JEFFERSON CITY - Nearly two dozen babies and their mothers packed a House committee hearing Tuesday, as the committee considered whether to ease the restrictions on midwives.
Current Missouri law considers midwifery to be part of the medical profession, and prohibits practicing without a special nursing license called a Certified Nurse Midwife, or CNM. Practicing without a CNM is a felony, and so-called "direct-entry" midwives can be charged with practicing medicine without a license.
A direct-entry midwife is trained as a midwife without being a nurse first. Missouri is one of only nine states to expressly prohibit the practice of direct-entry midwives. As of 2003, 21 states allowed for and regulated direct-entry midwives.
But the practice of midwifery has long been practiced -- and preferred -- by such groups as Missouri's Mennonite community, which considers the practice a part of their religious beliefs. Other groups, like the Amish and some fundamentalist Christians, also support the practice, and in Missouri many have continued to rely on a close-knit, underground network of direct-entry midwives practicing against state law.
Megan Cloud, a mother from St. Peters who had given birth at home, bounced her new baby on her lap as she told the committee it was time to bring that network into the open.
"We should have the religious freedom to choose who will deliver our children," Cloud said.
More than twenty mothers brought their babies in tow, along with their husbands, to show the committee they preferred giving birth at home, with a midwife.
James Shirk of Latham, a Mennonite father of several babies born with the help of a midwife, said the method of birth should be a family decision.
"We're not looking to do this out of ignorance or disregard for our children's health," Shirk said. "It's about recognizing birth as part of a natural process."
But members of several Missouri doctors associations expressed their concern about the proposed bill, which does not include a structure for direct-entry midwives to be trained.
"Anybody could do it, as it stands now," said Thomas Holloway of the Missouri State Medical Association. "There are no regulations, no licensing standards."
Holloway told the committee it was necessary for doctors to be available in case of a complication during birth, and that while "birth is a natural process...so is the death that accompanies it" if things go wrong.
Midwifery is already being employed by certified nurse midwives across the state, including southwest Missouri.
Linda Punch, a CNM with the Freeman Health System in Joplin, said midwifery allows for a more "wholistic" process of care for expecting mothers.
"It's much more than the medical," Punch said, who As a CNM, Punch has been delivering babies and working with their mothers for about seven years.
But Punch said she was uncomfortable with the idea of anyone practicing as a midwife without the proper training.
"People do need some kind of formal education program," Punch said.