Although only 1 percent of Utah births take place in the home, lawmakers learned Wednesday that the campaign to certify so-called direct-entry midwives is not going to quiet down anytime soon. While a certified nurse midwife works with doctors and delivers babies in controlled settings like hospitals, direct-entry midwives do not.

Facing a roomful of women, fathers, young children and colicky babies, lawmakers were told their refusal to recognize and regulate direct-entry midwives is forcing the practice to stay underground with no state oversight.

"Please make it legal so I can practice," Holly Richardson told lawmakers. "We are here to say we are safe and we want to deliver babies."

Rep. Jackie Biskupski, D-Salt Lake, began her push in the general session earlier this year for legislation that would provide licensing, state oversight and minimum education and clinical experience requirements for direct-entry midwives. Her billed failed, and she is back for another try.

As it is now, Utah's Medical Practice Act leaves direct-entry midwives unable to legally administer certain drugs to control hemorrhaging or even apply topical ointment to a newborn's eyes.

That puts practicing direct-entry midwives in violation of the law if they are obtaining the medication and using it to ensure safe deliveries and healthy babies, said Suzanne Smith, a representative of the Utah Midwives Association.

"Many midwives in contradiction to the law are administering the medication," she said.

That notion left Sen. Paula Julander, D-Salt Lake, appalled.

"Is this illegal drug trade, or what is this?" she asked. "It sounds so if you are obtaining them illegally and using them illegally without knowing what they are."

Julander said she would be much more comfortable if she had been unaware midwives were breaking the law and simply desired a change.

That left Smith to agree with her — hence the need for the legislation.

"We don't want to be illegal," Smith said. "When it comes down to it, a midwife is going to ask, 'Do you want to save her life or do you want to be legal?' The midwife is going to save the life."

Richardson said she stopped practicing because her ecclesiastical leaders asked her to, given the criminal implications.

An opponent, however, noted that legalizing something doesn't necessarily make it right.

"As Utah nurses we cannot support this," said Denise Pickett, a member of the Central Utah Nurses Association.

A nurse for 25 years, Pickett said home births present too many opportunities for medical emergencies — opportunities that can be more easily controlled in a hospital setting.

"There is no way of knowing how many failed home deliveries there are," she said.

But supporters said that nationwide, just 8 percent of home-birth cases require a transfer to a hospital where an attending physician can take over.

"This is a safe option, and no quality studies have shown otherwise," said Rebecca McInnnis, a midwife.

Biskupski was given another month or two to tweak the measure to try to satisfy lingering concerns of lawmakers, such as requiring a "consultant" relationship between a doctor and the midwife and other issues of liability.


E-mail: amyjoi@desnews.com