Mothers plead for choice in birth

JEFFERSON CITY - Samanda Rossi wanted to give birth to her children the natural way--at home and without medication. She chose to have her two sons with the help of a midwife instead of a licensed doctor. If caught, that midwife could be convicted of a felony under current Missouri law.

Sen. John Loudon, R-St. Louis County, wants to change that. His bill to legalize midwifery in Missouri was heard by a Senate committee Wednesday. About 100 women and children showed their support of the bill at the Capitol before and during the meeting.

Jessica Kerr of Rockhill had her daughter at home with a midwife. After a press conference before the meeting, she said that laboring at home was a good experience.

"At home, when we were laboring, it was dark, it was relaxed," she said. "My husband and I laid on the bed through the hardest parts of labor all by ourselves in silence. You can't get that at the hospital."

Loudon said he sponsored the bill because of a man at his church who previously lived in Florida and Virginia, where midwifery is legal. The man and his wife had their four children with midwives while living in those states.

"They'd like to have another baby at home," he said. "If we pass this bill, it will be too late for them. But they're facing going back to Florida to have the baby in a comfortable place and under a free system that they've enjoyed in the past. To think that in Missouri, we would flat disallow this is outrageous."

The difference between Loudon's bill and midwifery bills proposed in previous years is the establishment of the board of direct-entry midwives. The board would issue and renew licenses for midwives. Last year, Loudon said a similar bill faced a filibuster in the Senate.

Mary Ueland spoke in support of the bill, saying that scientific research supports midwifery as a safe form of child birth.

Internationally, Ueland said, "the best maternal morbidity rates are those that use midwifes as their primary care providers."

But Dr. Debra McCaul, an obstetrician from Rolla, testified that international health care and health care in the United States are not comparable and that these types of studies have problems of reliability and validity.

"The problems with the studies: there's self-selection, there's self-reporting, there's confusion of the terms and there's some studies that don't even delineate who provided that care," she said. "So we always have to look at studies with an eye of skepticism."

She also said that with the right training a Certified Nurse Midwife can practice legally in Missouri. CNMs receive 7 years of higher education, comprising a bachelor's and master's degree. Certified Professional Midwives, which are illegal, are required only to receive 1 year of training, she said.

"Doesn't have to be two as it's been referred to, but let's compare that: one year versus seven," McCaul said. "Do we think that's reasonable?"

Sen. Gary Nodler, R-Joplin and Sen. Harry Kennedy, D-St. Louis, expressed concerns about the safety of children who are delivered by midwives. While questioning Nicky Simmons, a witness who testified in support of the bill, Nodler said that he was concerned that midwives do not have relationships with hospitals.

Simmons said that midwives are no different than paramedics when it comes to responding to an emergency situation and that midwives have relationships with physicians rather than hospitals.

Kerr had problems with her own home delivery and was taken to the hospital during her labor. Her midwife had discovered a cyst on her vagina, and wanted Kerr to consult a doctor.

"When a home birth is transferred to the hospital, it is very rarely an emergency," Kerr said. "It's generally a situation like mine where there's no rush, it just seems like the wisest course."