alabama, North Carolina, Massachusetts, Illinois, Iowa and Wyoming, according to the national group, The Big Push For Midwives.

The legislation in Mississippi is expected to die under a Tuesday deadline. Senate Public Health Committee Chairman Hob Bryan, D-Amory, said he won’t bring it up for a vote.

“This is something there’s a good bit of concern about. Several people in the committee said they had gotten calls to oppose it,” Bryan said.

There are three types of midwives — certified professional midwives, certified nurse midwives and those who call themselves traditional midwives, who do not have credentials. All CPMs get their credentials through the North American Registry of Midwives, an international certification agency, said Katherine Prown, campaign manager for The Big Push for Midwives. She said many states require CNMs to be advanced practice nurse practitioners, who often work in hospitals.

The Mississippi Department of Health discontinued general midwifery permits in the mid-1980s. There is currently no midwifery law so anyone can call themselves a midwife in Mississippi.

Advocates say home births have been a long-standing tradition in the state, where 18 percent of the population is uninsured. Midwife deliveries have been solid options for some, particularly in the Delta, one of the poorest regions in the country. Advocates say a midwife delivery is usually about a third of the cost of one that occurs in a hospital because home births usually don’t involve anesthesia and other medical interventions.

The average cost of a midwife in Mississippi is $1,500.

About 40 or more home births occur each year in Mississippi, said Brett Thompson, an attorney with the Board of Nursing, which supported the bill. In 2008, more than 44,000 babies were born in the state.

There were five deaths during home births attended by midwives in 2008, according to the latest state Department of Health statistics.

Rep. Becky Currie, R-Brookhaven, said officials believe there has been an influx of uncredentialed midwives in the state because regulations are lacking. She said the bill sought to create a database so midwifery could be monitored.

“It is the privilege of the mother to decide if they want a home birth. I know that’s become a big Hollywood thing,” Currie said. “If you choose that, at least get somebody who’s regulated.”

At least 26 states have laws authorizing CPMs and there’s an effort under way to get more states to license them so the practice of out-of-hospital midwifery is regulated nationwide, Prown said.

Without those laws “you end up with this buyer beware kind of climate and anyone can claim to be a midwife,” said Prown.

After an investigation of the Pearl River County child’s death in 2008, authorities did not pursue charges. There was no midwifery law on the books.

Officials have released few details about the situation. Thompson said the unidentified midwife had lost her certification in Louisiana, but she didn’t know the reason. The woman had been crossing state lines to practice.

Hillman and other midwives are already preparing for next year’s legislative fight. Hillman said a new group has been formed, Friends of Midwives, and members will meet March 9 in Jackson to begin reviewing what laws are in place around the country.

“Every state is different, but we do need to do something in Mississippi,” Hillman said.

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