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04.08.2008 6:34 pm

Loudon proposes midwife compromise

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An updated proposal to legalize midwifery was brought to the Senate today, and the bill’s sponsor says it is a compromise that satisfies many complaints from doctors’ groups.

The changes include requiring midwives to carry malpractice insurance and restricting their ability to administer medication.

Two issues, according to bill sponsor Sen. John Loudon, that could not be worked out are requiring midwives to collaborate with doctors and licensing them by the board that also licenses doctors.

“There are two sticking points that it’s clear we’re not going to get agreement on,” said Loudon, R-Chesterfield.

Loudon’s bill would allow midwives to practice if they’re licensed by a group called the North American Registry of Midwives. Missouri only allows nurse midwives who must partner with a doctor. All other midwives could be charged with a felony.

Sen. Chuck Graham, one of the bill’s chief critics, has argued that not requiring more rigorous medical training for midwives is a threat to public health.

Loudon is a strident supporter of midwives and last year employed a creative technique to allow them to practice. A challenge to that law is pending before the state Supreme Court.

On Tuesday, Graham, D-Columbia, offered an amendment to place midwives under the doctor registration board, known as the state board of registration for the healing arts. Graham said it only makes sense for the doctors’ board to license midwives.

On the contrary, argued Loudon, who said doing so would gut the bill.

“We don’t have the architects looking over the shoulders of the acupuncturists,” he said. “If the doctors don’t want that group (midwives) practicing, they just don’t issue the licenses.”

Graham’s amendment has not yet been voted on. After about an hour of debate, senators laid the bill over to discuss other issues.

(For a more thorough reading of the midwife issue, check out part 1 and part 2 of a series by our own Michele Munz)

45 comments

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I’m not sure what else can be said other than what has already been defended by Ida, Jennifer, and Allison. I agree with them 100%. It is a sad day in Missouri when a senator, who is supposed to be representing the will of the people, will allow money and unfounded scare tactics to prevent the majority vote. Also, I resent being “dumbed down to” as a woman and mother, as if I cannot make an informed decision about what is best for my family. Should I allow someone with “impaired judgement” to dictate how and where and with whom I can have my baby? I can do the research for myself, thank you very much!

— Julie
12:42 pm April 9th, 2008

Home birth, home school, self service legal forms…. What will you people want next? Individual rights and liberty? You’re tromping on sacred ground when you mess with the AMA, NEA, and ABA. Just who do you think you are, anyway?

— Bb
1:20 pm April 9th, 2008

I have heard allot on this issue, the rights of the mother, the rights of the baby. I have read about how horrible our hospitals are and how they are not as good as mid-wives, I have read about Johns messed up legalization of abortion while trying to make mid-wife legal. Well from a personal note, I used to be a family friend of the Loudons and personal reason have changed that. In fact my personal experience tells me that John and Gina are working for their own views not those of whom he represents. If it happens to coincide that’s great! But Gina is not a good person when it comes to this topic, she INFACT DOSE disregarded the law to mid-wife. John and I had a falling out after he accidentally legalized more then he knew, and he got it from his daughters spelling book? that’s who i want writing my bills. He is working for the views of the few. If your experience at a hospital get a new doctor, because my wives experiences were wonderful in a hospital and i would never change that. You have options when it comes to birth already, I don’t want a dangerous MID-WIFE bill to be passed because of the negative effect it could have on our CHILDRENS BIRTH… Something tells me that THIS IS WRONG, and its by personal experience that tells me so. That’s all I know, think what you want but they will never have my vote again.

— IC
2:31 pm April 9th, 2008

Pass the bill, doctors dont like it and they have to certify people. there not going to be legally ablidged to cirtify anyone, and mid-wifes will be legal, but ther wont be any! Shuts both sides up, its a poorly written bill, but hey, leave it to the Doc, they shut it down!

— HAHA
2:34 pm April 9th, 2008

Here is my logic, piss the docs off, don’t get quality care when i need it. There for, I’m all for making the trained professionals do every they are trained to do, I wont make them mad because I need them to much.. though Loudon’s cant find a doctor in the state of Missouri, why is that?

— HAHA
2:41 pm April 9th, 2008

Many have already provided the multitude of reasons for this bill. I just wanted to say that I rarely agree with anything that Senator Loudon does. However, I support him on this midwifery bill and am glad he has championed the cause. I was very critical of how he went about it in the last session, one because it was devious politically but two, because that deviousness got thrown onto midwifery. But, that was last year and this is now.
The time has come to pass this legislation.

