HB301 - Voting to Take Away our Options

Most of you may not be Missourians. But for those of you who are, a moment of your time is what I ask of you today. 


State Representative Mike Talboy has filed a bill in the house that will dramatically and adversely change state law regarding midwifery. You can read a summary of the bill to see for yourself what it says, but what it boils down to is the end of legal midwifery in the state of Missouri. He wants to require that all CPM's carry at least $500,000 of malpractice insurance, which would essentially end their practices; most midwives run small, home-based businesses and insurance that high would easily cost them $100,000 annually, which is more than most of them likely make in a year. Midwives would also be required to practice in conjunction with an obstetrician. My first question is, "What OB is going to agree to this?" and the answer is that very few would , which is precisely the point. The few that would agree to practice with a midwife would not be likely to agree to the method of care that midwives currently provide. This is just one more nail in the coffin -- if a midwife can't find an OB who will agree to practice with her, she will be forced to quit, or go underground. Here is what the local midwife who alerted me to this bill had to say about it: 

 "I would recommend contacting your state representative and simply tell them how you feel about the following: to have an obstetrician in charge of who a midwife can attend (HBAC* would almost assuredly be eliminated), OB's will not sign collaborative practice (thus eliminating all CPMs from practicing), malpractice insurance would cost a midwife at least $100K per year, meaning if a midwife could even GET insurance and GET a collaborative practice agreement, homebirth would cost about $10K, requiring you to see a physician along with your midwife, requiring your personal information (name, address, phone number and due date) publicly available in a permanent database. This bill will effectively completely eliminate all CPMs from practicing. For updated information on committee hearing dates and how best to assist preventing this bill from being passed, contact @Friends of Missouri Midwives."


 I wrote to Mr. Talboy and stated respectfully yet firmly what I believe is wrong with his bill and asked him to reconsider his position on the matter. This was two weeks ago and I've heard nothing back. Not surprising. It's fairly common that state representatives don't want to hear from anyone outside their constituency. I am not one of his constituents, but the fact is that if his bill passes, we will all be affected by it, so it is only fair that we should be allowed to voice our opinions to him. I also wrote to my local representative, and was pleased to find out that he already planned to vote against this bill. Here is part of my letter to him:

"If it becomes impossible for CPM's to continue practicing legally, midwives will likely be driven underground and women will continue to see them for prenatal care, essentially reducing the quality of care they receive instead of increasing it as I hope and pray that Mr. Talboy's intention with this bill is. This would not be good for anyone. And if there were a few midwives who somehow could afford the exorbitant malpractice insurance he wants to require them to have, their prices would increase to the point where families who in the past could pay a midwife without the aid of insurance or the government would no longer be able to do so. This would force many low-risk women to undergo their prenatal care in a hospital setting, which has been shown time and again to increase risk of infections, unnecessary interventions during labor, and even increase mortality and morbidity in both mother and infant. Again, this is not good for anyone.... It is a fact that many highly educated families are choosing midwifery care over that of an obstetrician. Not because they are ignorant or scared of hospitals. But because they have done the research and came to the inescapable conclusion that midwifery and homebirth is the safest option for them and their babies. We know that the healthcare system in this country is broken -- taking prenatal care out of the hands of midwives and putting it into the hands of OB's is not going to make that problem any better." 

So what can you do? Write to Mr. Talboy and to your local state representative telling them how you feel about this bill. Remember, it is so much easier to stop legislation before it is passed than to overturn it after the fact. Don't ignore this issue because you're not starting a family yet, or are done having children -- consider that this will affect not only your ability to choose, but your sisters, your neighbors, and your own children.

If you want to be a part of stopping this legislation from passing, go to the Missouri House of Representatives website where you can find contact information for your local state representatives. Don't forget to send a note to Mike Talboy, as well! He needs to know that Missourians do not want this legislation.  

*HBAC stands for "Home Birth After Cesarean." Most obstetricians automatically tell patients that they must have a cesarean section  in any subsequent pregnancies after an initial cesarean (which obviously would automatically make home birth out of the question), when research shows otherwise.

And speaking of voting, check out my new poll gadget and tell me what you think!