There has been quite a battle going on in California this year. Midwives, midwife advocates, and childbirth advocates alike, have all been organizing, raising awareness, and talking to our leaders in the state capital about revisions for our state’s Licensed Midwifery Practice Act.
For those of you that may not know, prior to 1993 a woman could not choose to have a home birth if she wanted. It was only after California passed its Licensed Midwifery Practice Act in 1993 that this was made possible. This was a huge step in the right direction for midwives and birth rights advocates. However in spite of its recognition of midwives as medical professionals, it still greatly limited their autonomy as medical professionals.
Earlier this year, Assemblywoman Bonilla introduced AB 1308, which would remove the physician supervision requirement from existing law (The CA Licensed Midwifery Practice Act of 1993), as well as enable midwives to “directly obtain supplies, order testing, and receive reports that are necessary to his or her practice of midwifery.”
The rule of thumb since the MPA’s inception in 1993 has been that midwives must, and can only, operate within the purview of CA’s State Medical Board, subordinate to physicians. This has proven problematic in many ways. For one, some physicians view midwives with hostility and will outrightly deny them the cooperation they need in order to carry out their healthcare practices. This not only hinders their capability of being able to comply with state law, but can, and often does, hinder their ability to secure proper supplies and necessary tests.
The larger point at issue here, however, is the fact that midwives are licensed medical professionals. They are highly educated and skilled within the very specific scope of pregnancy, childbirth, and perinatal care. They know what they’re doing, and The California Legislature knows this. Even In 2000, the California Legislature stated in an amendment to the Midwifery Practice Act that:
“Numerous studies have associated professional midwifery care with safety, good outcomes, and cost-effectiveness in the United States and other countries. California studies suggest that low-risk women who choose a natural childbirth approach in an out-of-hospital setting will experience as low a perinatal mortality as low-risk women who choose a hospital birth under management of an obstetrician, including unfavorable results for transfer from the home to the hospital.”
Midwives need, and deserve, greater autonomy.