House committee approves bill that would restrict midwives in the state

A public hearing was held in the House Health Standing Committee on a bill that, while originally designed to expand the abilities of midwives in Alabama, has been substituted and amended to explicitly bar them from performing many newborn screenings.

SB87, initially introduced by Sen. Arthur Orr, R-Decatur, aimed to expand the authority of licensed midwives by allowing them to administer comprehensive newborn screenings—a critical step in detecting rare but serious health conditions within the first 24 to 48 hours after birth. However, Sen. Larry Stutts, R-Tuscumbia, substituted a bill that significantly narrowed this scope. The amended bill permits midwives only to perform a heel lance, the initial step in the screening process.

This revision has sparked concern among midwifery advocates and families who opt for out-of-hospital births. The Alabama Midwives Alliance has publicly opposed the substitute bill, emphasizing that delays in newborn screenings can lead to missed early interventions for treatable conditions. In a video shared on ALMA’s Facebook page, various Alabama mothers and families voiced their apprehensions, highlighting the challenges of securing timely physician appointments for newborn screenings after home births.

During the public hearing before the House Health Committee, licensed midwives and advocates testified about the importance of timely screenings and midwives’ abilities, despite opponents’ claims. They argued that allowing midwives to administer these tests would ensure that all newborns receive essential health assessments promptly, regardless of birth setting. 

Aaron Crawford, director of legislative affairs at the Alabama Birth Coalition, called the bill a “wolf in sheep’s clothing,” saying it had been “hijacked.”

“58,000 babies are born in Alabama yearly. 290 kids of that 58,000, or 1 in 200, face silent killers,” said Crawford. “Where will they obtain help in rural counties, where care is a mirage and transportation is not a simple matter?”

Rep. Ernie Yarbrough, R-Trinity, spoke in opposition to the bill as it stands, but in support of the bill before the substitute was engrossed. Yarbrough said he has two children who were born at home.

“As amended, the right to practice, options and freedoms of Alabama citizens, I believe, are being abridged and taken away. Choices and options are being removed or denied from Alabama mothers because it would seem that special interest and a general attitude that our mothers and their midwives can’t possibly make good decisions and should trust the experts,” said Yarbrough.

Linda Lee, a representative on behalf the Alabama Chapter of the American Academy of Pediatrics and Danne Howard, a representative of the Alabama Hospital Association, said that no evidence exists between expanding midwives’ abilities in that state and improvements to infant mortality rates.

“At a time when we are striving to reduce infant mortality, we must not compromise the quality of care provided to newborns. Lay midwives attending homebirths do not have the equivalent training or clinical experience as pediatricians or neonatologists,” said Lee.

The debate over SB87 ended with a favorable report for the legislation.​ The bill now goes to the House for consideration.