My name is Raegan. Nearly three years ago to the day, I found out I was pregnant with my first child. After researching exhaustively, I knew the traditional "American Way" of birthing was out of the question for my own experience. I was attracted to the idea of homebirth, but since this was our first child, and we didn't know what to expect (after all the nightmare "emergency c-section" stories we'd heard), we decided that a freestanding birth center was the way for us. Unfortunately, at the time, that meant a 2-hour drive from our home in Kansas City to the Columbia Community Birth Center in Columbia, Missouri. Despite experiencing transition on Interstate-70 somewhere around Boonville, we made it to the birth center just in time to push. Fifteen minutes later, 5 hours after my first contraction, my husband caught our son Khary. Later that day, the doctor told us we need to seriously consider homebirth for our next baby. "Already there!" was my response.
Fast forward to today. We are pregnant again, due five days after our edd with our son...meaning we're due April 1. Technically, it's not illegal to have a baby at home in Missouri. It's only a felony for the professional midwife attending the birth. I'm not personally comfortable having an unassisted birth, so into the underground world of the homebirth culture we delve. We are lucky--in Kansas, midwifery is a-legal, meaning it's specifically not illegal, but not regulated (imo, this is the ideal legal approach), and there is a good pool of experienced midwives already in our area. Of course, the one we've chosen lives over half an hour away, in Lawrence. (We just can't do anything the easy way!!)
A bit of background: Missouri is currently undergoing a legal challenge to a law that made Certified Professional Midwives legal in the state. As of 3 weeks ago, that law was thrown out, but there will in all likelihood be an appeal in the Missouri Supreme Court in the weeks to come. I actually attended the rally for midwives on August 2nd in Jefferson City, new to the knowledge that I was pregnant...so one of my first announcements was on a poster that read, "I'm Pregnant & I Want a Safe Homebirth." Just in case it was picked up by the media, I had to tell my parents earlier than I would have normally. (There will be pictures of that trip posted shortly.)
So this isn't the most exciting blog intro ever...but now you know a bit about me & now I feel a bit freer to spout random pregnancy drivel as i see fit! ~~oh, and i rarely capitalize anything, so don't be expecting that from here on out. ;)~~
Welcome to the blogosphere! I've been watching the legal situation in MO, and your blog came through on my Google alert--I look forward to reading more.
ReplyDeleteI just wanted to add a clarification about the legal status of midwives in KS and elsewhere where licensure is unavailable. There is no such thing as "alegal"--the word doesn't exist. In the absence of a statute defining the practice of DEM, exempting it from the medical/nursing practice acts and providing for administrative regulation/discipline, midwives are subject to criminal prosecution for practicing medicine/nursing without a license and for assorted other charges such as manslaughter, reckless endangerment and the possession or use of controlled substances (i.e. Pitocin).
KS has a state Supreme Court ruling declaring that the medical and nursing practice acts weren't intended to apply to midwives. However, the court declined to rule on whether or not this legislative intent applied to all midwives in the state or only to the midwife who had been criminally charged in the original case.
In the end, it declared that the case against the midwife in question had no legal standing because she was practicing under physician supervision; therefore she was exempt from being held criminally liable for practicing medicine/nursing without a license. So the ruling did nothing to protect other midwives in the state from facing the same charges, in addition to the others listed above.
Since this ruling, the Illinois state Supreme Court reached a different conclusion, declaring that all midwives in states without licensure are practicing medicine/nursing without a license, citing, in addition to the KS case, multiple appellate rulings in other states that reached the same conclusion. The US Supreme Court declined to take the appeal, meaning that it found no problems with the IL court's conclusions and decided to let the ruling stand. Which means that the IL ruling holds the force of law in that district and now stands as the strongest case-law precedent for determining the legal status of midwifery in states without licensure.
The climate for KS midwives has been much more favorable than in other states where they're not licensed. However, all it can take is the death or injury of one home birthed baby to trigger the same round of prosecutions that are happening in other states. The reason for this is that without administrative regulation under civil law (i.e. a midwifery board with legal jurisdiction) the only avenue for investigating a death or injury or for holdiing a midwife accountable for negligence are the criminal courts. No other agencies have jurisdiction over them.
In MO, it's clear that however the Supreme Court rules about the constitutionality of including midwifery in a healthcare insurance law, both groups will be back in the legislature next session to repeat the ongoing battle over licensing and regulating midwives there (since the healthcare bill provides neither). I think there's a strong chance the midwives will win this time around--with any luck, well before your due date!
Katie Prown
Legislative Chair
Wisconsin Guild of Midwives
thanks, katie, for the clarification! i hadn't realized a state regulatory board/agency would offer additional protection for a midwife (as opposed to yet another round of membership monies and red tape).
ReplyDeleteunfortunately, even if the bill passes in mo in 2008, it won't affect my homebirth, since i'm due at the beginning of april. the legislature ends their session mid-may and laws usually don't go into effect until july 1 at the earliest (though oct 1, the start of the government fiscal year, is more common).
man, i knew it was bleak in illinois, but had no idea it was that bleak!
thanks for posting...on my first day of blogging, no less! :)