The Midwifery amendment
Creates a governor appointed board to oversee midwifery
Requires midwives to be certified by the North American Registry of Midwives
Require written disclosure from each client
Restricts liability solely to the midwife]
JEFFERSON CITY - Senators complained Tuesday but ultimately moved forward to further outline midwifery in Missouri.
Midwifery language created by Sen. John Loudon, R-St. Louis County, and passed to the governor by a seemingly unaware legislature got silent support Tuesday with the senate's approval of an amendment that outlines how midwifery will work in the state and requiring licensing and oversight of all state midwives after hours of heated discussion. The bill the amendment is attached to was put on hold before the lunch break and the bill's sponsor said it may never be approved.
The bill must still be passed by the Senate and sent back to the House for discussion and with three days left in the legislative session, whether the bill will be passed may be up in the air.
"We won't know until it's over at the stroke of six o'clock Friday," the bill's sponsor, Rep. Curt Dougherty, D-Independence said.
Senate Majority Leader Charlie Shields, R-St. Joseph, said he will try to bring the bill back before the senate before the end of the week but was not sure when that would be.
"I was afraid something like that would happen," Dougherty said.
Loudon added the midwifery language to a small business insurance bill that passed both the House and Senate last week without much debate. Several legislators were angry with Loudon's actions saying he did not tell them he had added the wording to the 123 page bill.
Along with the bill's length, the language may have been overlooked because it does not specifically refer to midwifery or birth, instead, it authorizes people with "tocological certification" to provide birthing services.
Senate Minority Leader Maida Coleman, D-St. Louis, said Loudon's wording shows his intent to hide his actions.
Coleman said she does not know if she can trust any legislation put forth by Loudon.
"Everybody in this chamber should be held to a higher standard," Coleman said. "I still feel you have the obligation to be open and honest about what you're doing."
Loundon sent a letter to the entire Senate Monday apologizing to his Republican colleagues for not making them aware of the wording.
Coleman said she was upset that the apology was not extended to the entire senate even though Loudon initially had bipartisan support for the bill.
"I take exception to someone who had bipartisan support and does not apologize to the Democrats who supported him," Colman said.
If the bill is brought back to the Senate before the end of the legislative session it must still return to the House of Representatives where further changes could be made, including the possible removal of the midwifery language.
Rep. Jim Avery, R-St. Louis, said many representatives are upset with how Loudon got the issue approved. He said he anticipates a fight on the bill.
"I hope it's dead. I'll never vote for or support anything he's a part of," said Avery. "Even people who supported the bill don't appreciate how it was done."
Rep. Doug Ervin, R-Holt, sponsored the insurance bill and said Loudon told him about the other changes made but never mentioned the midwifery addition.
The bill has been sent to the Governor and no more changes will be made.
House Speaker Rod Jetton, R-Marble Hill, said although the House could reconsider the bill and Loudon's language, there are no plans to do so.
Shields attempted to repeal the midwifery legislation in the senate Tuesday by proposing an amendment to another bill. Loudon presented a substitute amendment, which would require midwives to be licensed and would create a state board to oversee midwives.
Despite hours of discussion, the substitute amendment passed with a vote of 21-13.
"We need to learn from the circumstances we create by our actions and inactions," Sen. Victor Callahan, D-Independence, said."There's so little trust in here."
Dougherty's bill began as a move to legalize and regulate mixed martial arts, commonly known as extreme boxing. As the bill passed through the House it faced a series of changes including licensing private investigators. Dougherty said the midwifery amendment was added to his bill to keep it from passing.
"The reason they didn't move it was it had a democrat's name attached to it," Dougherty said."I hoped they would have worked their issues out before trashing a decent bill."
Currently, practicing midwifery in Missouri is considered practicing medicine without a license, a felony, unless the person is a Certified Nurse Midwife, which requires extensive training.
The amendment passed Tuesday requires certification by the North American Registry of Midwives.
Dr. Elizabeth Allemann, Medical Director of the Columbia Community Birth Center, said the passage of the midwifery language will have a lot of impact on her and the Birth Center.
Allemann is required by law to be present at the 5-7 births at the birth center each month and said "it's just not sustainable at current staffing."
She said Loudon's actions was the fulfillment of twenty years of attempts to legalize midwifery.