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:
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