A Short History of the Idaho Midwifery Council and Legislation History
By: Barbara Rawlings
1980-2007
The state of Idaho offered no certification or licensure, however direct entry midwives were recognized in the Idaho code. Midwives were instructed to test prenatally for syphilis, administer erythromycin (eye ointment) to newborns, perform newborn metabolic screening, and file a birth certificate in a timely manner.
The Idaho Midwifery Council (IMC) was formed in 1980, originally in response to
the threat of legislation. A small group of young midwives gathered to get
acquainted, share information, learn from each other and share their sacred work. There were repeated discussions regarding regulation and licensing. Several times IMC was asked to present their position at Health & Welfare meetings. Opposition to regulation of any kind was
Unanimous among the midwives whenever the topic arose. Midwives in Idaho believed
(erroneously) that they had “a-legal” status because there was no law making it strictly
Illegal.
In 1988 the IMC purchased and adopted the Colorado voluntary certification program, aiming to have more organization and structure. Midwives found the program rigorous and cumbersome- with apprentice, intern and senior midwife levels. They established the Certification Review Board (CRB) to administer the program and testing where approximately 12 Certified Senior Midwives (CSM) were granted certificates over the next 10 years or so. Many felt the desire for some type of validation of knowledge, skills and formal accountability to offer clients and to have Certification in place if/when the regulatory issue arose again.
In 1999, the IMC voted to adopt the North American Registry of Midwives (NARM) and Certified Professional Midwives (CPMs) credential. Midwives who wished to be professionally recognized and have their skills verified sought certification through NARM and became CPMs.
At that time, the CRB, now called the Midwifery Review Board (MRB), became the accountability arm and reviewed complaints filed about Idaho Midwives. Midwives met annually for conferences and built relationships. There were many ups and down- but the organization continued.
2005-2006
the Idaho Perinatal Project (IPP) began gathering data on all hospital
transports from out of hospital births with a desire to “fix this midwife problem”. In
April of 2005 the IMC surveyed all the midwives in the state regarding licensing, 36 responded. Most midwives believed regulation was coming whether they liked it or not; and ALL believed the midwives should forge the way. About 20% were adamantly opposed to any regulation, almost everyone else could support voluntary licensing and approx. 20% were outspokenly in
favor of licensing even if it was mandatory. What had changed? Midwives from other places with different expectations had moved to Idaho; midwives with higher education and students were wanting a profession; and one midwife was jailed and charged with the practice of medicine without a license for administering pitocin.
The IMC began working, learning and organizing. They held many conference-
calls/meetings/letters/emails with NARM, IPP, ID ACNM and, as well as having
weekly IMC board meetings via the internet. In January of 2006, the IMC was invited to speak at
the IPP annual board meeting regarding regulation of midwives in Idaho. The IMC informed them about the CPM credential and surprised them with what was already in place. Beginning in April 2006, the IMC legislative committee began work on the first of several drafts of a bill, beginning with voluntary language.
2009
House Bill 185 An Act Relating to Midwifery was introduced to the Idaho House early in 2009. It was passed out of the House State Affairs Committee on February 26, 2009 unanimously and with no opposition, it went on to pass the Idaho House on March 3, 2009. The bill passed the Senate Health & Welfare Committee (7to1) on March 16th and the Idaho Senate (32 to 3) on March 25, 2009. It was presented to Governor Otter on March 26th and was signed into law on April 1st, 2009. This was a monumental and difficult journey for our organization. We lost and
gained support. This was not the first or the last fracture in our history but we
continue to persevere. Special thanks to: Barbara Rawlings, Michelle Bartlett, Paula Wiens, IMC board, Rep. Janice McGeachin, Senator Shawn Keough, Idahoans for Midwives, Ida Darraugh (NARM chair), Kris Ellis and Larry Benton (lobbyists), Idaho Perinatal Project, and the Idaho Medical Association.
2011
In March of 2011, legislation to allow licenced midwives a designation to become medicaid providers passed through the House Health & Welfare committee and the full House of Representatives- each time with a unanimous vote! It then passed in the Senate. Special thanks to Michelle Bartlett, Kris Ellis and Larry Benton.
2014
In March of 2014 a sunset review passed. Language was clarified including:
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Birth under thirty-seven (37) weeks. and after beyond forty-two (42) and 0/7ths completed weeks' of the estimated due date) gestational age
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Added Cytotec as a postpartum antihemorrhagic
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Added to Multiple gestation: except that midwives may provide antepartum care that is supplementary to the medical care of the physician overseeing the pregnancy, so long as it does not interfere with the physicians recommended schedule of care.
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Added Opiate use that places the infant at risk of neonatal abstinence syndrome.
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Added to non-cephalic presentation: unless imminent delivery is safer than transfer.
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Added: A midwife who deems it necessary to transfer or terminate care pursuant to this statute and any rules and regulations promulgated there under or for any other reason shall not be regarded as having abandoned care or wrongfully terminated services. Before non-emergent discontinuing of services, the midwife must notify the client in writing, provide the client with names of licensed physicians, and contact information for the nearest hospital emergency room, and offer to provide copies of medical records, regardless of whether copying costs have been paid by the client.
Special thanks to the following who assisted on IMC's legislative journey
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Barbara Rawlings, Michelle Bartlett, Paula Wiens and other members of the Idaho Midwifery Council
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Rep. Janice McGeachin, our House sponsor, and the many supportive members in the Idaho House
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Senator Shawn Keough, our Senate sponsor, and the many supportive members in the Idaho Senate
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Idahoans for Midwives
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NARM Chair Ida Darragh
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Lobbyists Kris Ellis and Larry Benton
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Idaho Perinatal Project, Idaho Medical Association and other professional associations and boards
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Special thanks to: Barbara Rawlings, Paula Weins, Nancy Draznin, Rachel Elling, Katy Rawlins, and the IMC board.