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Midwife measure amended

Senators acted to regulate midwifery, including licensing.
Wednesday, May 16, 2007 | 12:00 a.m. CDT; updated 6:39 p.m. CDT, Sunday, July 20, 2008

JEFFERSON CITY — Senators complained Tuesday but ultimately moved forward to further define midwifery in Missouri.

A controversial amendment allowing midwives to work in Missouri without a supervising physician, which was created by Sen. John Loudon, R-St. Louis County, and passed to the governor by a seemingly unaware legislature, got support Tuesday with the Senate’s approval of a new amendment that outlines how midwifery will work in the state and requires licensing and oversight of all state midwives. The decision came after hours of heated discussion. The new amendment was attached to a kickboxing bill that was put on hold before the lunch break, and the bill’s sponsor said it might never be approved.

The Midwifery amendment

  • Creates a governor-appointed board to oversee midwifery.
  • Requires midwives to be certified by the North American Registry of Midwives.
  • Requires written disclosure from each client.
  • Restricts liability solely to the midwife.


The bill must still be passed by the Senate and sent back to the House for discussion with only three days left in the legislative session.

“We won’t know until it’s over at the stroke of six o’clock Friday,” said the bill’s sponsor, Rep. Curt Dougherty, D-Independence.

Senate Majority Leader Charlie Shields, R-St. Joseph, said he will try to bring the bill back before the Senate before the end of the week but was not sure when that would be.

“I was afraid something like that would happen,” Dougherty said.

Loudon added the original midwifery amendment to an insurance bill that passed both the House and Senate last week without much debate. Several legislators were angry with Loudon’s actions, saying he did not tell them he had added the wording to the 123-page bill.

Along with the bill’s length, the language may have been overlooked because it does not specifically refer to midwifery or birth, instead, it authorizes people with “tocological certification” to provide birthing services.

Senate Minority Leader Maida Coleman, D-St. Louis, said Loudon’s wording shows his intent to hide his actions.

Coleman said she does not know whether she can trust any legislation put forth by Loudon.

“Everybody in this chamber should be held to a higher standard,” Coleman said. “I still feel you have the obligation to be open and honest about what you’re doing.”

Loudon sent a letter to the entire Senate on Monday apologizing to his Republican colleagues for not making them aware of the wording.

Coleman said she was upset that the apology was not extended to the entire senate as Loudon initially had bipartisan support for the bill.

“I take exception to someone who had bipartisan support and does not apologize to the Democrats who supported him,” Coleman said.

If the bill is brought back to the Senate before the end of the legislative session it must still return to the House of Representatives where further changes could be made, including the possible removal of the midwifery language.

Rep. Jim Avery, R-St. Louis, said many representatives are upset with how Loudon got the issue approved. He said he anticipates a fight on the bill.

“I hope it’s dead. I’ll never vote for or support anything he’s a part of,” Avery said. “Even people who supported the bill don’t appreciate how it was done.”

Rep. Doug Ervin, R-Holt, sponsored the insurance bill and said Loudon told him about the other changes made but never mentioned the midwifery addition.

The bill has been sent to the governor, and no more changes will be made.

House Speaker Rod Jetton, R-Marble Hill, said although the House could reconsider the bill and Loudon’s language, there are no plans to do so.

Shields attempted to repeal the midwifery legislation in the Senate on Tuesday by proposing an amendment to another bill, but Loudon presented a substitute amendment, which would require midwives to be licensed and would create a state board to oversee midwives. Loudon’s substitute amendment passed 21-13.

“We need to learn from the circumstances we create by our actions and inactions,” said Sen. Victor Callahan, D-Independence. “There’s so little trust in here.”

Dougherty’s bill began as a move to legalize and regulate mixed martial arts, commonly known as extreme boxing. As the bill passed through the House, it faced a series of changes, including licensing private investigators. Dougherty said the midwifery amendment was added to his bill to keep it from passing.

“The reason they didn’t move it was it had a Democrat’s name attached to it,” Dougherty said. “I hoped they would have worked their issues out before trashing a decent bill.”

Currently, practicing midwifery in Missouri is considered practicing medicine without a license, a felony, unless the person is a certified nurse midwife, which requires extensive training. The amendment passed Tuesday requires certification by the North American Registry of Midwives.

Elizabeth Allemann, medical director of the Columbia Community Birth Center, said the passage of the midwifery amendment will have a lot of impact on her and the birth center. Allemann is required by law to be present at the five to seven births at the birth center each month and said “it’s just not sustainable at current staffing.” She said Loudon’s actions were the fulfillment of 20 years of attempts to legalize midwifery.


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