IOWA FAMILIES DENIED ACCESS TO EVIDENCE-BASED CARE

(Bleeding Heartland welcomes guest diaries advocating for or against bills pending in the Iowa legislature. The link to the study mentioned in the second paragraph appears to be broken. Here is the abstract from a peer-reviewed medical journal. http://onlinelibrary.wiley.com... - promoted by desmoinesdem)

Friends of Iowa Midwives has worked with legislators to present companion bills in the House and Senate that would allow for safe and legal access to Certified Professional Midwives (CPMs) in Iowa.  For 15 years Friends of Iowa Midwives has worked toward licensure for CPMs. In 1999 the Iowa Legislature conducted a scope of practice review, the result of which was a recommendation to the legislature that the CPMs should be licensed through the Iowa Department of Public Health.  The bills propose that a license be created for the already trained and nationally certified midwives who seek to provide quality and safe care to Iowa women.

Every year in Iowa, more than 500 women choose to give birth outside of the hospital.  This number is on the rise both in Iowa and nationally.  A study published last month in the Journal of Midwifery and Women’s Health again demonstrated that for low-risk women out-of-hospital birth with skilled providers is a safe option.  This study found that almost 94% of the nearly 17,000 participants had a spontaneous vaginal birth.  The cesarean rate for this study was 5.2%.  The national average cesarean rate is 33%.  The in-labor transfer rate for this study was between 8-23%.  The most common reason for a transfer of care was prolonged labor or what is commonly called failure to progress. This study was one of among several that have demonstrated that out-of-hospital birth is a safe option for low-risk women. 

 

Midwives offer cost-effective and thorough prenatal, maternity, and postnatal care.  In addition, the care CPMs provide would be accessible to women in rural Iowa areas who are often under-served.  Certified Professional Midwives are credentialed nationally by the North American Registry of Midwives (NARM) and are trained and skilled in their trade.  This is a skilled labor force that Iowa families could choose to utilize if the licensure bill is passed.  At least one Iowa community college has a midwifery care program they would like to make available to students once licensure is passed and several others are considering offering this option to students.

There are tremendous benefits to integrated prenatal, maternal, and postnatal care, which includes midwifery care.  However, Iowa doesn’t currently offer midwives the opportunity to become licensed health care providers – so Iowa families are unable to choose this option for care.  The inability to access the evidence-based care of midwives is a violation of the human right to make informed decisions about care providers and location for birth. 

There is bipartisan support for this license in the State of Iowa.  28 other states have licensed Certified Professional Midwives. Not one has ever rescinded this legislation.  Licensed midwives in neighboring states have indicated they often serve Iowa women.  Since 2006, when Wisconsin first passed their licensing legislation, the number of licensed midwives has climbed from 12 to over 70.  

The bills have been assigned to sub-committees in both the Senate and the House.  The ability to move these bills forward is being hindered by the following legislators: Ralph Watts, Guy Vander Linden, Wally Horn, Jeff Danielson, Linda Miller, Linda Upmeyer, and Roby Smith.  These legislators are standing in the way of Iowa families being able to exercise their human right to access the care provider of their choice.  Iowa citizens and constituents of these legislators are urged to contact them and tell them to stop hindering the right to access to quality care. 

About the Author(s)

IowaBirth

  • thanks for the update

    This is a reproductive rights issue in my opinion. I see no reason why a woman should not be able to make an informed choice about her health care provider for labor and delivery.

    I would guess that House Majority Leader Linda Upmeyer, a nurse practitioner by training, will never be your ally on this bill.  

  • update

    The midwife licensing bill did not make it through the funnel and is dead for the 2014 session.

    Amanda Hardy Hillman, an Iowa State University faculty member and leading advocate of this bill as president of Iowa Birth Organization, published an open letter to State Senator Jeff Danielson after he told her Senate File 2152 would not be advancing from his subcommittee.

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