Delaware midwives call for licensing legislation

By Molly Albertson
Cape Gazette staff
http://www.capegazette.com

State officials say midwives could be a part of the solution to Delaware’s high infant-mortality rate, and new legislation regulating midwives will be considered in the House on Tuesday, May 8.

In its 2006 report, the Delaware Healthy Mother and Infant Consortium called for better prenatal care, a service provided by midwives. In addition, home births have been recognized by the American Public Health Association as a safe alternative to hospital births.

But in Delaware, there is only one legally practicing midwife. For the most part, midwives in Delaware say they have to work underground because state laws make it difficult to practice.

They have lobbied the state House of Representatives to pass a new bill that would license midwives and allow them to practice legally. The policy analysis and government accountability committee has approved House Bill 106, and it goes before the full House May 8.

The application of this woman-centered, cost-effective model of care has been proven to reduce the incidence of birth injury, trauma, and Cesarean section and has been shown to be as safe or safer for healthy mothers and babies as hospital birth, a synopsis of the bill states.

Under state law, a midwife must be certified by the American Registry of Midwives and must have an practice agreement with a licensed obstetrician.

But not many doctors want to sign such agreements, because the doctors become liable for any accidents, said Marilee Pinkleton. She’s a midwife who practices illegally in Delaware and has delivered about 400 babies in her career. I sent out letters to all 107 obstetricians in the state, and not one wanted to make an agreement with me, she said.

The bill, sponsored by Rep. Pamela Midwives Maier, R-Drummond Hill, would dissolve the need for a midwife to work with a doctor, at the same time creating a council to oversee licensure.

If passed, Delaware would accept current national standards for accreditation, recognized in 21 states, which require years of education and an apprenticeship.

The governor would appoint five members to the committee, including two midwives, two people who have received care from midwives, and one member of the Board of Medical Practices.

The new bill also states other healthcare professionals are not liable for malpractice related to midwife care.

Supporters of the bill say it would give women more healthcare choices because they could choose to have their babies at home rather than in a hospital. Access to prenatal care and delivery services is limited by the inadequate number of providers of such services, and the regulated practice of midwifery may help to reduce this shortage and improve maternal and infant morbidity and mortality rates and outcomes states the synopsis of the bill.

Home births are often less expensive than hospital births, the bill states.

Midwife-in-training Greer Thompson said a homebirth usually costs $2,000 to $5,000 while a hospital birth costs from $7,000 to $30,000.

If this passes, there would eventually be insurance reimbursement, so therefore people with varying economic backgrounds can have this choice,� she said.

Midwives care for patients is different from care provided by traditional doctors.
Pinkleton said she usually spends an hour with expecting mothers during each visit, while doctors spend only minutes.

We recognize that birth is a normal and healthy event in the life of a woman and her family, its not a medical event, Pinkleton said. She concentrates on nutrition and living a healthy lifestyle with patients.

If the bill does not pass, Thompson will quit her education or move from the state, and Pinkleton said she will be forced to give up her practice.

Rep. Pete Schwartzkopf, D-Rehoboth Beach, said he has not yet read the bill, but he expects to look over it in the next week. There’s some support for it, but I’ve gotten a letter from eight or nine doctors, and they’re not happy about it, he said.

Rep. Joe Booth, R-Georgetown said, “It sounds like the midwives are trying to professionalize their practice, and I support that.

He hasn’t gotten feedback from the medical community, but he does not see much controversy in the bill. I appreciate the midwives taking this on, he said.
Booth, who has five children and is married to a nurse, said he would be very well prepared when the bill comes to a vote before the house on May 8.

Maier did not return phone calls for comment.

Editor’s Note: This was originally posted on the CapeGazzette.com website, but it has been moved or deleted. We will archive it here.