A bill to criminalize Certified Professional Midwifery (CPM) in Mississippi was defeated today, according to reports, thanks to a groundswell of opposition led by the grassroots advocacy organization The Big Push for Midwives.
Had it been passed, HB 695 would have limited the practice of midwifery to Certified Nurse Midwives (CNMs), stating that “any person who is not a certified nurse midwife who engages in the practice of midwifery shall be subject to criminal penalties.” The bill also stipulated that the practice of midwifery would be overseen by the Board of Nursing, something Katie Prown, Campaign Manager of the Big Push for Midwives, saw as an “inherent conflict of interest.”
“This bill would have given the Board of Nursing power over the practice of midwifery when they are two distinct and different professions,” says Prown.
The bill also would have stripped women of an important option when it comes to prenatal, childbirth and postpartum care, leaving pregnant women in the state without the care they needed.
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“If CPMs were to become illegal in Mississippi and [had been forced to] stop practicing, then the families who have become reliant on out-of-hospital care [might] not get the care they need,” Prown noted. By criminalizing midwives who facilitate out-of-hospital and home births, Prown continued, “you’re not going to stamp out home birth. Getting rid of midwives who provide home care is only going to make things worse.”
Prown says that the bill, introduced in the House by Rep. D. Stephen Holland (District 16), was introduced with good intentions. According to Prown, the bill was a response to a 2008 case involving a Louisiana midwife who facilitated a home birth in Mississippi which resulted in the death of the newborn. Mississippi has one of the highest newborn mortality rates in the country, a rate which has risen in recent years.
Licensing and regulation of certified professional midwives is something which The Big Push for Midwives supports and for which it lobbies on the ground, but, says Prown, limiting state licensure to nurse-midwives would do nothing more than severely restrict women’s birth options, especially in a state like Mississippi where no nurse-midwives are providing home birth care.
“Rep. Holland had the right intention but he didn’t have the right information and didn’t understand that this bill criminalizes the midwives who practice out-of-hospital maternity care and outlaws out-of-hospital care entirely because there are currently no nurse-midwives in the state who provide out of hospital care.”
Certified professional midwives must be certified through the North American Registry of Midwives while certified nurse midwives receive an advanced nursing degree in addition to midwifery education and certification. Certified professional midwifery also involves education or apprenticeship. However, certified professional midwives are not universally regulated and licensed throughout the country. In one state, a CPM may be regulated and licensed through a Board of Midwifery, receive reimbursements through Medicaid and offer a range of prenatal, birth and postpartum care. In other states, as is the case in Mississippi, midwives are lawfully able to practice without regulation or licensure.
According to the North American Registry of Midwives (NARM), the organization by which all CPMs are certified, they are aware of only two CPMs in the state though there are likely many more practicing in Mississippi who live in surrounding states.
The Associated Press reports that “home births have been a long-standing tradition in the state, where 18 percent of the population is uninsured:”
Midwife deliveries have been solid options for some, particularly in the Delta, one of the poorest regions in the country. Advocates say a midwife delivery is usually about a third of the cost of one that occurs in a hospital because home births usually don’t involve anesthesia and other medical interventions.
Midwifery advocates were successful at stopping this bill by organizing quickly and efficiently and barraging Rep. Holland’s office with calls and emails. They also are encouraged by the headway they have made with Rep. Holland and the Mississippi state legislature. Prown says now that the “bad bill” is dead, they will push for an amendment but plan on coming back next year if that effort is unsuccessful. Says Prown, “And they’ve [advocates] definitely made an impression…Rep. Holland, told one of the callers to his office that in all his years at the state house, he had never heard “such a ruckus” over a bill before.”