Weekend Special: Guest Post on Proposed Midwife Legislation

Note: This is a guest blog post brought to you by South Dakota Birth Matters. While Dakota Rural Action does not have formal policy on midwives, we have historically supported this legislation and any legislation that would open up opportunities for more women to access more birth services, particularly in rural areas.

There are two midwife bills being introduced this year in the state legislature that would give South Dakota families access to Certified Professional Midwives (CPMs), the specialists in out-of-hospital birth.

HB 1162 would set up an advisory committee under the Board of Nursing to license and regulate the practice of licensed midwives. The bill requires licensed midwives to be Certified Professional Midwives who have graduated from an accredited program or were licensed in another state for the previous five years. This is similar to the education requirements of Wyoming, which had no CPMs living in the state when they passed their licensure bill in 2010. Wyoming now has thirteen licensed midwives, demonstrating that this is a workable solution.  Including these educational requirements in the bill has garnered the support of the South Dakota state organization representing Certified Nurse Midwives.

Certified Nurse Midwives (RNs who go on to get additional training in midwifery) have been licensed in South Dakota since 1979 and have been legally attending out-of-hospital births in our state since 2008. There are currently only three CNM’s in the state that are attending out-of-hospital births and four others living outside of the state. Most of these midwives do not have full time practices and often turn families away because their calendars are full. Moreover, most areas of the state are still without access to a midwife. Most nurse midwives get all their training in the hospital setting, and consequently, that is where most prefer to practice.  Across the country and in South Dakota only a small percentage of nurse midwives attend out-of-hospital births.

Certified Professional Midwives are the only US healthcare providers with required training in out-of-hospital birth and they are the ones attending the majority of home and birth center births in the country. Thirty states have already passed laws (28 licensure laws) that support CPM practice.  South Dakota is one of only a few states that actively prosecutes CPMs for assisting home birth families.

Despite our midwife shortage, South Dakota’s out-of-hospital births tripled from 2005 to 2013.  Our rates are still much lower than states like Alaska (6%) and Montana (4%), where CPMs attend the majority of out-of-hospital births. Both of those states enjoy much lower perinatal mortality rates (deaths from 20 weeks gestation to 28 days after birth) than South Dakota.

HB 1162 could help improve our mortality rates by providing South Dakota families greater access to midwives.  HB 1162 is modeled after the statute that regulates nurse midwives (36-9A) and so contains licensure fees. Because of those fees, the bill will require a 2/3 majority to pass.

SB 117 requires a simple majority and is meant as a bridge towards licensure as it allows CPM’s licensed in other states as well as student midwives training under a registered preceptor to practice in South Dakota. It also sets up a voluntary Midwifery Regulation Fund where families can make donations to help set up a future midwife regulatory board or advisory committee.  SB 117 will be repealed in 2020.  The bill sponsors are making it clear to legislators that if HB 1162 passes, the sponsors will withdraw SB 117.

If you agree that South Dakota families should have access to the services that Certified Professional Midwives are legally providing in 30 other states, please contact your legislators and let them know you support these bills.  If you would like to follow the progress of these bills, you are encouraged to sign up for email alerts from SD Birth Matters, the organization that has spearheaded the development of the bills and is leading lobbying efforts in Pierre.


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