This year the Missouri legislature will, once again, be asked to consider the issue of midwifery. Missouri is the only state in the nation which states in law that midwifery is part of the practice of medicine. This means that only doctors can be midwives.
Current Missouri law places mothers and babies in danger, particularly those who give birth at home. It is legal in Missouri to have a home birth, but it is not legal to hire a midwife to help with that birth. For those families who do find a midwife, the illegal status of midwives means that their insurance does not pay for the birth. Midwives receive their pay out of pocket and often serve families with limited incomes.
I am a home birth physician and an expert in natural childbirth. I take several calls a year from families who live in rural areas and who have rapid labors. They cannot reliably make it to a hospital that provides maternity care. They have no option but to give birth at home. They cannot find a midwife. I don’t know what to tell them. In more than 40 states, midwives are legal and available to at least try to make it to the homes of women in this situation, to help with a baby that needs help getting started or to help a woman who is bleeding heavily.
The current situation puts physicians like me in a legal bind. If I care for a family who has seen a midwife, I am not supposed to know that, or perhaps I will be a party to the felony. But if I don’t know that they have had care from a midwife, how can I know what has already happened in the pregnancy? How can I provide excellent care if I have to stay ignorant and uninformed? Women and babies do best in a system where doctors and midwives work together.
Nearly 1,000 babies are born at home in Missouri each year. Every one of them deserves the excellent care of a skilled midwife. Legalizing well-trained midwives would be a big step towards that goal.