The Truth about HB 226

The Home Birth Safety Act

A publication of the Coalition for Illinois Midwifery

INTRODUCTION: Each year, 800 - 1000 Illinois women, including some from the Amish, Latin Mass
Catholic, Orthodox Jewish, and other communities, choose to have a home birth for deeply-felt reasons.
In most states, a licensed midwife could assist in these home births, but it is illegal in Illinois to assist in a
home birth unless a midwife is also a nurse and practices with a physician. Thus, only about 4 of Illinois'
102 counties have a licensed home birth provider, and even in those counties, the demand for homebirth
far surpasses the number of providers. As a result, an underground industry of unlicensed
midwives currently serves Illinois mothers creating an unsafe situation. HB 226 would
license certified professional midwives, as 26 other states already do, to regulate this
market and protect Illinois moms who choose home birth, and their babies.

Over the past few months the Illinois State Medical Society (ISMS), and other sub-specialty private
physician professional groups, distributed materials that we believe misrepresent the facts about HB
226 and about the midwives who would be licensed for home birth by HB 226.

These Physicians groups offer many false criticisms but absolutely no viable solution. What is their
answer to the home birth crisis that Illinois women must face every day? This document was produced
to set the record straight about our solution, HB 226, the Midwifery Licensure Act.

Claim "These midwives are significantly different from certified nurse midwives."

In terms of providing care beyond maternity care, yes. But when it comes
to providing maternity care throughout prenatal, intrapartum and
postpartum period, CPMs have nearly identical training to nurse-midwives
The Facts with special attention paid to out-of-hospital techniques. This training
along with the required additional background education has received
the approval of the ISAPN and INA.

ISMS supports the collaborative relationship that currently exists between

Claim physicians and certified nurse-midwives."
Illinois OB/GYNs support only the inclusion of the provision requiring
written collaboration, not the real-life practice of providing homebirth
collaborative care. As a group, they do NOT support homebirth or
homebirth providers, including homebirth nurse-midwives, in spite of the
statute requiring that nurse-midwives secure written and signed
The Facts agreement with a physician. Nationally, ACOG has officially turned its back
on the home birth population, stating, “Although ACOG acknowledges a
woman's right to make informed decisions regarding her delivery, ACOG
does not support programs or individuals that advocate for or who provide
out-of-hospital births.” (American College of Obstetricians and Gynecologists Executive
Board. (2006). "ACOG Statement of Policy on Out of Hospital Births in The United States".
October 2006. www.acog.org)
Coalition for Illinois MIdwifery Truth About HB 226, pg. 2

Claim "Midwives are asking to ‘prescribe dangerous drugs.’”

There is absolutely no prescriptive authority in this bill. Licensed

midwives will be allowed to carry and dispense only a tiny number of
The Facts medications, and only as strictly regulated in the statute. The medications
section in the bill was written in collaboration with the Illinois Society for
Advanced Practice Nursing.

Claim “These midwives will not be prepared to deal with emergencies.”

As loving parents, we strongly agree licensed midwives should be

prepared to deal with emergencies. That is why HB 226 would only
license nationally certified midwives whose training includes continuous
hands-on, one-on-one care throughout labor to anticipate potential
problems and help prevent them or deal with them as they emerge.
National rates of emergency transfer of care during labor or right after the
birth, for Certified Professional Midwives, were only 3%, and good
The Facts outcomes were achieved in the majority of instances. The fact is CPMs
are trained in the same way as nurse-midwives to identify complications
and call for transport. CPMs are educated to carry oxygen and drugs for
possible hemorrhage just like nurse-midwives, and are also trained
in CPR and Neonatal resuscitation including use of oxygen, just like
nurse-midwives (often attending these specialty classes taught by the
American Academy of Pediatrics and American Heart Association
instructors, together with nurse-midwives.)

"Passing HB 226 bill is comparable to ... lowering the standards for a

Claim licensed obstetrician.”

Licensed midwives would NOT be practicing obstetrics but professional

midwifery -- an entirely different profession for which licensed midwives
under the statute would be fully prepared. Licensed midwives would not
perform hundreds of complicated medical procedures (like surgical
treatment for fibroids, screening for breast cancer or prescribing literally
hundreds and hundreds of truly dangerous drugs) for which OB/GYNs
The Facts must be prepared. Physicians and nurse midwives almost uniformly DO
NOT attend homebirth. Far too often it is neighbors, church ladies and
friends who deliver babies at home in Illinois. Passing HB 226 bill is not
about lowering standards; it will increase current “standards” from the
the level of a neighbor, friend or church lady to a nationally certified, well-
trained midwife who could could legally practice in 26 other states.
Coalition for Illinois MIdwifery Truth About HB 226, pg. 3

"Substituting under-trained, unsupervised individuals for physicians and

Claim advance practice nurses increases the risk to mother and child."

This would only be true of doctors and advanced practice nurses were
The Facts actually attending home birth. They are not -- in Illinois, nor anywhere in
the country, with very few individual exceptions. In fact more than 80% of
Illinois has NEVER had licensed home birth providers. The truth is that
HB 226 will “substitute” nationally certified, highly skilled individuals
for uncertified women calling themselves midwives, friends,
grandmothers and church ladies (who are not MDs, APNs or CPMs).
This will immediately increase the safety for mother and child.

Claim “These midwives just see 40 births and then get ‘certified’.”

During her education, a student CPM observes hundreds of births. First

as a labor support person during dozens of births. Then, the student
CPM moves on to the role of assistant midwife. Finally, after a year or
two, having observed hundreds of pre- and post-natal exams and
births, and advancing in her education thoroughly enough to qualify,
does the student CPM begin to assume primary care (but still
The Facts supervised). It is this in this role as “primary midwife” during which the
75 prenatal exams, 40 births, 40 post partum maternal exams, and 40
newborn exam requirements are met, after which the student CPM
qualifies to sit the 8 hour national board exam. This is nearly identical
to the number of births and prenatal exams required for nurse-
midwives and family practice physicians.

Illinois home birth mothers and babies deserve licensed midwives

who practice with transparency, oversight and accountability.

Vote YES on HB 226.

Contact Colette Bernhard !773" 504-8442 or Vicki Johnson !815" 262-2235 for more information.