A bill to license and regulate professional midwifery died on the calendar without a vote after Public Health Chair Hob Bryan, D-Amory, did not bring it up in committee before the deadline Tuesday night. 

Bryan said he didn’t take the legislation up this year because he’s not in favor of encouraging midwives to handle births independently from OB-GYNs – even though they already do, and keeping them unlicensed makes it easier for untrained midwives to practice. The proposed legislation would create stricter standards around who can call themselves a midwife – but Bryan doesn’t want to pass legislation recognizing the group at all.

“I don’t wish to encourage that activity,” he told Mississippi Today.

Midwifery is one of the oldest professions in the world. 

Proponents of the legislation say it would legitimize the profession, create a clear pathway toward midwifery in Mississippi, and increase the number of midwives in a state riddled with maternity health care deserts. 

Opponents of the proposal exist on either end of the spectrum. Some think it does too much and limits the freedom of those currently practicing as midwives in the state, while others say it doesn’t do enough to regulate the profession or protect the public.

The bill, authored by Rep. Dana McLean, R-Columbus, made it further than it has in years past, passing the full House mid-February. 

As it stands, Mississippi is one of 13 states that has no regulations around professional midwifery – a freedom that hasn’t benefited midwives or mothers, advocates say.

Tanya Smith-Johnson is a midwife on the board of Better Birth Mississippi, a group advocating for licensure. 

“Consumers should be able to birth wherever they want and with whom they want – but they should know who is a midwife and who isn’t,” Smith-Johnson said. “… It’s hard for a midwife to be sustainable here … What is the standard of how much midwifery can cost if anyone and everyone can say they’re a midwife?”

There are some midwives — though it isn’t clear there are many — who do not favor licensure.

One such midwife posted in a private Facebook group lamenting the legislation, which would make it illegal for her to continue to practice under the title “midwife” without undergoing the required training and certification decided by the board.

On the other end of the spectrum, among those who think the bill doesn’t go far enough in regulating midwives, is Getty Israel, founder of community health clinic Sisters in Birth – though she said she would rather have seen the bill amended than killed. Israel wanted the bill to be amended in several ways, including to mandate midwives pay for professional liability insurance, which it did not.

“As a public health expert, I support licensing and regulating all health care providers, including direct entry midwives, who are providing care for the most vulnerable population, pregnant women,” she said. “To that end, direct entry midwives should be required to carry professional liability insurance, as are certified nurse midwives, to protect ill-informed consumers.”

The longer Mississippi midwives go without licensure, the closer they get to being regulated by doctors who don’t have midwives’ best interests in mind. 

That’s part of why the group Better Birth felt an urgency in getting legislation passed this year. 

“I think there’s just been more iffy situations happening in the state, and it’s caused the midwives to realize that if we don’t do something now, it’s going to get done for us,” said Erin Raftery, president of the group.

Raftery says she was inspired to see the bill make headway this year after not making it out of committee several years in a row. 

“We are hopeful that next year this bill will pass and open doors that improve outcomes in our state,” she said. “Mississippi families deserve safe, competent community midwifery care.”

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