For the last few months I’ve been watching the situation in Colorado, where the bill allowing direct-entry midwives to practice was set to expire.
Indra Lusero and a group of consumer advocates were working hard to improve the new version of the law. They wanted to make sure that midwives were given the best opportunity to practice their trade, supported by the law.
This is a legislative situation we don’t hear much about. A lot of the news focuses on states trying to get these licensing laws established in the first place (there are currently 23 states without them on the books). But all of these laws do “sunset” at some point, and have to be renewed. It presents an opportunity to change things for the better, which is what these folks were able to do.
Indra and I spoke on the phone during the campaign. Indra became a midwifery advocate after her own home birth. This is what she had to say about why they began the campaign:
Midwives were frustrated with the current state of the law which was inacted in 1993 and hadn’t been improved in 17 years. Some of those initial compromises that had been made in that fraught time were really limiting. Some of the language was explicitly opposed to midwifery—”we’re going to regulate you but we don’t feel good about it.” Some of the scope of practice things: not being able to carry anti-hemorrhagics. Rogam, Vitamin K. And one of the bigs one that we’re fighting over this session is suturing—the ability to repair minor tears at home.
In political environments that are often very midwife unfriendly, these battles can be particularly challenging. Midwives are afraid if they push to hard, they might lose altogether and no longer be able to practice in the state. So often what results is compromise laws that can severely limit the midwives ability to practice as they are trained to do.
Indra’s group though, presented a different advocacy effort–that of consumers, not the midwives themselves. Their stake in the fight is different, and can be received by elected officials in new ways.
In the end it was a big success, and the new version of the bill has passed through the State Legislature with little opposition, to be signed into law by the Governor soon. They weren’t able to secure suturing privileges, but there is a possibility that could be allowed through other mechanisms.
Here are a few of the changes they were able to achieve:
- Registered CPMs can now be simultaneously licensed as nurses (and vice versa). This was prohibited in the original law.
- Registered CPMs can now obtain and use these drugs: Vitamin K, Rogam, antihemorrhagic drugs, and eye prohylaxis.
- The language that spoke negatively of midwifery was removed.
Those are just a few highlights! You can read all the nitty gritty details here. A big congrats to the folks in Colorado who worked on this bill.