Midwifery: Bill to revise midwifery law passes out of committee with additions intact

A bill to broaden the scope of what Colorado's home-birth midwives can do passed another hurdle yesterday: The Senate Health & Human Services Committee approved it in an 8-1 vote. Testimony stretched for three hours and included impassioned pleas from both sides, including from Indra Lusero, the home-birth mom and midwifery advocate profiled in our recent cover story, "Special Delivery."

"This change requires imagination as much as caution," Lusero said of the revisions on the table, which include allowing midwives to administer certain medications and IVs and to suture women who experience tears during childbirth.

At the beginning of the hearing, bill sponsor, Senator Morgan Carroll, an Aurora Democrat, introduced an amendment that she called "consensus-ish." Those against the bill -- doctors and nurses, who consider home-birth midwives less qualified and less trained to deliver babies -- and those for it -- midwives and their supporters -- had reached "90 percent consensus" on some key sticking points, she explained.

For example, the amendment adds a provision that would require midwives to refer infants to a pediatrician within seven days of birth. It also says midwives must transport to the hospital women who experience post-birth hemorrhaging -- even after they administer drugs to stop the bleeding. It also includes compromises on drug-related language.

But there are still disagreements. The biggest yesterday was whether midwives should be able to suture. Eliza Buyers, a local OB/GYN representing the Colorado chapter of the American College of Obstetricians and Gynecologists, testified against it.

"We are opposed because of the complexity" of the procedure of stitching the tissue together, she said. She gave a few graphic examples of what happens if it's done incorrectly, including incontinence or worse, and said that midwives don't suture enough to be good at it. "Competence is almost always related to experience," she said.

Midwives, however, argued that they know what they're doing. "Midwives are not new to the perineum," said midwife Elizabeth Moore. Midwife Janelle Boyington called suturing "an essential skill" that midwives must learn to do but are then prohibited from doing.

And women are not always better off in the hospital, the midwives argued. A female doctor who had her third child at home with a midwife testified that she had a terrible repair in the hospital with her second child; when she tore again with her third, she wished her midwife could have done the suturing. Instead, she had to call someone else to do it in her home.

The doctor's testimony had an effect on Senator Irene Aguilar, a doctor herself. Aguilar, a Denver Democrat, said she was prepared to offer an amendment to remove suturing from the bill but then changed her mind.

However, Carroll did introduce an amendment that would require midwives to have a discussion with mothers-to-be about whether, in the event of a tear, they'd like the midwife to suture them at home or whether they'd like to go to the hospital. "This ensures that's an up-front discussion," Carroll explained.

Senator Joyce Foster, a Denver Democrat, was the sole "no" vote on the bill. "I'm not comfortable with suturing," she said. When it was Lusero's turn to testify, Foster addressed her personally. "I respect you," she said, "but by me supporting this, I'm saying to women that the state of Colorado says it's okay." Foster said she doesn't think it is.

The rest of the committee disagreed with her and voted "yes." The bill, which is called Senate Bill 88, now heads to the Senate Appropriations Committee.

More from our Politics archive: "Indra Lusero's quest to fight for Colorado midwives started with her own pregnancy."

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