HCS HB 974 -- MIDWIFERY

SPONSOR:  Phillips (Davis)

COMMITTEE ACTION:  Voted "do pass" by the Committee on Children
and Families by a vote of 10 to 0 with 1 present.

This substitute specifies that it is the intent of the General
Assembly to recognize the right of a woman to give birth in the
setting and with the caregiver of her choice.  A caregiver
includes a person who provides midwifery services; however, this
service does not include the practice of medicine, nursing,
nurse-midwifery, or any other medical or healing practice.

Every midwife is required to provide a written disclosure
statement informing each client of his or her current certified
professional midwife credentials, completion of at least 10 hours
per year of continuing education and three hours of peer review,
and an affidavit stating that he or she has attended a minimum of
40 births in the home setting.  The disclosure must also state
the number of years of experience, number of deliveries as a
midwife, possible benefits and risks, certification in CPR and
either infant CPR or neonatal resuscitation, malpractice or
liability insurance coverage, and a contingency plan in the event
of an emergency.

A midwife does not have to provide a current certified
professional midwife credential, as long as the individual is at
least 21 years of age, is a resident of this state, has passed
the North American Registry of Midwives Skills Assessment, and
provides an affidavit that he or she has provided the service of
midwifery for at least 15 of the last 20 years prior to
August 28, 2006.  Only the midwife who provided care to the
client will be held liable for negligent, willful, or wanton acts
or omissions.

FISCAL NOTE:  No impact on state funds in FY 2007, FY 2008, and
FY 2009.

PROPONENTS:  Supporters say that scientific data published in
medical journals, such as the British Medical Journal, show home
births and midwifery care to be a safe and viable option.  Home
birth is the safest way to give birth for a healthy woman and a
healthy baby.  A properly planned birth at home can lead to fewer
problems and allows the patient to be surrounded by family and
friends.  Home birth families have the right to make an informed
health care choice with a highly skilled midwife.  A certified
midwife will spend about $25,000 to attend a three-year
educational program.

Testifying for the bill were Representative Davis; Missouri
Midwives Association; Lisa Thomas; Elizabeth Allemann; Christine
Skinner; Brenda Abercrombie; Heather James; Mary Ueland; and
Laurel Smith.

OPPONENTS:  Those who oppose the bill say that complications can
occur in even the most routine of deliveries.  A hospital setting
is the safest environment to deal with complications and
emergencies where there are trained staff, nurses, and doctors.
Midwives do not have transfer agreements in the event of an
emergency; therefore, the attending physician will not have any
information on the patient's history or even documentation of the
patient's blood type.  Physicians are regulated by national and
state boards; however, the bill will not provide any state level
regulatory oversight for midwives.

Testifying against the bill were Missouri State Medical
Association; American College of Obstetricians and Gynecologists
- Missouri Section; Missouri Academy of Family Physicians;
Missouri Nurses Association; and Missouri Association of
Osteopathic Physicians and Surgeons.

Dominic Lackey, Legislative Analyst

Missouri House of Representatives
93rd General Assembly, 2nd Regular Session
Last Updated November 29, 2006 at 9:41 am