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Legislation that would loosen restrictions on certified nurse midwives appears to be in intensive care and in danger of dying in a legislative committee.
“They're tough odds,” said Autumn Cook, chairwoman of Nebraska Friends of Midwives, which is striving to move three bills through the State Legislature.
About 25 certified nurse midwives practice in Nebraska, most of them overseeing births or providing other services in hospitals such as the Nebraska Medical Center, Methodist Hospital, Creighton University Medical Center and St. Elizabeth Regional Medical Center in Lincoln.
The following bills are in the Health and Human Services Committee:
— LB 481, which would remove the state ban against certified nurse midwives delivering babies in homes.
— LB 457, which would remove the requirement that midwives have a signed collaboration agreement with a physician.
— LB 406, which would add certified nurse midwives to the list of providers who can't be denied the right to be considered for hospital privileges solely because of her credential or title.
In Iowa, certified nurse midwives may do home births and function without a formal partnership with a physician.
The Nebraska Medical Association opposes the three bills. “It's a pure safety concern,” said Dr. Todd Pankratz, an obstetrician-gynecologist in Hastings. He serves on the NMA board.
Pankratz said that if a birth at home in an isolated area suddenly becomes complicated and requires a cesarean delivery, a patient with a midwife might not have time to get to a hospital for a successful delivery.
Nebraska law allows women to have babies in their homes. So it doesn't make sense to forbid a certified nurse midwife from delivering babies in the home, said State Sen. Arnie Stuthman of Platte Center, a member of the committee in which the three bills are found.
Nevertheless, Stuthman said, his assessment of the seven-member committee suggests the midwife bills may not have the four votes to make it out of the committee and onto the Legislature's floor.
The Nebraska Department of Health and Human Services has opposed LB 457 and LB 481, citing the benefits of physician supervision and the risks of having a baby in the home. A spokeswoman said the state agency didn't take a position on LB 406.
Half to two-thirds of states require midwives to have some physician agreement or involvement, said Susan Jenkins, legal counsel for the national Big Push for Midwives, a midwife advocacy group.
But only two states, Alabama and Nebraska, don't let midwives oversee home deliveries. Nebraska is “neck-and-neck with Alabama for having the most backward midwifery laws on the books right now,” said Wisconsin's Katie Prown, campaign manager for the Big Push.
Heather Swanson, a Nebraskan and board member with the American College of Nurse-Midwives, said midwives generally care for pregnant mothers who are at low or moderate risk of complication. They consult with physicians when there is greater risk, Swanson said.
Contact the writer:
444-1123, rick.ruggles@owh.com
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