Legal standing

The opponents say the way the provision was added to the bill is unconstitutional
Friday, August 3, 2007 | 12:24 a.m. CDT; updated 10:01 p.m. CDT, Monday, July 21, 2008

JEFFERSON CITY — Lawyers representing midwifery advocates and opponents debated the constitutionality of the midwifery provision before Cole County Circuit Judge Patricia Joyce on Thursday.

A coalition of physicians’ groups led by the Missouri State Medical Association is challenging the provision, which would permit certified professional midwives to legally practice in Missouri.

Joyce said she will try to reach a decision by the end of next week, and both sides say it’s likely the issue will reach the Missouri Supreme Court.

The attorney for the physicians’ groups, Harvey Tettlebaum, argued that the provision is unconstitutional because it is not relevant to the bill it was added to, which is titled “relating to health insurance.”

The state constitution requires that the content of bills remain true to their original purpose, have a clear title and not contain multiple subjects.

Tettlebaum said Sen. John Loudon, R-Chesterfield, added the provision in a secretive manner that violated sections of the constitution calling for a fair, transparent process.

Representing the state, assistant attorney general John McManus said the bill, not the process of creating it, is at issue. He said the courts shouldn’t micromanage the legislature.

“Sometimes the things that go on in the General Assembly are a contact sport,” said Jim Deutsch, an attorney representing the midwifery advocacy groups.

McManus and Deutsch said state Supreme Court precedent shows that health insurance and health services are so closely tied together that the title “relating to health insurance” includes health service issues such as midwifery.

But Tettlebaum said the bill’s supporters were focusing too much on the word “health” and not enough on the word “insurance.” He said that because the midwifery provision didn’t specifically address insurance, it was unrelated to the bill’s purpose and title.

A few blocks away from the legal finagling, about 250 people gathered at the capitol building to show their support for midwifery. Speakers told personal stories and encouraged supporters to engage their representatives on the issue.

Elizabeth Alleman, physician and medical director of the Columbia Community Birth Center, said she was pleased with the hearing.

“The process was fair and clear, and the debate stayed focused on the constitutional issues,” she said.

Alleman said legislators and the public have become much more aware of midwifery since she joined the midwifery movement 20 years ago, and now it’s time to hammer out the details.

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Elizabeth Allemann August 4, 2007 | 4:19 p.m.

I congratulate the author of this article and its editors. This is the clearest, most focused peice to date on the events regarding midwifery this week. Your article prior to the event was outstanding as well. Thank you for excellent reporting.

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