Rep. Mike Talboy tries to repeal midwives’ law
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



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.
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.
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?
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.
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.
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…
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.
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?
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.
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..