Editorial: Bill improves safety by requiring disclosure by unlicensed midwives


Published Jul 17, 2013 at 05:00AM / Updated Nov 19, 2013 at 12:31AM

Oregon’s midwives are among the busiest in the nation, at least statistically. More than 15 percent of births in this state are attended by midwives, according to The New York Times, compared with just over 8 percent nationally.

And while midwife-attended births can be safe and less expensive than those attended by an obstetrician in a hospital, things can go wrong. It’s because they can that Oregon lawmakers approved House Bill 2997, a measure that will make it tougher for unlicensed direct-entry midwives to do business in the state.

Coming to an agreement on a bill tightening restrictions on midwives was no slam dunk, and the bill reflects that. It does not outlaw unlicensed midwives but imposes new burdens on them.

Most important, perhaps, they may not advertise their services and must give prospective clients an informed-consent document that no doubt will persuade at least some women to choose either a physician or a licensed midwife or midwife nurse practitioner.

Among other things, the form will make clear that the midwife is unlicensed and that some midwives are licensed — a reflection of their education. It will tell patients that should something go wrong, no state agency will take a complaint, investigate and perhaps fine the midwife. Rather, a patient’s only recourse will be to file a civil lawsuit. Too, it will tell patients that unlicensed midwives cannot administer prescription drugs for pain or anything else.

If the document doesn’t change women’s minds, this might. When the law goes into effect after the governor signs it, insurance companies and the Oregon Health Plan will not reimburse patients who opt for unlicensed direct-entry midwives.

We’d have been happier with the measure if it made practicing midwifery without a license illegal in Oregon. Knowing that you’re more than 10 times more likely to have an infant die if delivered by a nonlicensed midwife — information given to lawmakers who were working on HB 2997 — is enough to convince us it’s a practice that must be stopped.

Yet according to those who followed the course of the bill, its current form is the best that could have been hoped for during the recently completed legislative session. It contains compromises, to be sure, but without them it never would have been approved.