— suzyjax
5:52 pm April 9th, 2008

I’m sure I could find statistics on the internet and elsewhere that would both substantiate and repudiate (depending on what I was looking to do) everything that has been posted here about the safety of birthing those young ‘ens at home. The fact of the matter is, there are myriad variables in play in any home birth situation, and no study or group of statistics is going to control for even the most important ones. You take several important checks on one’s competency to safely attend a birth, as well as checks on the safety of the surroundings, out of play when you allow private individuals to choose someone to come into a private home to facilitate the birth of a baby. At least when you go to a hospital, you know the place is maintained to regulated health and safety standards and you know that the person assisting you - not to mention the group of professionals that are there assisting him or her - have all been extended to privilege to practice there.

I am a member of an already licensed and regulated profession in this state, so I’m not looking for anyone to legalize what I do. You should consider that in formulating the rhetoric in these postings. If you want respect, try to be nice. For bonus points, refrain from using the word “ignorant” or any of its derivations.

— Penelope
6:05 pm April 9th, 2008

IC, you can only be lying for claiming to be a friend of the Loudons. Two reasons: only a liar could claim to be a friend and also hold that Gina is a midwife. Certainly a friend would know better. Secondly, you are nearly illiterate and I am pretty sure the Loudons generally associate with people who can write. At least you have “HAHA” to make you look bright.

— Illiterat Friend
6:13 pm April 9th, 2008

On abortion: This bill is not about legalizing abortions, that is already legal in Missouri. Certified Professional Midwives are caretakers of BIRTH in out of hospital settings, not abortion. Two distinctly different issues. Nowhere in any legalization efforts in all of the history of midwifery here in Missouri was the abortion procedure included. Totally different subject.

On training: The NARM process for certification is (I assure you since I”M in the process of it) very lengthy, thorough and challenging. This is not a 6 week class or a mail-order “degree”. This is a legitimate educational path to professional midwifery. One, by the way, that the Missouri Department of Secondary Education legitimizes and provides funds for students pursuing it. Don’t trust “internet mail-order schools”. Fine. But I think everyone trusts DESE to determine if a school/edication is worth funding. And they do. They are. As of TODAY. To say that the CPM credential is “underqualified” is like saying EMT’s are “low-class doctor-wanna-be’s”. I think not.

On our dear Sen. Graham: Politics at best. Or worst. Filibustering, big-money, distorting and withholding the truth from his constituents and the entire state of Missouri… politics. Don’t forget Sen. Graham, you intend to run for a state-wide office this fall. Trust me, your behavior in this very-important midwifery issue is not going to be forgotten come poll-time. We are all watching, and hoping you will be a man of honor and uphold the integrity of your office. The people have spoken. The statistics support them. Other states license CPM’s with WONDERFUL success as well as saving tax-payer money… Stop listening to the money Sen. Graham. Please.

— psalms66
7:20 pm April 9th, 2008

Penelope–
The term “ignorant” can be used as a descriptive term as well as as a perjorative term. In its descriptive mode, “ignorant” means “one who has not apprised themselves of the facts relating to a situation”. I, for example, know a fair amount about the midwifery issue and the politics surrounding it in Missouri, through much study and several years of helping with the effort to make Missouri’s midwives legal. I am, however, thoroughly ignorant of almost everything relating to the actual writing of a computer program in the C programming language–even though my husband is an expert and it’s what puts food on our table. You admit, in your last post, that you have NOT, indeed, informed yourself about the issue upon which you are commenting. By definition and your own admission, you are ignorant of the particulars surrounding the midwifery issue in Missouri. This being the case, those who have replied to you have been QUITE respectful. They have merely requested that you make informed comments.

As to the safety of the birthing environment, both home and hospital have their problems. Homes lack the equipment to do an emergency C-section (meaning a woman who needs one has to transport to the hospital), although midwives do carry equipment to do such things as resuscitate a baby or stop a postpartum hemmorhage. Hospitals, even ones “maintained to regulated health and safety standards”, come with problems such as nearly endemic MRSA (and other hospital-borne infections, such as my baby caught), and, if anything, too much equipment, etc, which brings the temptation to use it when the evidence-based proper approach is hands-off. This leads to such things as our current 30%+ C-section rate–when the World Health Organization and actual evidence-based practice recommend about a 15% C-section rate as being representative of optimal care of mothers and newborns.

I no longer have a personal dog in this fight, as I left MO in October, but I am rooting for MO to finally give its birthing families the privilege of the option to choose the birthing method that is best for each family.

— Heather
7:30 pm April 9th, 2008

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