A mosaic from Daphni Monastery in Greece (ca. 1100), showing the midwives bathing new-born Jesus Christ. Courtesy of Wikipedia Commons
By Sandie Love
Indiana will become the 28th state to legalize and regulate midwifery when a new law goes into effect July 1.
Until now, it has been illegal for midwives to practice in Indiana unless they were certified-nurse midwives licensed by the state.
Rep. Don Lehe, a Republican from Brookston who authored the bill, said he estimates that there are less than a dozen individuals who are federally licensed and trained as certified professional midwives but practice illegally in Indiana. That's because they aren't also nurses.
By passing this law, Indiana will take steps to authorize those federally certified midwives.
"I thought it was good legislation and the right thing to do," Lehe said. "It benefits those in the state who prefer to do homebirths."
Certified-nurse midwives are registered nurses who graduated from a nationally accredited school of midwifery, passed a national certifying exam and are licensed by the state board of nursing.
But most of the certified nurse-midwives in Indiana work primarily with hospitals and attend few at-home births.
The law creates a new licensed position called the "certified direct entry midwife." It won't automatically give licenses to those who are federally certified but it is meant to give them a path to becoming legal.
The Indiana Medical Licensing Board is responsible for licensing the new certified direct entry midwives and establishing continuing education requirements.
The law also requires a physician to examine a client of a certified direct entry midwife once during the client's first trimester and once during the third trimester.
The midwife must collaborate with a physician and can administer prescription drugs only under a physician's order.
The law establishes a Class D felony for practicing midwifery without a certificate.
Kathy Williams, a lobbyist for the Indiana Midwives Association, said the organization, which represents the federally certified group of midwives, not the nurse midwives - pushed the legislation.
Previously, it was a felony for anyone other than a doctor or nurse-midwife to deliver a baby at home.
Williams said the law will present a few challenges to midwives, such as requiring a written, collaborative agreement with doctors and requiring liability insurance in a relatively small market of midwives.
"We're hoping that the board will not put more obstacles in the path of midwives becoming legal," Williams said.
Lehe said the most important aspect of the new law is overall safety for women and their children.
He said some people prefer at-home births for financial or cultural reasons, but this law will "provide great assurance that they've got someone available to perform at-home births."
Lehe said legislation supporting licensure for midwives has been brought up in the General Assembly for the past 20 years.
He credited support from the chairmen of the health committees and strong testimony for the bill's passage this year.
But the Indiana State Medical Association, an organization representing Indiana physicians, continued to testify against the bill throughout the session.
Even though this year's bill included a new provision that requires midwives to work with physicians, Michael Rinebold, director of government relations, said the organization still opposes the law.
He said the state shouldn't allow a certified professional midwife to practice in Indiana; only those who are also registered nurses and physicians should be able to practice midwifery.
"Home deliveries represent about 1 percent of all deliveries in the country," Rinebold said. "But in critical times, even the most low-risk pregnancy can become a high-risk pregnancy very quickly."
Ellie Price is a reporter for TheStatehouseFile.com, a news service powered by Franklin College journalism students and faculty.