Illinois House OKs bill to license professional midwives

SPRINGFIELD - Midwifery moved one step closer to becoming an officially licensed occupation in Illinois on Thursday with the passage of House Bill 3401.

HB 3401 creates the Licensed Certified Professional Midwife Practice Act, which would license individuals who perform out-of-hospital births and have earned the credentials associated with being a professional midwife.

The bill, sponsored by Evanston Democratic Rep. Robyn Gabel, garnered bipartisan support, with only one Republican and one Democrat voting against it.

Gabel said the Illinois State Medical Society, the Illinois Nurses Association, American College of Gynecologists and Obstetricians, and the Illinois Health and Hospital Association are among many medical groups that support the bill.

"This will make (certified professional midwives) legitimate, legal, licensed and safe," Gabel said on the House floor. "This is a group of midwives who are trained to do home births, and that's what they do. Up to this point, it's been illegal in this state to do that, and they couldn't get insurance, they couldn't transfer to a hospital, they couldn't talk to a doctor."

The bill "makes them legal, so they can now try to get insurance, they can have relationships with a hospital so they can transfer a baby if that should happen," Gabel said.

Midwives are currently licensed in 35 states and Washington, D.C.

The bill defines the practice of midwifery as the "means of providing the necessary supervision, care, and advice to a client during a low-risk pregnancy, labor and the postpartum period, including the intended low-risk delivery of a child, and providing normal newborn care."

The definition specifically excludes the practice of nursing and medicine. The bill distinguishes between a certified professional midwife and a certified nurse midwife, which is a separate occupation that requires a nursing degree.

Certified professional midwives are accredited by the North American Registry of Midwives, which issued its first CPM credential in 1994, according to its website.

In addition to certification, the bill also requires completion of a postsecondary midwifery education program through an institution, program or pathway accredited by the Midwife Education and Accreditation Council, which is defined in the bill as the nationally recognized accrediting agency that establishes standards for the education of midwives in the U.S.

A midwife accredited by the North American Registry of Midwives who has not completed a Midwife Education and Accreditation Council program can still obtain licensure if they have practiced as a CPM for more than three years and acquire other certifications.

The bill also creates an Illinois Midwifery Board that could recommend revisions to the Licensed Certified Professional Midwife Practice Act, among other duties, and it tasks the Department of Financial and Professional Regulation with administrating and enforcing the legislation.

Rep. Jay Hoffman, a Swansea Democrat, voted against the bill, citing the opposition by the Illinois Trial Lawyers Association, which is a group advocating on behalf of plaintiff lawyers who represent injured victims, oftentimes in medical malpractice and wrongful death cases.

"My understanding is that the consultant who provides the consultation, whether that's a doctor or hospital, and the midwife followed this negligent advice, they would not be liable under your bill and that's the concern. So, I'm not going to be able to support your bill today. I do want to support it," Hoffman said.

Rep. Anna Moeller, an Elgin Democrat, said the bill goes far enough in providing sufficient liability protections.

In the committee process, Moeller said, health care providers testified that "maintaining the language that encourages collaboration between doctors, nurses and the midwives," was "incredibly important," as was "ensuring that liability is neither expanded or more limited based on that collaboration."

"Removing that language would actually create a chilling effect and would lead to a more dangerous situation where you would have parties not working together for the benefit of the mother and the baby as part of the home birth," Moeller said. "And, the fact of the matter is, right now we know that home births are happening in Illinois, but they're happening in a very unregulated and potentially unsafe manner."

Rep. C.D. Davidsmeyer, a Jacksonville Republican, also opposed the bill because it lacks a requirement that midwives have an affiliation with a medical doctor.

The bill does, however, require a certified midwife to consult with a physician or certified nurse midwife if the pregnant woman presents certain complications, such as abnormal lab results, or specific risk factors.

The bill passed by a 105-2 vote and heads to the state Senate for further debate.