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Midwives decriminalization bill passes House

Brandon Moseley

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By Brandon Moseley
Alabama Political Reporter

Tuesday, April 25, 2017, the Alabama House of Representatives passed House Bill 315. HB315 was sponsored by State Representative Ken Johnson (R-Moulton) to legalize midwives is now on the floor of the House.

Rep. Ken Johnson said that under Alabama law it is currently a misdemeanor for a certified professional midwife (CPM) to be present at a home birth.

State Representative Mary Moore (D-Birmingham) said, “I have some concerns about this bill.”

Rep. Johnson said that midwives practice in the majority of the States in the nation. There are two or three certifying associations nationally that have come up with an education component necessary to be certified midwives.

Rep. Moore asked, “Would they see the person prior to the birth?”

Rep. Ken Johnson said, “Yes.”

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Rep. Moore asked if they would have a board to oversee the certification of midwives.

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Rep. Ken Johnson said that he has sponsored another bill, HB316, which would set up the state certification standards for CPMs and create a State Board. That has also been passed by committee. Johnson said that 33 of 67 counties don’t even have an OBGYN.

Moore said that she is concerned that they are voting to decriminalize midwifery without there being a board for oversight, for setting continuing education requirements, and for credentialing midwives.

State Representative Jim Patterson (R-Meridianville) said, “I want to thank you for bringing this bill. We have a lot of our women in Huntsville that believe in midwives and they have to drive to Tennessee,” to have their babies.

State Representative Paul Beckman (R-Prattville) said, “I have got concerns about this bill.” Who are the authorities that credential certified professional midwives.

Rep. Ken Johnson that certified professional midwives currently have three nationa organizations that credential certified professional midwives. This does not decriminalize lay midwives.

Rep. Beckman asked, “Who is going to determine whether this certification is valid?”

Rep. Ken Johnson aid that his HB316 woul have a regulatory board. There would be a doctor and a nurse on the board as well as midwive.

Rep. Beckman said, “I have no problem with decriminalization.”

State Representative Laura Hall (D-Huntsville) said, “Thank you for bringing this bill. I have carried this many times and never could get it passed. I am excited that it has gotten this far. This is a choice. This is a good example of the choices that families may make. I found that the opposition would often refuse to meet and reach a happy middle. I was delivered by a midwife named Miss Emma.” 37 other states have this and are doing OK. Georgia has it, Florida has it, Tennessee has it. The notes that I received from the medical community were not kind.

State Representative John Rogers (D-Birmingham) said, “We need to take Medicaid money.” “What does a midwife do if there is a problem.”

Rep. Ken Johnson said that CPMs are highly trained to identify and eliminate those high risk pregnancies and refer those women to the care of an OBGYN.

Rep. Rogers said, “Some women don’t know that they are pregnant. What happens then?”

Rep. Ken Johnson said that would be a 911 emergency situation and there would not be a midwife there.

Rep. Rogers said we have three years to get that money (Medicaid expansion). “The state made a mistake by not taking that money. “I delivered a baby at a hospital at the airport. It was not difficult as I just had to catch it.”

State Representative Barry Forte (D-Eufaula) said, “Why would we tell a mother where she has to have her baby. In my county a mother would have to drive to Dothan or Montgomery to have a baby. I don’t think we need a law and I am voting against it.”

Rep. Arnold Mooney (R-Indian Springs) offered amendment preventing CPMs from being present at a birth where the Mother had a previous caesarian section or uterine surgery; multiple births whether it is twins, triples, quadruplets, etc.; a non-cephalic birth (where the head is not coming first) and post maturity (where the pregnancy has extended 41 weeks or beyond).

Rep. Ken Johnson said that would be best introduced in the other bill.

Johnson’s motion to table Mooney’s Amendment passed 57 to 19.

State Representative Elaine Beech (D-Chatham) said, “You have got to have some rules. Are these people going to carry malpractice insurance. Where do they get their training? Is there a midwifery school I don’t know about.”

Rep. Ken Johnson said that there is a course that is recognized by the US Department of Education.

Beech said, “But has the medical association recognized it?”

Rep. Ken Johnson said that CPMs deal with low risk pregnancies only.

Rep. Beech introduced an amendment to give doctors, hospitals, and nurses civil immunity if anything goes wrong with a patient who is referred by a nurse midwife in an emergency.

Beech’s amendment was tabled 67 to 22.

Rep. Beckman asked, “Will Medicaid cover it?”

Rep. Ken Johnson said that they won’t but there is a pilot program in Washington State where Medicaid is paying midwives.

The bill passed 85 to 11.

Rep. Johnson told reporters, “We have educated the members to understand more the safety and the freedom of it.” Johnson predicted that the House passing HB315 would help HB 316.

Johnson said that midwives delivered lots of babies. In 1975 the law was changed to allow nurse midwives and outlawed lay midwifery. Strong forces within the medical community have been blocking midwives. “We are the only state where the only option is the hospital.” All other states allow other options whether it is: certified professional midwives, nurse midwives, or birthing clinics.

Rep. Johnson said that he thinks that Senator Paul Bussman (R-Cullman) will carry his bill in the Senate but I have to confirm that with him.

The bill now goes to the Senate.

 

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