A Hollow Victory in Utah
By Danell Swim
February 28, 2008
By Emily Jones
We took a field trip to the Capitol in Salt Lake today. The state legislature is currently debating a bill that will affect midwives and women who choose home birth throughout Utah. We went to show our support, and help the legislators to see that real families would be affected. It was fun and exciting, with lots of drama, including a compromise and a last-minute substitution bill!! It would take too long for me to go into all the details of this saga, but the short version is this: the substitute bill has passed, and will now go to the House for a final vote.
I would rather there had not been a bill at all, as it would SEVERELY restrict a woman’s right to choose her birth place. The original form of the bill made hospital and OB care mandatory for most pregnant women, because of the many restrictions it placed on midwives. It also put unlicensed midwives under the same legal parameters as the licensed midwives, which would make no sense, as that is why they chose not to get licensed in the first place.
As grown, intelligent men and women, we should have the right to choose our medical care, and decide for ourselves which risks we are willing to take.
The effort by the Utah home birth community to oppose this bill has been nothing short of tremendous. Of course, the midwives have been working hours on end for two months trying to negotiate with the medical community for a compromise bill. But what has really been amazing is the response of the community. The concerned men and women of Utah have been emailing, calling, writing, and personally visiting their representatives by the hundreds.
At the committee meeting to discuss passing the bill to the House floor, there was standing room only. The room was full of mothers, pregnant women, fathers, babies, midwives, and a few others. When the meeting started, another substitute bill was being worked out, and the bill was not yet ready to be debated on. The committee chair heard a motion to table the bill until next year. Rep. Litvack opposed with this comment, “If we table the bill this year, we’ll have to deal with it again next year. And I don’t think my Blackberry can handle any more emails.” What a statement about the strength of the voters! The meeting was cut short because of the time constraint, but Rep. Menlove apologized that there was no time to hear public comments, and she commended the effort of the community to participate in the legislative process.
The substitute bill basically relaxed a lot of the restrictions for low-risk pregnancies, and made OB care mandatory only in the more high-risk cases. Home birth supporters still do not believe many of these cases to be high-risk, but because of the fight they have been facing, decided to concede on a few points. (This is the seventh substitute worked out in two weeks). The substitute also removed the legal ramifications for the unlicensed midwives. And most importantly, both sides, the medical and the midwives, made a verbal commitment not to pursue any further legislation until the DOPL study has been completed in 2011. This study will give the medical community the morbidity and mortality rates for the licensed midwives, and help everyone to see how safe it *really* is to birth at home in low-risk cases, and for many cases traditionally considered to be high-risk. It is prudent to wait for these statistics before claiming home birth to be inherently dangerous, since the medical community has yet to prove that women are statistically at higher risk for injury and death in a home birth.
The general consensus among the home birth community now is one of guarded optimism. This bill should never have come into existence, since there has already been in place for three years a governing body for the licensed midwives, and because there have been overwhelmingly positive outcomes for Utah home births in that time. However, the substitute is the best possible compromise that has been seen yet, and more importantly, was a compromise that was agreed upon by all parties involved. It would be a miracle if the bill itself was killed on the House floor, but that is unlikely to happen, since the legislators really don’t want to deal with this issue any more.
There are still unanswered questions. If a woman is considered high-risk by this new legislation, and she wants to have a home birth, will she consent to the mandatory hospital care which carries a certain amount of risk? Or will she choose an unlicensed attendant, or no attendant at all, which also carries a certain amount of risk? Will women lie about their conditions to their midwives in order to avoid the legally required transfer? Although the compromise bill is better than its predecessor, it still leaves a bad taste in the mouth. Placing restrictions on women’s choices in health care won’t make it safer - it will make it dangerous in a different way.
It is a hollow victory, and a temporary one as well. The first substitute to this bill was submitted by the Utah Medical Association without the midwives’ knowledge or consent, and was described to the legislators as a “compromise” between the two camps. Even though they have committed to not pursue legislation against the midwives any further until 2011, the home birth community may yet have some battles to face.
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4 Responses to “A Hollow Victory in Utah”
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Thanks for a great synopsis, Emily. I appreciate it.
And yes, power to the people.
QUOTE “There are still unanswered questions. If a woman is considered high-risk by this new legislation, and she wants to have a home birth, will she consent to the mandatory hospital care which carries a certain amount of risk? Or will she choose an unlicensed attendant, or no attendant at all, which also carries a certain amount of risk?”
I agree that this is a hollow victory, however, how is there more risk in having an unlicensed midwife? I have had unlicensed midwives with all 6 of my homebirths, my last two being very complicated, breech and severe shoulder dystocia. My unlicensed midwife handled these complications beautifully. Let’s not start an “I am better because I am licensed” argument, it is damaging to everyone.
Emily didn’t say that unlicensed midwives were risky, she said that unassisted birthing carries a certain amount of risk. Read carefully before you get out your guns.
Thanks Briana. Yes, I specifically avoided using language that implies one choice is more risky than another. I do not believe unlicensed midwives are inherently riskier. All choices in birthing carry some amount of risk, just in different areas, and it should be up to the parents to research each option and choose for themselves which set of risks they are willing to take. It should NOT be up to legislature to decide for them which set of risks are preferable to another. And congrats on 6 beautiful outcomes!