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Midwives will not receive Illinois licensure to assist in home births anytime soon

March 24, 2009 – Women choosing to give birth at home suffered a major defeat this month when an Illinois House committee voted down a bill that would have allowed certified professional midwives to deliver babies.

House Bill 226, which died March 4 in the Health Care Availability and Accessibility Committee, would have expanded child birth options for expecting mothers and prevented pregnant women from hiring unqualified midwives or giving birth at home without medical supervision, said Colette Bernhard, legislative chairwoman for the Coalition for Illinois Midwifery.

“By refusing to license certified professional midwives to distinguish between unqualified providers and nationally certified midwives, the state is complicit in the harm done to babies,” she said.

Home births, which account for less than one of every 100 U.S. births, are safer and more natural than hospital delivery, she said, and certified midwives often have more hands-on experience delivering than registered nurses. Infant mortality and morbidity – a term used to describe babies born with disease or infection – rates are lower among home-born babies and birth weight is often higher.

Currently, Illinois law allows only registered nurses, nurse practitioners and obstetricians to deliver babies. Illinois is one of 25 states that prohibit non-nurse, certified professional midwives, known as “direct-entry” or lay midwives, from practicing, according to The Big Push, a national resource center for midwife advocates.

Advocates in eight of those states, including Illinois, have introduced legislation this year to reverse the prohibition. Advocates in at least 10 other states have begun planning for midwife legislation.

But the Illinois State Medical Society, a trade group for medical professionals and one of state’s strongest lobbies, has put up a strong fight against the Illinois bill.

“Licensure does not necessarily mean sufficient education,” said Dr. James Milam, a practicing obstetrician-gynecologist in Vernon Hills and president-elect of the Medical Society. “As a society, we have to require every baby comes out in the healthiest way possible.”

Milam said he supports nurse-midwifery, in which registered nurses deliver babies in coordination with a hospital and often in a hospital setting, because the practice ensures that medical attention is available in case of emergency.

But Bernhard said her own midwifery experiences contradict that claim. Bernhard delivered all three of her children at home with help from a midwife. Her first child, now 14, was positioned badly for natural birth but her attending midwife was able to shift the baby before delivery without any medical procedure, she said.

The bill has strong support from the House and the coalition is confident its sponsor, Rep. Julie Hamos (D-Evanston), who has not birthed any children but has helped raise her husband’s children, is committed to midwife licensure. Bernhard said advocates would continue to push to include this bill on relevant legislation. If that fails, she said, they would reintroduce it in 2011.

“For Julie, this is a matter of a woman’s right to give birth wherever she feels comfortable,” said Angie Lobo, chief of staff for Hamos. “The bill impacts maybe only 1,000 women across the state right now, but for those women, the process is not safe.”

Less than one percent of the approximately160,000 babies born each year in Illinois are born at home, and about half of those are born without the help of a licensed nurse, said Bernhard. Midwives oversee about 7.5 percent of all U.S. births and about 1 percent of midwife births take place in a hospital, according to the American College of Nurse-Midwives.

Strong resistance from the powerful Medical Society and a stigma attached to home birthing has impeded the bill’s progress, Lobo said. In the first half of 2008 alone, the Medical Society gave more than $400,000 in campaign contributions to Illinois lawmakers, while the coalition gave nothing, according to the Illinois Campaign for Political Reform.

But Milam said the Medical Society is just trying to protect expecting mothers from “somebody just walking around with a duffle bag and saying, ‘I’m your friendly neighborhood midwife.'”

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