Midwifery bill moves to House

Thursday, February 9, 2006 | 12:00 a.m. CST; updated 3:00 p.m. CDT, Wednesday, July 16, 2008

JEFFERSON CITY — A move to allow lay midwives to deliver babies at home without fear of criminal prosecution advanced Wednesday with strong support from a state House committee.

In a 10-0 vote, the House Children and Families Committee forwarded a bill sponsored by Rep. Cynthia Davis, R-O’Fallon, that would repeal the 47-year-old designation of midwifery as the illegal practice of medicine.

The bill now advances to the House floor, with an identical proposal awaiting a Senate hearing. Bills to decriminalize lay midwifery have passed the state House at least five times since 1989, most recently last year.

Supporters call the issue a matter of reproductive choice and birth a natural event that doesn’t always require medical intervention in a hospital.

“Birth is safe,” testified Elizabeth Alleman, a Columbia family doctor who said she has supervised hundreds of home births.

Representatives from the Missouri State Medical Association and the Missouri Academy of Family Physicians spoke against the bill, arguing that it offers lay midwifery the legal status enjoyed by other professions in Missouri without the accompanying state regulation.

“This bill essentially creates a new profession,” said David Redfern, a Springfield obstetrician and gynecologist. “Is it fair to grant lay midwifery a privilege that has not been granted to 53 professions already licensed by the state?”

Home births in Missouri aren’t illegal. The state Department of Health and Senior Services recorded 719 out-of-hospital births in 2004, or fewer than 1 percent of all live births that year.

But the practical hurdles to home births are considerable. Doctors such as Alleman face losing malpractice coverage and hospital privileges. Alleman said she knows of just two other physicians — a second in Columbia and one in St. Louis — who deliver babies at home.

State law allows certified nurses trained in midwifery to deliver at home, provided they have the approval of an affiliated doctor within 30 miles.

According to Alleman, there are two such nurse-midwives statewide. One of those certified nurses, Brenda Abercrombie, spoke in favor of Davis’ bill Wednesday.

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