Guest Author: Sarah Whedon, Ph.D
Here in Massachusetts, midwifery supporters have been working for many years to pass a bill that would license Certified Professional Midwives (CPMs). We believe we now have a real shot at passing the bill into law in the current legislative session.
This January we re-filed the bill, An Act Relative To Certified Professional Midwives (SB 1825/HB 2941), sponsored by Representative Kay Khan and Senator Anne Gobi. If passed into law, the legislation would:
- require all midwives practicing out-of-hospital to be CPMs;
- create state licensing requirements for CPMs;
- establish a Committee on Midwifery to issue CPM licenses and regulate CPM practice.
Currently, Massachusetts regulates only Certified Nurse Midwives (CNMs), who do not attend homebirths here. There is no state oversight of CPMs, who provide out-of-hospital care to approximately 500 women and their families across the state each year, a number that is growing annually.
Representative Khan, the House sponsor of the bill has said, "It is critical for the future of maternal health care that we establish oversight for the homebirth midwives practicing in the Commonwealth. Not only will it ensure accountability and offer families secure options for choosing to deliver their child at home, but it will reduce medical costs, promote collaboration among healthcare professionals, and improve public safety for consumers."
Although the bill was originally drafted in 1998 by supporters of Massachusetts CPMs, they quickly formed a coalition with CNMs to advocate for the midwifery legislation. That coalition operated for more than a decade until, for both administrative and policy reasons, the formal coalition was dissolved in 2010 and the bill was cleaved into two, one that would regulate the practice of CPMs and the other which expanded the scope of practice for CNMs. The CNM bill passed in 2012, freeing CNMs from a requirement to work under a supervising physician and allowing them to both write prescriptions and order tests.
The CPM bill has been reintroduced into the Massachusetts legislature multiple times, working its way through various committees. During this time, it has the gained the support of powerful consumer organizations like the Massachusetts ACLU, Amnesty International, Massachusetts NOW, Mass Friends of Midwives, Massachusetts League of Women Voters, Our Bodies Ourselves, and the Massachusetts' Women's Bar Association. However, due to pressure from powerful medical organizations, the bill has been stalled each time.
Judy Norsigian, who for many years was executive director of Our Bodies, Ourselves, wrote to debunk myths about the midwifery bill perpetrated by medical dissenters. She asserted that, "failure to license CPMs will make the several hundred home births that occur in Massachusetts every year less safe by failing to create an integrated maternal health care system with enhanced collaboration among all care providers. This bill would affirm that all Massachusetts maternal health care providers are committed to practicing with state oversight and public accountability."
Massachusetts Midwives Alliance and Massachusetts Friends of Midwives continue to collaborate on advocating for the bill. We recently received the good news that Rep. Jeffrey Sanchez will now be the House Chair of the Health Care Financing Committee and Rep. Kate Hogan will be the new House Chair of the Public Health Committee. Both have been supporters of the midwifery bill during prior sessions and have indicated an ongoing commitment to advance this legislation. We congratulate Reps. Sanchez and Hogan in their new leadership roles and look forward to working with them on An Act Relative To Certified Professional Midwifery.
We are hopeful that this session will be the one in which Massachusetts formally recognizes the vital role of Certified Professional Midwives in providing broader birth options for low-risk birthing families.
For more information and to get involved please contact:
The history of this bill is drawn from an unpublished paper by Molly J. Lawney, "Massachusetts: 'An Act Relative To Certified Professional Midwives'" March 18, 2013.