INDIANAPOLIS – The state Senate Health Committee heard somewhat circular arguments Wednesday on legalizing midwifery, with supporters noting midwives are already helping Hoosier women with home births regardless of a state ban.
But doctors and other opponents pointed to statistics nationwide – and even in other countries – showing a complication rate two to three times higher for home births.
A vote is slated on House Bill 1135 next week.
We have this dichotomy. We’re operating as if we’re legal and we’re not, said Mary Ann Griffin, president of the Indiana Midwives Association.
She is a certified professional midwife – a national certification that some states recognize but not Indiana.
Indiana has only licensed certified nurse midwives, which means a registered nurse who has graduated from a nationally accredited school of midwifery, passed the National Certifying Examination given by the American College of Nurse-Midwives, and is licensed by the state nursing board to practice as a nurse-midwife.
It is a felony to practice midwifery – helping mothers give birth, often at home – without a license in Indiana.
Midwives are especially popular in Amish and rural communities. According to data from the Indiana State Department of Health, there were 1,058 intended live births at home in 2010. Of those, 357 were by nurse-midwives.
Locally, DeKalb County midwife Barbara Parker, 55, was charged this month with three felony counts related to deliveries she performed in August.
According to police and prosecutors, she assisted in 48 deliveries in 2012. Within a week in early August, she served as midwife for three women, and two of the babies had complications and died, authorities said.
Griffin acknowledged some midwives in Indiana are practicing outside the acceptable scope of care.
We know there have been arrests in northern Indiana, she said. I think licensure will cut down on some of the rogue midwives we see practicing. These midwives are not us.
Dr. Gary Dillon, a former state senator, said he previously voted against legalizing midwives but now feels it is necessary.
This really isn’t a radical move. It’s done elsewhere, he said of the 27 states with similar midwife regulations being proposed. Even if you feel that delivering at home is not the best way to deliver babies, I hope that you’ll look at this as an opportunity to make a bad situation better.
Under the bill, it would take five years to complete the training and requirements to become a certified professional midwife in Indiana.
Dr. Alan Wagoner of Frankfort said the cost to deliver at home might be as much as $3,000 compared with $13,000 for an uncomplicated delivery in a hospital.
He said he has helped many midwives even though he might be legally liable.
Warren Mathies of the Indiana Trial Lawyers Association said House Bill 1135 gives immunity to doctors who assist certified professional midwives but doesn’t require the midwives to carry insurance.
When no one is left accountable, no one is safe, he said.
Fort Wayne Dr. Todd Rumsey, an OB/GYN, testified that weeding out high-risk pregnancies is not that difficult. But predicting which mothers are going to become high-risk during birth can’t be anticipated reliably.
When something serious occurs, a doctor in a hospital is more equipped to care for the safety of the mother and child, he said.
Rumsey also said Indiana’s infant mortality rate is dismal, and leaders in the field are already studying the issue for improvements.
By endorsing this bill, you send a message to the public that you think these guys are legitimate, Rumsey said.
Sen. Ryan Mishler, R-Bremen, said he was confused during the hearing how someone wanting to be licensed would obtain the requirement in the bill of participating in 115 births if there aren’t licensed certified professional midwives now.
Griffin said there are 12 certified professional midwives practicing in Indiana, and the bill would essentially grandfather them in and let them provide the training to new licensees.
So basically if you’ve been operating illegally, we’re going to exempt you and make you legal and allow you to teach more people, he asked, shaking his head.