Before an audience of cooing babies and nursing mothers, a legislative committee on Thursday approved a measure to legally define when Utah women can deliver their children at home.

The bill, which moved to the full Senate on a 4-2 vote, amends one passed two years ago to license direct-entry midwives. It gives the Legislature the right to define what constitutes a "normal" pregnancy, labor and delivery — the areas in which licensed midwives are allowed to provide care.

The state Division of Occupational and Professional Licensing has spent the past two years defining normal situations, but many, including the Utah Medical Association, believe the rules are broader than lawmakers originally intended.

Catherine Wheeler, an obstetrician and past UMA president, told members of the Senate Natural Resources, Agriculture, and Environment Committee that physicians' concerns for patient safety "essentially hit deaf ears" during the rule-making process.

"Yes, it is a natural event, but it's a natural event that can have significant complications," Wheeler said. "The physicians who are the safety net for this group are incredibly concerned."

The approval of SB243, sponsored by Sen. Margaret Dayton, R-Orem, means lawmakers are favoring medical standards over traditional midwifery, said Laura Poe, DOPL bureau manager.

"The reality is, is that you have a group of people who have a philosophy of natural childbirth," Poe said. "Their professional standards are almost 180-degrees opposed to the medical standards."

Dayton, whose husband is a retired obstetrician, said that SB243 is not about favoring hospital birth over home birth. "This is not about forcing everyone into the hospital, and it's not about eliminating choices," she said.

Still, the Utah Midwives Association contends the bill would effectively eliminate most of the home births handled by direct-entry midwives. Of the 94 babies delivered last year by licensed midwives, 96 percent would not have been allowed under Dayton's bill.

"This bill would, in effect, prevent pretty much everyone I know that currently chooses to use midwives ... from having that option because the nature of the restrictions are quite limiting," said Laura Lund of Provo, who came to Capitol Hill Thursday with her 4-month-old daughter, Leah, to lobby against SB243.

Opponents don't have a problem with many of the bill's restrictions, including no midwifery in pregnancies involving pulmonary or renal disease, hypertension, diabetes and genetic disorders.

Women with three or more consecutive miscarriages, a stillborn child or prior C-section would also be ineligible for a home birth.

But opponents said forbidding home birth for women who have had previously delivered a baby weighing more than 8 pounds 13 ounces is overly restrictive.

Of the dozen or so mothers at the Thursday morning hearing, nearly half indicated they had successfully delivered a baby of that size, or larger, at home.

"We're assuming that every woman is 5-foot-2," said Raeann Peck, a midwife with 28 years experience "Midwives do not want problems," Peck said. "We want to give the best care possible to moms and babies. And we certainly want to avoid risks."

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