Missouri Legislature Targets Midwives

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The Missouri Medical Association is trying to stop midwives -- again.
Four years ago, the Missouri Legislature decriminalized midwifery -- making it legal for a woman who's certified by one of two national midwives' organizations to deliver babies here.

But the state's physicians don't like the competition. They sued, unsuccessfully, to stop the legalization in 2007. And now they're pushing a bill to require midwives to be licensed by the state, on top of national certification, and meet a host requirements so onerous that midwives say they could be forced right out of business.

The Columbia Missourian reported last week that a lobbyist for the the Missouri Medical Association -- the powerful physicians' lobbying group in Jefferson City -- actually helped write House Bill 301.

In addition to requiring state certification, the bill would force midwives to carry at least $500,000 in malpractice insurance, pay a licensing fee and perform at least 30 hours of continuing education every two years. It would also require them to notify the state in writing every time they get a new client -- and only allow them to work "in collaborative agreement with a licensed physician" who has privileges at a nearby hospital.

Not surprisingly in light of its origin, the bill carves out special exemptions for physicians, even while cracking down on midwives. According to the bill's official summary, it "exempts certain emergency medical providers from civil liability when treating a woman or infant during childbirth as a consequence of care received from a licensed midwife."

According to the Missourian, a lobbyist for the physicians' group testified that the current system was like "invit(ing) your neighbor over to help you deliver your baby" -- an analogy that might make a bit more sense if midwives weren't required to do extensive training first.

But if money talks at the Capitol, the midwives might be in trouble.

A Daily RFT analysis of reports filed with the Missouri Ethics Commission shows that the physicians' political action committee, MO Medical PAC, donated $199,349 to various legislators in the 2010 cycle. That includes $500 to Representative Mike Talboy, the Democrat who serves as the bill's primary sponsor, and another $500 to Talboy's co-sponsor, Republican Ryan Silvey.

MO Medical PAC also donated $1,000 to the new Speaker of the House, Republican Steve Tilley, according to ethics commission records.

The House Professional Registration and Licensing Committee could vote on the bill as early as this week.


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