AL House Health Committee Advances Midwifery Bill Despite Questions About Newborn Screenings

The Alabama House Health Committee heard widely divergent views on SB87 during a public hearing on Wednesday, April 23 before giving the bill a favorable report.

SB87 would expand the scope of practice of midwifery in Alabama, as well as furthering the powers of the State Board of Midwifery. State Representative Ben Harrison (R-Elkmont) spoke for the bill before the Committee at the request of the bill’s sponsor, State Senator Arthur Orr (R-Decatur). Rep. Harrison is the sponsor of a complementary bill to SB87, HB257.

Rep. Harrison reminded the Committee that last year a similar bill had been introduced, but encountered problems related to free-standing birthing centers. That provision, as well as two of the three newborn screening tests included in the initial version of the bill have been removed.

Aaron Crawford, President of the Alabama Birth Coalition spoke on SB87, calling it a matter of freedom to choose midwifery, and that SB87 had been hijacked to become “a wolf in sheep’s clothing.” He pointed out that midwives currently serve 64 of Alabama’s 67 Counties; only 24 Counties have hospital obstetrics, leaving 43 Counties “abandoned.” He argued that blood spots, pulse oximetry and simple hearing checks are easily done even by “rookie nurses,” and are done by midwives in other states. SB87 currently bans midwives from providing these screenings babies need, forcing mothers to travel unnecessarily and denying care to Alabama babies.

Linda Lee, Executive Director of the Alabama Chapter of the American Academy of Pediatrics, rose to represent 900 Alabama Pediatricians. She read a letter opposing SB87 from Pediatrician Dr. Nola Jean Ernest of Enterprise, who could not attend the hearing. Dr. Nola contended that midwives do not have the equivalent training as Pediatricians or Neonatologists, and home deliveries lack the resources of hospital-based delivery facilities. She acknowledged that SB87 would allow midwives to collect the blood mandated for newborn testing, but that all further assessments should be done by Pediatricians, Family Physicians or Nurse Practitioners.

Rep. Ernie Yarbrough (R-Trinity) rose to oppose the bill as it currently stands, but stated he was in favor of the original bill. He said that his opposition was related to the amendments to the bill. He said that he believes the rights and freedoms of Alabama citizens are being taken away, and choices and options are being removed from mothers because of special interests “and the general attitude that mothers and their midwives can’t possibly make good decisions, and should trust the experts.” He reminded the Committee of the 6,000 year history of midwifery, and that the current bill violates Article 1, Sec. 35 of the Alabama State Constitution.

“The bill, in its original form, would do three things,” Yarbrough said. It would “ensure midwives could administer all newborn screenings, remove restrictions on trade and scope of practice, and maintain access to blood glucose screening.” He urged the Committee to take a good amendment that is pending for the bill under careful consideration.

Danne Howard, COO of the Alabama Hospital Association (AHA) rose to state that hospitals across the State have not abandoned labor and delivery. She could not speak to the issue of free-standing birthing centers because of the ongoing litigation surrounding this issue. But, the AHA supports the bill as it was passed by the Senate, she said.

Mariah Cranford, a Certified Professional Midwife with a Master’s in Midwifery, licenses in three States and 10 years of practice experience, who practices in a “maternity care desert” in Northeast Alabama and Chattanooga, TN, rose to speak on the bill. She is the former Clinical Director for the largest Certified Professional Midwifery program in the nation, and is an experienced midwifery instructor. She is also a home-birth mother who received care from licensed professional midwives, including newborn exams and screening. She discussed how midwives are trained in newborn care and screenings, all of which she’d taught midwife students to do in Tennessee, where she is allowed to do so. She pointed out that she cannot do this in Alabama under current Alabama law.

Rep. Harrison closed out the public hearing on SB87 by pointing out that there have been no infant nor maternal deaths over the last six years of the Alabama midwife program, with over 1902 births. There have been just over 200 transfers— 11%—to higher levels of care, with no deaths of mother or child. He said he could not understand why midwives aren’t allowed to do the screenings that would help protect these infants, and that he would ask for that.

SB87 passed the Committee on a voice vote and received a favorable report. It will now go to the full House.

The House Health Committee meeting can been seen on YouTube on The Alabama Channel HERE.