Midwives Progress Toward Licensure in Illinois

Published August 1, 2007

By this fall, expectant mothers in Illinois may no longer be forced to leave the state or hide from authorities in order to deliver their babies at home.

Talks between the Illinois State Medical Society (ISMS) and the Coalition for Illinois Midwifery could iron out their few remaining differences over the proposed Certified Professional Midwife Licensure Act, possibly before the General Assembly resumes this autumn.

Midwifery has been banned in Illinois for the past decade.

The discussions between the doctors and professional midwives are crucial as rural Illinois deals with the national shortage of ob-gyns. According to the American College of Obstetricians and Gynecologists, 22 states, including Illinois, are now in “red alert” crisis mode.

Vicki Johnson, a lobbyist for the coalition and one of several certified midwives forced to deliver Illinois babies in bordering states, believes the need for enabling legislation has never been greater. A 2005 Illinois judicial decision rendered uncertified midwifery illegal.

California, Florida, Minnesota, and Vermont already allow midwives to practice as licensed professionals. Other states have laws governing other forms of midwifery, such as uncertified midwives, lay midwives, and nurse midwives.

“Without midwifery licensing, families have no protection, no recourse, and no access to collaborative childbirth care,” said Johnson. “This is a public health nightmare for women who are educated about maternity care options and want the safest, healthiest, drug-free model of maternity care–the midwives’ model.”

Required Training

The main sticking point between the ISMS and the midwives coalition is the training required for licensure.

“The majority of a lay midwife’s training is an apprenticeship program that only requires a candidate to attend a certain number of home births with a preceptor–someone already ‘recognized’ as a lay midwife,” the ISMS told its members earlier this year.

The midwives coalition says it understands the need for professional licensure. It also opposes “lay” midwifery, in which instruction is based more on birthing experiences than medical training.

Insurance Concerns

Doctors say Illinois’ high malpractice insurance rates are a key reason so many ob-gyns have left the state.

While midwives fear they may face the same problem once they are licensed, they may fare better than doctors burdened with high malpractice insurance costs, say policy analysts such as Greg Blankenship, executive director of the Illinois Policy Institute.

“Trial lawyers are more likely to go after people with deep pockets,” Blankenship said, pointing out that licensed midwives delivering babies at home will not have the same financial resources as traditional ob-gyns.

Midwives also carefully evaluate expectant mothers, referring high-risk cases to traditional physicians, Blankenship noted.

“Because midwives do not take on high-risk clients, their exposure is less,” Blankenship explained, “and they may actually not experience as much financial risk as many may suppose.”

The Senate version of the bill, S.B. 385, passed on March 29 by a 51-7 vote. It was referred to the House Rules Committee on May 29. Summertime negotiations were expected to produce an agreed-upon version for the General Assembly to consider during the fall veto session.

Fran Eaton ([email protected]) writes from Illinois.