The midwives who attend such births are well-trained, highly skilled professionals who play valuable roles in their communities. Most are certified professional midwives, certified midwives, or have been practicing for many years. But until now, they have been doing their jobs without state oversight or a process for licensure.
Fortunately for the midwives and the women for whom they care, that’s changing.
This spring, the Legislature passed a bill that will require licensure, training standards and data collection for midwives practicing outside hospitals. Gov. Paul LePage vetoed the bill, but an April override by lawmakers saved it. The bill was supported by the majority of Maine’s midwives, along with other groups including the Maine Medical Association, Maine Family Planning and the Alliance for Maine Women.
While nobody wants their profession to be overregulated, a licensure system and some basic requirements for midwives are long overdue.
Under the new law, by January 2020 midwives must prove to the state that they have completed an accredited midwifery education and training program. Midwives who completed their training through an institution that lacks accreditation will need to finish a midwifery “bridge certificate” to show competency.
What impact will the new law have? Most importantly, it will help ensure patient safety. The law gives out-of-hospital midwives a broader scope of practice, giving them the ability to order laboratory tests and ultrasounds, bill insurance companies and use emergency medications when necessary.
Midwives will be required to submit detailed information on an annual basis about the out-of-hospital births they attend. This data will help midwives and the state licensing board to spot and address any safety concerns and to discipline midwives who don’t follow rules meant to ensure patient safety.
The law also provides peace of mind for the growing number of women who choose to give birth at home, at birth centers or other out-of-hospital settings. They will know that their midwives meet the highest standards of education and training.
And for the midwives themselves, the new law will provide the legitimacy they deserve. It acknowledges their professionalism and the thousands of hours of education and training they have dedicated to this essential work.
Professional recognition matters. No one understands this more than those of us who are midwives as well as naturopathic doctors. Naturopathic doctors have been licensed to practice in Maine since 1996, after clearing many of the same hurdles faced by the state’s midwives.
Now, many naturopathic doctors collaborate or even work in the same offices with doctors of medicine, doctors of osteopathic medicine and a range of other providers, such as licensed acupuncturists and massage therapists. This is the new model of integrative medicine, as consumers are seeking out and realizing the benefits of both conventional and complementary care. This integration would not have been possible in Maine without the 1996 law that licensed naturopathic doctors, and I believe this year’s law regarding midwives will have a similar impact.
I graduated from the National University of Natural Medicine in Portland, Oregon, in 2009. There, in addition to my naturopathic doctorate, I completed a two-year certificate in natural childbirth that included more than 200 hours of class work in midwifery, as well as a two-year apprenticeship with a naturopathic midwife.
Because the university of natural medicine has not chosen to become a Midwifery Education and Accreditation Council-accredited school, I will need to complete a midwifery bridge certificate before 2020, when that piece of the new Maine legislation goes into effect. I have no qualms with this requirement. Stipulations such as the bridge certificate help ensure the quality and rigor of the midwifery profession.
Maine is a great place for midwives to live and practice. It is a place where we can build lasting, trusting relationships, and provide care that will be remembered for a lifetime. With this new law, I believe our future is even brighter.
Dr. Carrie Werner is a naturopathic doctor and staff midwife at Northern Sun Family Health Care in Topsham. She also is a faculty member at Birthwise Midwifery School in Bridgton.