By Angie Welling
Deseret Morning News
Tuesday, February 6, 2007

The state Capitol was full of babes in arms Monday, accompanying about a dozen women up in arms about a recently unveiled proposal to regulate midwives

The measure would amend a contentious bill passed two years ago to license direct-entry midwives through the state Division of Occupational and Professional Licensing.

Sponsored by Sen. Margaret Dayton, R-Orem, SB243 legally defines what constitutes a "normal" pregnancy, labor and delivery — the areas in which licensed midwives are allowed to provide care.

The bill forbids midwifery in pregnancies involving conditions such as pulmonary or renal disease, hypertension, diabetes and genetic disorders. Women with three or more consecutive miscarriages, a stillborn child or prior c-section would also be ineligible for a home birth.

Dayton said her bill simply aims to "set forth the definitions" not included in the original legislation and is not an attack on midwives. Women who gathered to protest SB243, however, had a different take on the bill.

Since the passage of the Direct-Entry Midwife Act, 15 midwives have been licensed by the state. They delivered 94 babies last year, and, according to the Utah Midwives Association, nearly all of them — 96 percent — would not have been eligible for a home birth under the "extreme restrictions" in SB243.

The bill constitutes a clear restraint of trade, the women said, despite what they believe is overwhelming evidence about the benefits of home birth.

"It's important for women to know they have a choice," mother Andie Henthorn said. "People who have home births are not crazy."

Dayton, who opposed the original midwife bill in 2005, said she does not intend to take away anyone's choice.

"I think people should have the choice of going to the very ultimate high-range obstetrician, high-risk consults or to stay at home alone in the dark in the bathroom if they want to," she said.

Dayton said she opposed the earlier bill because it gave "the idea that all these choices are equal. And all the choices in my mind aren't equal."

Prior to having children of her own, Dayton worked for five years as a labor and delivery nurse. Her husband is a retired obstetrician.

The Utah Medical Association helped draft SB243 to address concerns raised during the rule-making process for the original midwife bill. The absence of a definition for "normal pregnancy and birth" resulted in a grant of discretion beyond the original intent of the law, said Michelle McOmber, the association's director of government relations.

"This way, it takes the guesswork out and lays down exactly what it means," McOmber said. "The hospitals and physicians are the backup for these individuals who deliver at home and we want the best outcomes possible."

According to a November report to the Health and Human Services Interim Committee, two of the 94 babies, and one mother, attended to by licensed midwives between January and August 2006 had complications serious enough to require hospitalization. Other transfers to the hospital, for both mother and child, were handled with good outcomes, the report notes.Contributing: Shawn Mansell, Lisa Riley Roche