LAS VEGAS (KLAS) — Midwives provide care for mothers-to-be, and they also help deliver babies. Most are not regulated in the State of Nevada, though, and legislation is being considered to change that.
“There is still not a credentialed pathway for them, basically to show the consumer, who might be wanting to do an in-home delivery, there is a difference between levels of midwives,” explained Republican State Senator Scott Hammond.
He is introducing Senate Bill 271 to license some midwives. There’s also a similar bill being considered in the assembly.
Opponents of licensing midwives say it would take away a mother’s right to choose. Some spoke out in a YouTube video by the group Nevada Friends of Midwives.
“You’re taking my right to choose who I have at my birth away from me,” said one woman.
“I feel safer at home choosing who can attend my births, who can care for me and my babies,” said another.
While some states issue and require licensing or certification at the state level, Nevada does not. Different national and international organizations provide certification.
There are different kinds of midwives:
- Traditional Midwives: May not be certified or licensed
- Certified Nurse Midwives: Registered nurses, also educated in graduate level midwifery programs. They have medical training, and some work with physician groups and have hospital privileges. The State Board of Nursing reports there are 64 certified nurse midwives in Nevada.
- Certified Professional Midwives: Have a certificate through an organization like the North American Registry of Midwives (NARM)
Ida Darragh, executive director of NARM, says the organization’s certificate is earned by passing a test and working under the supervision of an experienced midwife for prenatal visits, newborn exams and at least 55 births.
The I-Team asked Darragh what she would say to critics who say they’re essentially providing medical care without medical training. She responded:
“I would say they’re providing midwifery care with midwifery training.”
Dr. Staci McHale, an OBGYN in Las Vegas and the president-elect of the Clark County Medical Society, shared, “100 deliveries was the number of deliveries I did in my first month of my four years of residency. First month.”
She says she supports a collaboration between a midwife and physician from the start.
“The difference in the levels of training are very … noticeable, and those levels of training and the need to have expertise and the need to have someone provide backup in an emergency situation is crucial for the health of our mothers in Nevada,” said McHale. “I have seen many of the complications that can happen with deliveries, even those that we anticipate are going to be normal, and having home birth midwives makes me very anxious.”
We asked Darragh about those rare emergencies and if it’s worth taking a chance:
“Could something really surprising come up? It can come up, and that’s why you need to address what you will do if you have problems like that,” she said.
Right now, Nevada has no oversight of any midwives.
Through Senate Bill 271, Hammond is proposing the creation of a board of certified professional midwives, licensing for CPMs and permits for apprentices. With oversight, regulations and disciplinary action would be possible.
While Assembly Bill 387 is similar, it states, if an unlicensed person practices midwifery, they must obtain a statement from a client, acknowledging they know the person is not regulated by the state. If the midwife doesn’t get that statement, they could be charged with a misdemeanor crime. It also lists guidelines for when a CPM must arrange for consultation with a healthcare provider.
“What midwifery care is here in Nevada now is unregulated,” said McHale, “and that’s why it’s unsafe.”
“I hope it allows consumers to have freedom of choice, as well as to have midwives have a good path to getting licensed that is not too erroneous for them to meet,” said Darragh.
The legislation is currently being considered. No hearings have been scheduled yet.
The I-Team checked in with local hospitals to find out whether they have relationships with midwives.
Spokespeople for Southern Hills and Sunrise hospitals say they do not.
For Dignity-St. Rose Dominican hospitals, a spokesman says there is one midwife who works with a doctor at Siena.
A spokeswoman for MountainView Hospital says some certified nurse midwives have affiliations with the hospital.
A spokeswoman for the Valley Health System says they have certified nurse midwives with core privileges at their four hospitals that offer maternity services.