Desperate midwives 

Sen. Miller continues to block legislation

Laura McPhee

Sen. Miller continues to block legislation

Laura McPhee
Sen. Pat Miller
The Indiana General Assembly is once again considering legislation giving parents a choice about where to have a baby and who can help in the delivery. Oddly enough, the "alternative" birthing method seeking state approval is as ancient as childbirth itself. While homebirth is legal in all 50 states, nine states (including Indiana) prohibit by law the practice known as midwifery by non-medical professionals. According to state law, anyone desiring to practice midwifery in the state of Indiana must first be a registered nurse. No other applications will be considered and no other licenses granted. There are approximately 100 licensed nurse-midwives in the state of Indiana, and more than 95 percent work in hospitals or birthing centers where the average cost of delivering a child is $6,400. There are approximately 50 certified professional midwives working illegally in the state; most are hired by couples who want to have their child at home. House Bill 1237 seeks to establish a state midwifery license board and set qualifications for a certified professional midwife (CPM) to practice in non-hospital settings. The current bill has been introduced in a similar form annually since 1993. It has passed the House of Representatives twice; and it has consistently had the support of Republicans and Democrats alike. This year's version is authored by Rep. Peggy Welch (D), who is herself a nurse, and has the support of Rep. Tim Brown (R), a physician by profession and chair of the House Public Health Committee. But one state senator doesn't want midwives without nursing degrees practicing in Indiana, and she has used her power in the state senate to prevent that from happening for more than a decade. Sen. Patricia Miller (R) of Indianapolis is a nurse and the chair of the Senate Public Health Committee. Year after year, she has prevented the bill from receiving a hearing in her committee, essentially killing the legislation herself before it ever receives a vote on the Senate floor. "My concern is whether or not they [midwives] are adequately trained and prepared to provide not only for the birthing of a child but also an emergency situation," Miller contends. The legislation is receiving increased attention this year as a midwife from Bloomington is currently facing charges stemming from her participation in a birth last summer. Jennifer Williams, 54, is a certified professional midwife working in Central Indiana since 1989. She has delivered over 1,500 babies in her capacity as a midwife. In June of 2005, a Shelby County couple hired Williams to facilitate a homebirth. Tragically, their son died during childbirth. After an investigation, Williams was found to have acted appropriately both in the delivery and her response to the emergency; but she was later arrested for practicing medicine without a license. Currently out on $10,000 bond, Williams is charged with a felony and faces possible prison sentencing. "I acted completely appropriately," Williams says. "The charges are not about the baby, or because of anything I did or didn't do at the birth, but because the state of Indiana requires midwives to be licensed, but does not provide a way for that to happen." Williams' credentials qualify her to practice legally in more than 30 states. She received her midwife certification from the North American Registry of Midwives, a nationally accredited program that meets all the standards of the legislation currently being blocked by Miller. The North American Registry of Midwives grew out of the confusion of state laws governing at-home births and midwives, and quickly became the nation's most respected accreditation process for midwives. NARM requires more than 1,350 supervised clinical contact hours, including prenatal and postnatal care, supervised participation in more than 30 births and completion of written, clinical and oral assessments as part of its Certified Professional Midwife program. While the majority of states now accept the accreditation of NARM as a basis for state licensing of midwives, Indiana does not. More than 100 women have been charged for the crime of midwifery in Indiana in the past 10 years, the vast majority of whom have the professional experience and credentials to help parents give birth to their child in the manner and location of their choosing. This is not the only example of legislation Miller has used to limit the parenting options of Indiana residents. Last fall, she introduced a bill that would require any woman seeking in vitro fertilization or other forms of artificial reproductive therapy to file a "petition of parentage" before seeking the medical treatment. Included in the bill was the stipulation that only married women could become impregnated through medical means, and doctors performing the treatment on women without court approval would face felony charges for "unauthorized reproduction." Miller later pulled the bill following national coverage and overwhelming public opposition.

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Laura McPhee

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