I often write about bills in the Colorado legislature that pertain to healthcare, but Senate Bill 088 is one that is particularly important to me on a personal level. The law in Colorado regarding the regulation of direct-entry midwives is up for review this year. SB 088 renews the existing regulations, and would also allow direct-entry midwives in Colorado to provide some additional services, such as sutures and the administration of Vitamin K to newborns and RhoGAM to Rh- mothers.
Our son was born at home with the help of two very competent midwives, nearly three years ago. Our second child is due to arrive in just a few weeks, and we’re planning another home birth, again with the help of excellent midwives. There is little doubt in my mind that our son would have been delivered via c-section had we been in a hospital, or at the very least I would have been given Pitocin to speed up my labor. I had a very long labor and what an OB would have considered “failure to progress”. But while my body did take a good long time to give birth, and didn’t progress in textbook fashion, it did indeed get the job done, and I will be forever grateful for the excellent care – and patience – that our midwives provided.
I’m not going to get into all of the research that has been done regarding the safety of planned home births for low-risk pregnancies. Studies have been done that support both sides of the debate, and it can be difficult to sort through the conflicts of interest that exist. The decision about where and how to give birth is ultimately a very personal one, and there is no one-size-fits-all perfect location for birth. This is why it’s so important to provide safe, regulated options for women who would choose a less-common approach to birth.
SB 088 would extend the current regulations on midwifery practice another five years, until July 2016. It lays out the specific guidelines for a midwife to be legally registered in the state of Colorado, including examination, education, and experience requirements. (it’s important to note here that many women who would choose to have a home birth would do so regardless of whether the state regulated midwives or not. By having these regulations in place, women can be more confident in their selection of a midwife, as the registration process confirms a level of competence and experience that has been evaluated by the state).
Section 9 of SB 088 (see page 11) would expand the scope of direct-entry midwifery to allow midwives to provide better, more comprehensive care for their clients. It would permit midwives to administer IV fluids, Vitamin K shots to newborns, RhoGAM to Rh- mothers, antihemorrhagic drugs to mothers following birth, and eye prophylaxis for newborns (direct-entry midwives are already authorized to administer the eye drops, the language of the bill would simply allow them to obtain the prophylaxis). This section of the bill would also allow midwives to provide sutures for perineal tears and administer local anesthetic prior to suturing. These additions to the regulatory law make sense. I doubt many women who have just given birth at home are going to be persuaded to get up and go to a hospital in order to receive a couple of stitches. In a similar fashion, a mother who is hemorrhaging after giving birth will be much better served by a midwife who can administer antihemorrhagic drugs on the spot than one who has to call for an ambulance and wait for EMTs to arrive, or take the mother to a hospital in order to get the medications.
SB 088 also contains language that is similar to that pertaining to the registration or licensure of any profession that is regulated by law, including details regarding suspension of registration, fines for non-compliancy, etc.
Yesterday, the Senate Committee on Appropriations referred SB 088 to the Senate Committee of the Whole. The bill has generally been well-received in the Senate. It’s passage will help to maintain and enhance the availability of competent, regulated midwives who can care for women who choose to give birth at home.