Massachusetts Medical Society: Testimony in Opposition to An Act Relative to Out-Of-Hospital Birth Access and Safety

Testimony in Opposition to An Act Relative to Out-Of-Hospital Birth Access and Safety

The MMS would like to be recorded in opposition to H.1948 and S.1332, identical legislation to require the establishment of a Board of Registration in Midwifery to license and regulate professional midwives.  

H.1948 and S.1332 proposes a Board of 8 persons within the Division of Professional Licensure, 5 of whom would be midwives newly licensed by the passage of these bills, one would be a nurse midwife and one would be a member of the public. Only one would be a licensed physician.  The MMS does not believe this proposed Board composition would provide the appropriate “checks and balances” necessary to oversee the licensure of a new category of health care provider.  Previous versions of this bill put the Midwifery Board under the Board of Registration in Medicine.  While the MMS opposed that bill, it did support the involvement of the Board of Registration in Medicine.  

Under the proposed law midwives would be allowed to order and interpret clinical tests and to obtain and administer certain medications. Midwives would be allowed to practice independently, without the supervision of, or in collaboration with, any other health care provider – in any practice setting.   It does not require midwives to carry malpractice insurance. MassHealth would be required to provide coverage for midwifery services, including prenatal care, childbirth and postpartum care, again, regardless of the site of service. The Massachusetts Medical Society opposes the state’s public endorsement through the licensure process the ability of a midwife to prescribe certain medications and order tests and images without proper education and training.   

Nationally recognized, accredited education which meets the clinical needs of all patients and meaningful professional certification must be prerequisites of any state license.  The state’s historical role protecting the health and safety of citizens must be rigorously defended. The Commonwealth must not undermine the quality of health care through licensing poorly trained individuals.

The MMS respects a woman's right to choose between a diversity of health care professionals and settings, but also recognizes the safest location for birth is a hospital or birthing center due to the unforeseen and life-threatening crises that could cause serious injury and harm to a woman and her newborn, such as severe maternal bleeding and fetal delivery problems.  A free choice is an informed choice. By providing state licensure to untrained or minimally trained midwives, the state is inserting its stamp of approval and influencing the choice of prospective mothers in an unsafe and deceptive way. We urge the Committee not to approve House 1948 and Senate 1332.

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