Illinois lawmaker wants to legalize midwives statewide

(Pristyazhnyuk Sergey Anatolievich)

SPRINGFIELD, Ill. (AP) — Mishra Keller skirted a state law when she chose to deliver her second child at home with the help of a midwife, given that the trained birthing professionals have been barred from practicing since 1987 in Illinois.

Keller, a holistic health coach in Evanston, disagrees with the state's stance, saying that midwives are a "good resource." ''With the right training, they can help people have positive outcomes," Keller said.

State Rep. Robyn Gabel agrees, and is making her second attempt in a year to get the Home Birth Safety Act to the House floor - and hopefully into law. The act would issue licenses to midwives for the first time since 1963 and legalize the practice, which she says is needed give women more delivery options. But its passage is uncertain in the General Assembly, and the proposal is still staunchly opposed by doctors, who say there are possible risks to mothers and babies that could arise during at-home births.

A spokeswoman for Republican Gov. Bruce Rauner said he would review the plan if it reached his desk.

Almost 30 states, including neighboring Wisconsin, allow the practice of midwifery by nationally certified professionals, who receive fewer years of training than nurse-midwives and are not licensed for hospital births or primary care. There are about 1,000 home births per year in Illinois, up from about 800 in 2011, according to the Coalition for Illinois Midwives.

"The time is now," said Gabel, an Evanston Democrat, of the measure that will be heard in committee in April. She and coalition members say they are hopeful the proposal will gain support because of last year's move by the American College of Obstetricians and Gynecologists to endorse training and education standards of the International Confederation of Midwives. Coalition leaders also said licensure could save the state millions in Medicaid costs.

But Dr. Maura Quinlan, an assistant obstetrics and gynecology professor, practicing OB/GYN and the chairwoman of Illinois' ACOG chapter, said the organization might be more receptive to Gabel's bill if it included pathways for professional midwives and doctors to work collaboratively on issues such as assessing a mother's risk prior to delivery. Problems that can arise during at-home births include postpartum hemorrhaging and the need for resuscitation.

"We see attempted home births and the baby is dead or hasn't had oxygen or the mother is sick. We are a little jaded because we see the disaster cases that eventually come to the ER," Quinlan said.

A certified midwife who has practiced in Illinois and Wisconsin since 2010 delivered Keller's child, and spoke to The Associated Press on condition of anonymity because she wants to protect her ability to continue helping pregnant mothers in Illinois.

The woman, who said she became a midwife to help give more holistic care to expecting mothers, assists up to five low-risk clients a month and carries emergency tools such as anti-hemorrhage medication and an oxygen tank. However, she did have to call 911 once because a baby wasn't breathing.

"(Emergency responders) could very well ask me for proof of licensure or to sign a document with my name and information that if I provide it I would be putting myself at risk," she said. "The reality is we can't give them all of our information so we come up with creative ways to give them our clients' history," such as pretending to be a family member or birthing coach in order to stay with the mother in a hospital.

Opponents overlook possible Medicaid savings, as low-income women who would normally deliver at the hospital could instead hire a midwife, said Rachel Wickersham, the president of Coalition for Illinois Midwifery. A 2012 study commissioned by the coalition projected $5 million in Medicaid savings for Illinois.

Hospital births cost $10,000 or more. At-home births with a certified professional midwife would cost between $2,500 and $5,000, she said, noting that because it's mostly an out-of-pocket expense, most women who hire midwives are upper-middle class.

"When states allow certified professional midwives to be licensed, Medicaid providers save millions," she said.

Ultimately, midwives and doctors said their first priority is the mother and child.

"We all want the same thing," said Quinlan. "This is not a turf battle. It's a safety issue."