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02.05.2009 12:39 pm

Rep. Mike Talboy tries to repeal midwives’ law

Post-Dispatch Jefferson City Bureau
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Talboy

Talboy

JEFFERSON CITY — Remember tocology? Midwives gained more authority in Missouri by slipping that obscure term into a health insurance bill in 2007.

Now, Rep. Mike Talboy, D-Kansas City, is trying to repeal the provision.

Talboy has introduced HB476, which would repeal a single sentence. That sentence allows people who hold “ministerial or tocological certification by an organization accredited by the National Organization for Competency Assurance” to provide services dealing with obstetrics.

Former Sen. John Loudon, R-Chesterfield, tucked that line into a bill to bypass a long-running filibuster orchestrated by the Missouri State Medical Association, which represents doctors. For years, Missouri had limited the practice of midwifery to certain specialized nurses, working in collaboration with doctors.

The doctors’ group says the current law makes it unclear who can offer obstetric services. Talboy said he hopes to broker a compromise between the doctors and midwives.

“I would like to bring them to the table and find what we can do moving forward, so mothers and children are protected,” he said. “I think there should be some safety requirements.”

In the past, those negotiations have broken down because the medical lobby demanded that midwives be regulated by the Board of Healing Arts, which is dominated by doctors. Under the doctors’ plan, an advisory board of midwives could only offer licensing suggestions

20 comments

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Dude doesn’t get it. Missouri women want to make their own choices about childbirth options. I don’t need that guy “protecting” me, and I certainly don’t need him preventing midwives from practicing in Missouri. Aren’t there more pressing issues he could be working on?

— KBO
2:20 pm February 5th, 2009

The doctors say “the current law makes it unclear who can offer obstetric services” but in fact, it is as clear as day: Under the current law, midwives can serve women. Doctors would “clarify” the law by putting midwives out of business. It’s all about money, and not one bit about patient health.

— Nick Kasoff
2:30 pm February 5th, 2009

PS - Since the Post never bothers, here’s a few contributors to Mr. Talboy’s campaign who might have an interest in putting midwives out of business:

Missouri Society of Anesthesiologists - $1,000
Cardiothoracic Anesthesia Assoc - $350
Missouri Ambulatory Surgery Center Assn - $1,000
Molina Healthcare Inc. - $325
Northport Health Services of Missouri LLC - $350
Gerard Grimaldi ((Truman Medical Center Public Affairs) - $100
Missouri Hospital Association Healthpac - $1,000
Missouri Health Care Assoc. - $1,500

— Nick Kasoff
2:43 pm February 5th, 2009

I thought that Talboy considers himself a champion of freedom and personal rights. Perhaps I was wrong.

Maybe he believes that the government can make better choices for women and babies than mothers will make for their babies. After all, the government cares personally about the health and well being of the baby in a way no mother ever would. Yeah, right.

Women are smart and make good choices when given freedom and responsibility. I’m disappointed to see that Talboy thinks they need his help in choosing healthcare providers.

Maybe it’s not really that he’s worried about the intelligence or health of women.

Maybe it’s more about being worried about impressing doctors to donate to his next campaign. Senator Chuck Graham tried that - siding with the docs over the midwives. It didn’t work. He lost to a Republican in an overwhelmingly Democratic tide in his district.

Perhaps Talboy should go visit Graham and ask for some advice before he gets too far out on a limb.

— J Cline
3:16 pm February 5th, 2009

It is an outrage that Talboy — supposedly a champion of women’s rights — would even consider sponsoring a bill such as this. The MO Supreme Court acted sensibly in upholding the tocology law in June, and after 50 years, Missoui women have finally been grated access to legal midwifery care! Talboy’s assertion that the current law does not set up any safety guidelines is incorrect — the law only permits certified professional midwives (CPMs) to practice, who go through rigorious preceptorship, examination, and skill evaluation on a national scale. Certifie professional midwives ARE safe, and MO women are smart enough to make thier own choices! The legalization of midwifery is a HUGE step forward for Missouri women, and yet Talboy wants to strip women of their right to choose their maternity care, and move backwards instead. What’s next, revoking a woman’s right to vote!? Missouri women and feminists everywhere will not stand for this!

— HWatson
5:28 pm February 5th, 2009

Why on earth does a democrat want to side with the powerful medical lobby against women and families? Please do the reading–midwifery care means safer birth and healthier babies.

— LCarter
5:58 pm February 5th, 2009

Talboy, keep your hands off my midwife! I can make the best choices for myself, my body, my baby and my birth!

— Dee
10:34 pm February 5th, 2009

Hmmm - freedom of choice for women?
A new concept?

— Thomas F. Maher
11:40 pm February 5th, 2009

Why would subjecting Certified Professional Midwives to charges of a Class C felony for delivering a baby help anything? Seriously.
Seven years in prison?? That’s the same maximum penalty that former Rep. Scott Muschany will face if he is found guilty of raping that 14 year old girl. Certified Professional Midwives deserve equal treatment for their “crime” of delivering babies under Missouri law?

Senator Loudon’s law (removing the criminal penalties for those who are nationally certified) brought some sanity to Missouri law!

I wish Talboy would focus on putting someone other than midwives in jail!

— Brett
12:40 am February 6th, 2009

You cannot tell me that a bright democrat in Missouri has nothing better to do right now than this. Other than physicians who think they will be out a few bucks (and who the supreme court said have no standing to oppose the law), who is this law endangering?? National certification seems like a pretty decent safety requirement to me.
I would like to hear what he has in mind. If he wants to talk about writing a better law stating that every woman deserves a midwife, because they are safer than OBs and hospitals for the healthy pregnant woman, THAT would be a good way to spend our government’s time.

