Another round of fighting over laws regulating midwives has tapped the patience of committees and legislative leaders.

Thursday, before passing out SB93, which would clarify rules for midwives delivering babies in the home, the Senate Health and Human Services Committee strongly admonished those fighting over proposed changes to the law to resolve their differences. The warning was later echoed by Senate President John Valentine, R-Orem, who said that he "will hold lawmakers' feet to the fire" to make sure that the issue gets settled, ideally for good.

Essentially, they were told by committee members that a compromise needed to be reached before the bill would be debated in the Senate. To accomplish that, advocates on both sides of the issue — including Sen. Margaret Dayton, R-Orem, who is sponsoring SB93, and Rep. Jackie Biskupski, D-Salt Lake, who sponsored the Direct-Entry Midwife Act in 2005 — agreed to meet within the next few days.

In the committee hearing Thursday morning, Dayton said that SB93 is needed to clean up language and clear up the intent of that 2005 bill. 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. Although one of the complaints involved a hospital transfer, both of the complaints were dismissed as unfounded.

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.

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