Bill could expand Mo. women’s choices
Published Feb. 12, 2008
Laura Ann Schwarb was pregnant with the Schwarb’s fourth child when she and her husband Allan moved to Missouri.
When the Schwarbs lived in Florida and Virginia, midwives assisted Laura in giving home births to all of the couple’s children, services for which Allan’s insurance paid in full. The couple did not expect the situation in which their next child entered into the world to be any different.
Their experience in other states caused the Schwarbs to be completely shocked when they discovered that it is illegal for certified professional midwives to practice in Missouri, and that in this state they would be paying for Laura’s home births out of pocket.
Missouri is one of 10 states where it is illegal for a midwife who is not also a registered nurse to practice. Certified professional midwives who practice in Missouri risk being convicted of a felony.
“Missouri has a climate where midwives can’t get experience — they have to sneak around,” Laura Ann Schwarb said.
The requirements that must be fulfilled for a woman to be classified as a certified professional midwife vary from state to state, and some certified professional midwives do have nursing licenses. But having a nursing degree is required of every midwife registered as a certified nurse-midwife. It is legal for certified nurse-midwives to practice in all 50 states.
Although the Schwarbs have had great confidence in the people who helped Laura with the home births of their two youngest children, both delivered in Missouri, Laura said that because Missouri state laws impede Missouri midwives from improving their skills by training and becoming more capable, she and her husband didn’t have as many choices as they would have had in other states.
“Birthing at home is happening all over Missouri, above the ground and underground,” said Chris Willow-Schomaker, the Columbia coordinator of the nonprofit group Friends of Missouri Midwives.
A state Senate committee heard testimony Wednesday on a bill that would potentially make it legal for certified professional midwives to practice.
Sen. John Loudon, R-Chesterfield, is sponsoring a bill that would make it legal for certified professional midwives to practice in Missouri by establishing a “Board of Direct-Entry Midwives” that would have the power to issue licenses to certified professional midwives and also to set guidelines for their practice in accordance with those established by the National Association of Certified Professional Midwives.
Loudon said he is trying to create a set of standards that would give pregnant women the power to make the decision rather than the state.
The committee also heard testimony on another bill sponsored by Loudon.
This bill would remove a passage that the senator inserted into a health insurance bill last spring that made it legal for unlicensed midwives to practice in Missouri. A county judge struck down this law in August, finding it went beyond the original purpose of the health insurance bill, but that decision has been appealed to the Missouri Supreme Court.
Mary Ueland, a lobbyist on behalf of Friends of Missouri Midwives, said the first bill is preferable to the language that was removed from the health insurance bill because the only thing that law did was decriminalize unlicensed midwives. Not only would the current bill make it legal for certified professional midwives to practice in Missouri, it would also put in place a system of state oversight by setting strict guidelines for them to follow.
Ueland said the biggest effect the bill passing would have on Missouri women would be to provide them with choices. It would make it easier for them to choose where they would like to deliver their children, and it would give them the option to shop around for a midwife they feel best suits their needs — the option that women currently have when searching for an obstetrician.
Laura Ann Schwarb agreed that it is an issue of choice. She said because midwives were not an issue in the other states she lived, she took her freedom to choose for granted until she moved to Missouri.
“When you have a freedom you don’t think about it until it is taken away or infringed upon,” she said.