— CNM student
4:48 pm February 6th, 2009

How disappointing, that Rep. Talboy would waste time on trying to undo something that Missouri men, women and families have been striving for over many years. If he really is interested in brokering a compromise, then why doesn’t he draft that compromise, and have the repeal of the current law included in that bill? Repealing this law without having a compromise already in place seems like he’s not really intending to fight for the Missourians who believe we should have a choice in our reproductive care.

— Carrie
6:46 pm February 6th, 2009

Any bill is no compromise. It is Missouri midwives giving up something that they have. I hope that the Missouri midwives stand firm and that there is a legislator who is just as willing to filibuster on their behalf as Chuck Graham was for the medical lobby.

— libertyinmo
8:12 pm February 6th, 2009

As a pregnant woman, I would greatly appreciate it if Rep. Talboy would respect my right to choose my own care! Instead he appears to be concerned with the “right” of the medical industry to monopolize the market and criminalize the competition.

Patients are also consumers, and consumers have a right to choose where to go for the products (or care) they pay for. There is a reason women want midwifery care- who wouldn’t want a care provider who takes the time to listen to your concerns, who respects you, respects the natural processes of labor and birth, and cares more about you as a person than as a way of making money?

— Natalie
8:50 pm February 6th, 2009

As a woman who has had two safe and wonderful home births, I am offended by this move on Talboy’s part. Those who support legalized midwifery (which number in the 10’s of thousands in Missouri) are not trying to force women to give birth “their way”; but we would appreciate it if those who support hospital births would give us the same consideration. This issue is about choice…when we make midwifery legal we give women the power to research and choose the best birth option for themselves. The numbers PROVE that home births are safe and that, if this is the woman’s choice, it leads to the ultimate birth experience. Please give women the credit they deserve Mr. Talboy.

— LT
7:05 am February 7th, 2009

As a pregnant mother I am upset that Rep. Talboy thinks that he needs to dictate to me what is safest for my child and me. Of course I care deeply about what is safest for my baby, and that is why I am choosing a highly skilled and educated midwife who takes the time to listen to my concerns and work with me through them. A home birth is certainly not for everyone, but each woman should be given the option to research and decide what is best for her situation.

— Anna C
9:33 am February 7th, 2009

The change in law status from felon to legal for midwives brought a renewed rush of enthusiasm to the midwives of Missouri who are diligently getting their certifications and supporting one another to do so. These women are stepping up to the plate, WANTING to be certified, wanting to ensure that there are no holes in their education, that they have the wits, the skills, the expertise and the passion to do this incredible work. Many have been using their art for years and years, quietly and successfully. The Medical Model has been plying a different brand of maternal health care, not so quietly, and certainly not successfully…..check the c-section rate, the maternal death rate, the ranking among the world’s industrialized countries….pititful! We need the sanity, the safety, the choice, and the love that midwives bring to birthing babies. Legislators better step back and look long and hard before messing with progress…

— I M Midwife
9:42 am February 7th, 2009

Imagine that-A man wanting rule over a woman’s vagina. Throw a little money on top of that and what do you have? Rep. Mike Talboy and the boys who line his pocket. It is ridiculous that this is even an issue. What about equal rights? What about freedom of choice. I guess it only counts if you have a penis.

— KG
12:40 pm February 7th, 2009

Missouri families deserve the right to choose where, and with whom to birth their babies. Multiple studies show the safety, higher satisfaction and lower costs of out-of-hospital birth, but doctors and their paid-for legislators want to limit women’s choice to hospitals only. Hospital statistics with obstetricians are getting scarier, with higher costs every year. Fully one-third of babies are born by cesarean in Missouri due to the cascade of interventions pushed on women in hospitals. Midwifery care is about normal women having healthy babies in a loving and caring environment, not an assembly line. Evidence-based care shows the improved outcomes and lower costs through use of midwives, and if health care is truly going to be reformed in the future, maternity care is the best place to start. Missouri’s legislators should spend their time fixing legal problems, not taking women’s rights away! Do they even care what women want?

— S Stone
2:03 pm February 7th, 2009

It is very clear who can offer midwifery services–the North American Registry of Midwives (NARM, the certifying body for Certified Professional Midwives, CPM) is the only organization accredited by the National Organization for Competency Assurance (NOCA) that offers tocological certification. So the new law clearly defines that only CPMs can offer services. Additionally, there are safety requirements for midwives. Before filing destructive legislation, I suggest that Representative Talboy talk with a CPM and read through the entire NARM website (PDFs too) and discover just how extensive the process is to become a CPM. Don’t believe what the doctors tell you, go directly to the source. Lastly, one profession should not govern its competition. How would the doctors feel if the midwives ran the doctor’s licensing board, and only allowed the OB’s to make “suggestions”? Follow the money. Missouri families just want a legal choice. OB’s just want Missouri families’ money.

— Anita
10:47 am February 9th, 2009

I think he is simply saying that the medical field is complicated. Most missourians would like to think that yeah midwives provide great services and many do, but not having Midwifery heavily regulated (Like Doctors) puts missourians at risk. The risks would include infections to the mother and baby for lack of sanitation, injustice to a family that expirenced loses due to lack of judgment, the lack of expirence that great doctors go through to not make mistakes and ect…Imagine if a doctor did not have such heavy training and education. The mistakes would be terribly upsetting. It’s not about a choice..It’s about making Missourians safe..

— A mother who knows
10:08 pm March 12th, 2009