From Deseret News archives:

Vote on midwife bill is deferred

Measure would establish voluntary state licensing

Published: Friday, Jan. 28, 2005 7:46 p.m. MST
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Bogged down by questions about safety and suffering from a lack of hard statistics, lawmakers again deferred a vote to advance a bill that would license Utah's midwives.

Midwifery is legal in Utah, but only registered nurses who also practice midwifery are under the supervision of the state.

Sponsored by Rep. Jackie Biskupski, D-Salt Lake, the bill would establish voluntary state licensing for lay midwives. It would require midwives to complete a three-year education program and pass a written national exam and a skills test, as well as a state-approved course in pharmacology.

Biskupski believes such a license will make home births — of which there are about 600 each year in Utah — safer.

But no state agency is currently tracking home birth statistics and in the absence of any, members of the House Health and Human Services Committee skipped a vote on the bill Monday and asked for any data that illustrates how moms and babies fare in emergency situations. The committee will bring the bill back for a vote on Friday, chairman Rep. Brad Last, R-St. George said.

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Physicians and the Utah Medical Association continued vehement opposition to the bill Monday. Dr. Stephen Lamb, an obstetrician with 20 years of experience said he thought the bill is a move to allow midwives to practice medicine without having gone to medical school.

Doctors opposed the bill in part, Lamb said, because of "the fact that we've had these bad cases laid at our door steps time and time again. Mothers that are dying, babies that are dying."

Rep. Steven Mascaro, R-West Jordan, challenged Lamb's statement, saying Lamb's remarks suggest a problem lawmakers have not seen in the four years the midwifery bill has been debated on Capitol Hill.

Lawmakers also wanted to know more about the drugs the bill would allow lay midwives to administer.

Under the Biskupski's bill, licensed midwifery would allow practitioners to provide prenatal care, perform some invasive procedures, such as the administration of intravenous drugs, and use other medicines, including oxygen, anti-hemorrahagics and local anesthetics.

Lamb said allowing midwives to use those drugs takes them "further down the decision tree" and could lead to more medical problems for mothers and their children because transfer to a hospital would be delayed.

"I would hope that we would not legitimize the unsafe practices that are going on by giving lay midwives an air of authenticity through licensing," Lamb said. "Some may be well trained, but I've met midwives who read a book, saw a movie and went to a few births."

In response to a question, Lamb said that he would be willing to sit on a state oversight committee if the bill passes.

Mascaro said he likes the bill but wanted Biskupski to add a requirement for statistical tracking and an annual report back to lawmakers. He also said the makeup of the oversight panel should include more doctors.

Mascaro also noted that even if the bill passes, the licensure would only be voluntary.

"That's correct," Biskupski said. "What we are doing here is kind of throwing out the carrot to bring in the women that are doing this. We're trying to get them to come to the state and be under our supervision."

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