Midwife legislation dominates talk at Cracker Barrel meet

Midwife legislation dominates talk at Cracker Barrel meet by David Lias Whether or not to allow lay midwives to practice in South Dakota so that more women could give birth in their homes was the dominant topic at the District 17 legislative Cracker Barrel meeting Saturday morning at the Silver Dollar Restaurant in Vermillion.

And judging by the comments of District 17 representatives Judy Clark and H. Junior Engbrecht, and District 17 Sen. Joe Reedy, the three lawmakers' opinions on legislation that would allow lay midwives to practice in the state range from mixed support to firm opposition.

Debbie Pease, Centerville, who is involved with a grass roots organization called South Dakota Safe Childbirth Options admitted that she was about to change the tone of conservation at the meeting by beginning discussion on a piece of legislation about regulating midwives to practice in South Dakota.

"I know the first time that I heard about home births and midwives, I thought, 'why would anybody want to do that?' "

Since that time, she said, she has had three children in the hospital and two children at home.

"So I speak from experience," Pease said. "After having my first home birth, I just thought this is the way God meant birth to be. There's such a different model with the hospital. It's a medical event that must be managed and we were just forced with a lot of things that we didn't want at birth (when in the hospital)."

She was willing, she said, after her experiences in a hospital setting, to listen to someone who had given birth to a child at home.

"It took us over five months to find someone to help us with our home birth in South Dakota, because in South Dakota, there is no law pertaining to lay midwives and these are the midwives that usually help with home births," Pease said. "There's only a law on our books that pertains with certified nurse midwives, and the certified nurse midwife that I talked to would not do a home birth because she had been practicing with a physician."

Chances of the House bill that would allow lay midwives to practice in South Dakota to survive this legislative session seem remote at this time. The issue was deferred to the last day of the session. At that time, it may or may not be brought before lawmakers for further debate.

Although this would appear to most to be a defeat, the bill's supporters declared it a victory. No midwifery legislation has ever made it to consideration of either the full House or full Senate before, regardless of whether or not it was the last day.

Pease continued Saturday to defend the intentions of bill.

"Midwives have been working in South Dakota since before we became a state," she said. "It's only been since the 1970s, since certified nurse midwives have been regulated, that lay midwives have now been persecuted by the medical monopoly. They've been kind of going after them and trying to get them out of the state."

That makes it difficult for expectant parents who want to choose a home birth to find someone to help them, Pease said. She cited findings in studies that indicate that women who give birth at home have fewer complications.

"Fewer mothers and babies die with midwives and home births," Pease said. "The first time I heard that, it was really hard for me to believe, but the more I looked into it, the more I researched, the more it made sense to me, and after I experienced home birth, I can see why."

There are fewer interventions in the birthing process with a home birth, she said, and unlike a hospital setting where a doctor can stop by for short amounts of time while a woman is in labor, a midwife stays with the mother-to-be throughout labor and delivery.

Parents need experienced caregivers. They need people who are trained in home births. Engbrecht admitted that when he first heard about the bill, he didn't think he could support it. But he's changing his mind, he said, mainly after hearing input from legislators from the West River regions of the state. The fact that medical caregivers are so few and far between in some places west of the Missouri, he said, nearly makes the practice of midwifery a necessity.

Reedy noted that the day that this legislation was heard in committee, he talked to a couple of midwives who were in the Capitol building that day.

"I asked one of them how many certified midwives do we have in the state, and if I'm not mistaken she told me two," he said. "So I don't understand why we don't have more certified ones."

Clark said she believes midwives are trying to achieve something admirable, "but I personally would rather see us have better medical care in the rural community so you wouldn't have to depend on midwives," she said. "I just think that when you think that when you have someone there to handle the problem, you'd be less likely to take off for the hospital sooner when you need to."

Clark added she wouldn't vote to "smoke out" the bill for consideration on the last legislative day.

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