Midwives laud approval of regulatory bill

A bill that would establish a statewide system to grant licenses to midwives just needs the governor’s signature to become law.

Senate Bill 1033 proposes to establish regulatory requirements for midwives in Hawaii in order to reverse a lapse in regulatory oversight since 1998, when nurse-midwives were placed under the purview of the state Board of Nursing.

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Among the regulatory measures proposed by the bill is a requirement for anybody using the title of “midwife” to obtain a license by July 2020, outside of a handful of exceptions, such as if the midwife is currently a midwifery student, or is rendering aid in an emergency.

Another exception to the licensing requirement is for anyone acting as a birth attendant without administering drugs and discloses their qualifications and lack of licensure. According to the current text of the bill, however, that exception would be removed in July 2023.

Obtaining a license would require documentation proving one to be a certified midwife or a certified professional midwife, the latter of which also would require proof of a successful completion of a formal midwifery education. Applicants would also need to submit any other midwifery licenses held in other jurisdictions and pay an application fee.

Licenses would need to be renewed every three years and could be revoked if the licensee is found to commit malpractice.

The bill stresses that the proposed law is not intended to interfere with traditional Hawaiian healing practices and “will continue to allow a woman to choose where and with whom she gives birth.” Nor will the act interfere with anyone practicing midwifery on an immediate family member.

The bill has been controversial among Hawaii midwives. A testimony hearing in March generated nearly 700 pages of written testimony, hundreds of which criticized the bill for fear that it would “make traditional/cultural midwives illegal after 2023,” as dozens of form letters read.

Those fears are unreasonable, said Big Island certified professional midwife Dani Dougherty, who added that the pathways to certification can be completed online or at local courses, meaning those seeking certification don’t need to leave the island.

Dougherty said certification courses can be completed before the 2023 deadline, meaning nobody needs to be prohibited from practicing traditional healing.

Meanwhile, Dougherty said, establishing a licensure program will only benefit midwifery in Hawaii.

“It recognizes the importance of midwifery and sets standards for competency, just like any other industry,” Dougherty said.

In addition, enshrining midwifery in state law will help further legitimize it as a potential career path for state residents, decrease the state’s current maternity provider shortage, and integrate midwifery with modern health care, Dougherty added.

“People who are in opposition think that the bill wants to get rid of home births entirely,” said midwife Nina Millar. “And that’s absolutely not true; we support home birth.”

Millar said the only fear she has regarding the bill is that it lacks assurance that the licensing fee is affordable for all. The current draft of the bill does not specify what the fee would cost.

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“This isn’t going to change traditional midwifery,” Dougherty said. “I strongly believe licensure will help preserve traditional midwifery in the modern day.”

Email Michael Brestovansky at mbrestovansky@hawaiitribune-herald.com.

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