Doctors oppose midwifery bill

A bill that would certify so-called direct-entry midwives and allow them to administer drugs ran up against the medical establishment Monday.

As a result the House Health and Human Services Committee continued testimony on HB227, sponsored by Rep. Jackie Biskupski, D-Salt Lake.

The proposal faces opposition from the Utah Medical Association and some midwives who say they don't want the state meddling in what should be a private contract between parents and the caregiver.

Other midwives, though, told the committee Monday morning that they need to be free from the fear of being prosecuted and able to deliver basic care to both mother and child. Eighteen states across the country have "legalized" the practice or offer some regulation.

A rewrite in 1993 of Utah's Medical Practices Act wiped away any official recognition by the state of direct-entry midwifery, leaving those in that field vulnerable to be charged with practicing medicine without a license.

The law does recognize nurses who have been certified in training as midwives, a similar recognition that the Utah Midwives Association is seeking.

Carrie Kemp, holding 6-month-old Grace, said she wanted to have a home birth even though she works in a hospital environment.

Too often, she said, doctors and hospitals regard pregnancy and childbirth as an "illness" that requires treatment, rather than a natural, normal part of being a woman.

"Doctors are there to provide a service for me. I am not there to provide an income for them."

Currently, direct-entry midwives are prohibited from prescribing or administering any type of controlled substances or prescribed medications. Nurse midwives, on the other hand, can prescribe some classes of controlled substances and commonly used medications.

Biskupski's bill would add direct-entry midwives to the list of medical professions monitored by the state Division of Occupational and Professional Licensing. It would also establish a committee to help monitor the practice and institute guidelines as to what types of services could be provided.

But a doctor and a representative from the medical association said what the group wants goes too far.

A section in Biskupski's bill would allow midwives to administer pitocin and methergene post-partum, which Dr. Dale Sundwall said are by no means "benign" drugs.

"Pitocin can cause seizures and death . . . methergene is even worse," Sundwall told the committee.