Senate debates midwifery

JEFFERSON CITY - A bill that would legalize midwifery was held over after debate on the Senate floor Thursday. This is the second attempt after a Cole County judge threw out part of a health insurance bill that passed through the legislature last year that would have legalized midwifery.

The provision that was thrown out by the court used wording such as tocology rather than midwifery that confused legislators and caused it to slip past undetected. This time, it is receiving much more scrutiny.

The majority floor leader, Sen. Charlie Shields, R-St. Joseph, and an employee for Heartland Health Hospital in St. Joseph, said that liability should be considered before passing the bill.

"That ambulance comes in the door, (and) it is swarmed by people that want to do the right thing. And they're not worried at that point about liability," Shields said. "They swarm that patient, they do the right thing, they're going to try to save that baby, they're going to try to save the mom, but something's happened and it's going to go bad because of something they didn't do, and in the end they're going to get sued."

Shields added that access to insurance could keep midwives from taking responsibility for their malpractice.

"If I can figure out how to make the rest of the medical community totally immune from having to pay for somebody else's mistake, that's what I want to do," he said.

The bill's sponsor, Sen. John Loudon, R- St. Louis County, said midwives would be held responsible. He said the absence of insurance does not equal absence of liability.

Loudon also said this bill would give families an alternative to hospital care.

"We're empowering families to make the choice," he said.

He added that midwives will have adequate training.

"The midwives have rigorous training, and requirements on keeping a sterile environment, and by the way, if they don't keep a sterile environment they can be sued and they can lose their license," Loudon said. "That is all part of the licensing and regulatory process."

Shields, however, argued that it could be difficult to track whether a midwife was involved when there is a medical problem.

"You could get into the position where something goes terribly wrong, and some could say 'OK, I won't tell that I had a midwife,'" he said.

"Again something bad happens. You have a child that is damaged for life. Somebody's got to figure out how to financially take care of that child the rest of their life. And who are they going to turn to? They're going to turn to the EMT. They're going to turn to the doctors, they're going to turn to the hospitals, and that's who's going to get sued," Shields said.

Sen. Yvonne Wilson, D-Kansas City, said she was concerned about how records would be kept.

"I think it's important that records be kept for at least three years," Wilson said. "I think this is protecting the mothers, protecting the midwife, so that if they have to go back for those records, they've got them."

This debate sparked an amendment that was presented to require midwives to retain confidential records for six years. This would comply with the Health Insurance Portability and Accountability laws that set the standard for medical records.