Midwife regulations may tighten

After strongly admonishing those fighting over a midwife licensing bill settle their differences — by this afternoon or sooner — the Senate Health and Human Services Committee voted 3-2 Thursday morning to move SB93 to the Senate floor.

The bill is needed, said sponsor Sen. Margaret Dayton, R-Orem, to clean up language and clear up the intent of the Direct-Entry Midwife Act passed in 2005. Clarity of the text, not ending the practice of in-home deliveries as opponents claim, is the purpose of the bill, Dayton said.

Sixteen direct-entry midwives — the term refers to a midwife who has entered the profession as an apprentice to a practicing midwife rather than attending a formal school program — sought state licensing under the act. They now fear that Dayton's effort to clarify language that got them licensed will be used to regulate them out of business.

Dayton disagrees. Because an "essentially normal pregnancy" was not defined as the act was being written into the state code, she said, the midwives have been expanding the scope of what normal is and have been assisting women who are at high risk for delivery complications.

Two complaints of midwives practicing beyond their scope have been filed, according to the state Division of Occupational and Professional Licensing. One of the complaints involved a hospital transfer.

Dayton, who used to be a nurse and whose husband is an OB/GYN, said midwives must realize that with state license comes practice parameters, just like any other state-licensed occupation.

Sen. Scott McCoy, D-Salt Lake, said he is uncomfortable with being asked to vote for technical changes that should have been included as the act was written into law.

"What was wrong enough with the rules process that we're at this point now?" McCoy asked.

The rules process didn't address intent of the law; that was just a handshake agreement, Dayton and proponents said.

One transfer to a hospital does not mean that a pregnancy was risky, McCoy said.

"Green can turn to red under the best of medical circumstances and equipment," he said. "This could effectively eliminate any kind of delivery because every birth can suddenly turn high-risk."

Other committee members said the core of the problem is regulation of a state-sanctioned procedure, and not a matter of what the family receiving services wants.

If passed, both high- and low-risk situations would be defined and a standardized procedure for determining when a direct-entry midwife should relinquish treatment to those with more training.

The debate has even come to the attention of Senate leadership. President John Valentine, R-Orem, is insisting the issue be settled and that he "will hold lawmaker's feet to the fire" to make sure it is.

---

E-mail: jthalman@desnews.com