About the Bill

The Direct-Entry Midwife Act is a voluntary licensure act for direct-entry midwives in Utah.

Fact Sheets

These fact sheets are in WordPerfect format and are printable.

	Basic Facts about the Direct-Entry Midwife Act and changes in the 2005 bill
	Safety of Direct-Entry Midwives (graphs)
	Are direct-entry midwives qualified to use the formulary?
	Why is there a Formulary Committee?

Full Text of the Bill

Direct-Entry Midwife Act FAQ

Why are you doing this?

We started this effort because we discovered 2 years ago, with the arrest of a midwife in St. George, that much of what we do as midwives has become illegal. Utah law guarantees to parents the right to deliver their babies how, when, where, and with whom they choose regardless of regulation by the state (which is good!), but it does not define direct-entry (that is, non-nurse) midwifery anywhere, and does not protect the midwife and allow her to properly care for her clients. Update: The Utah Attorney General has stated recently that direct entry midwifery is ILLEGAL in Utah, and is watching our bill.

This bill will correct this situation by defining midwifery and expressly legalizing it for all midwives in Utah. In addition, the bill allows midwives who qualify and who choose to do so, the ability to license with the state so that they may legally obtain and administer a small list of prescription medications. These medications include pitocin to stop a postpartum hemorrhage and local anesthetic for numbing the perineum before sewing it up. Again, it is voluntary—once the bill passes a midwife does not have to do anything to make her practice legal unless she wishes to use medications.

Does licensed mean my insurance will cover it?

No, although being clearly "legal" may encourage some companies to cover the services of a direct-entry midwife, it is not specified in the law that insurance must cover them.

Will it mean midwives must/may have malpractice insurance?

No. There are NO practice acts in Utah that REQUIRE malpractice insurance. Facilities where licensees practice can and do require malpractice insurance for care-providers who work there. Also, malpractice is not available, especially for any midwife in a quasi-legal situation as currently exists in Utah.

How will it affect midwives who choose not to license?

Midwifery will be expressly legal in this state. Midwives who choose not to license and who do not carry medication will be free to practice midwifery in the manner they chose. Midwives who choose to carry medication and NOT license will continue to be in violation of the law. Penalties are addressed in the bill.

Who will regulate licensed midwives?

The Division of Occupational and Professional Licensing, under mandate from the Utah Legislature.

Why is the licensure voluntary and not mandatory?

Because there are many midwives (and clients) who are happy with the legal situation as it stands and do not want to be recognized by the law. This way, those midwives who choose to license can, and those who choose not to gain the right to practice legally in Utah. Parents have the right to choose to deliver "how, where, when and with whom they choose, regardless of licensure" and mandating licensure would take away one of their choices. Not having the licensure also takes away one of their choices, so this does allow those midwives who choose to license the ability to do that under the law.

Will it mean more money for midwives?

No. Midwives will set their fees independently, as they always have.

Will it mean midwives must graduate from the Midwives College of Utah or
another MEAC-accredited school?

No. To be licensed, a certified professional midwife (CPM) credential will be required. One way to achieve this is by attending a midwifery school, but there are many other options including direct apprenticeship. For more details, see the North American Registry of Midwives, which administrates the CPM credentialing. As a side note, all states that license or certify direct entry midwives use the CPM credential as their standard.

What training/experience/qualifications will a midwife have to have to qualify for licensure?

Again, a midwife will have to be a certified professional midwife, through NARM. This requires intensive academic preparation as well as clinical preparation. A national exam must be taken and passed, both written and clinical. If a midwife chooses to go through a MEAC-accredited school, the clinical component may be completed at the school.

What "prescription drugs" will certified midwives be allowed to carry?

	Antibiotics to prevent Group B strep (GBS)
	Erythromycin ointment to prevent newborn blindness
	Vitamin K injection to prevent hemorrhagic disease of the newborn
	RhoGAM to prevent isoimmunization in Rh- women
	Prescription vitamins (to allow vitamins to be covered under insurance)
	Pitocin and Methergine to stop a postpartum hemorrhage (explicitly for postpartum hemorrhage. Pitocin WOULD NOT be used for induction!)
	IV fluids to treat shock
	Oxygen to resuscitate a non-breathing newborn
	Local anesthetic for numbing the perineum when suturing tears
	Sterile water to alleviate back pain in labor

That's it. That's the list. It's all pretty innocuous stuff. Interestingly, we are actually currently required by law as "a person attending the birth" to administer the erythromycin ointment, yet it is a felony for us to do so. This is one of many legal quagmires our bill fixes.

Here is more information about this legislation, including explanations of some parts of the bill, how to find and contact your legislator, and helpful resources from Citizens for Midwifery, a national organization.