State’s midwives seeking licensure


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Melanie Moore said she believes it’s her calling to help women give birth in their homes.

She’s familiar with the process — she’s had babies at home herself five times.

Moore is a certified professional midwife. But in 2007, the state of Iowa prosecuted her for practicing without a license.

Iowa is one of 11 states in which midwifery — providing maternity care by someone not licensed as a doctor or nurse — is prohibited, according to the national group Citizens for Midwifery.

But bills in the Iowa House and Senate, which could be reviewed in committee this week, may change this.

If legislators pass the proposed law, midwives would be allowed to legally practice beginning July 1, 2011.

Monica Brasile, a member of the Iowa Friends of Midwives group, said this would allow midwives with a national certification to provide care at patients’ homes. That’s something nurses and doctors rarely accommodate, said Lynne Himmelreich, a nurse-midwife at the UI Hospital and Clinics.

Nurse-midwifes provide close relationships and focus on natural birthing aspects but in a hospital setting, Himmelreich said.

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In 2008, 370 women gave birth at home in Iowa, compared with 329 in 2006, according to the Iowa Department of Public Health.

Brasile said midwives form close relationships with patients throughout their pregnancies, often offering longer appointments than traditional doctors. They focus on pregnancy and birth as natural processes in a woman’s body, she said.

To become nationally certified, midwives must follow a set curriculum, including tests and clinical hours, Brasile said, and the process usually takes three to five years.

But Himmelreich is concerned because the certification process doesn’t require midwives to receive formal academic education, an aspect women using a midwife may not know.

“I think that’s a bad precedent to set from a public health point of view,” she said.

During some home births, she said, midwives don’t have the right equipment to address immediate complications, such as providing neo-natal resuscitation.

Brasile said most midwives screen women before agreeing to home births, reducing the risk of complications. Legalizing certified national midwife practices may stop some midwives, fearing legal prosecution, from hesitating to take women to the hospital when something goes wrong, she pointed out.

Sen. Joe Bolkcom, D-Iowa City, said he supports the bill because it will help ensure all midwives have the skills required to practice.

“We’re just going to have to work through any opposition that might be raised,” he said.

Jennifer Hamner, who has given birth both at a hospital and with a certified professional midwife, said she prefers the latter.

Hamner said her midwife invited her 5-year-old son and husband to be involved throughout her pregnancy. Her son even measured her belly at each appointment and cut the cord after she gave birth, she said.

Hamner said she thinks her son’s involvement helped him form a relationship with his new sister, Rowan.

“He just adores her now,” she said.

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