Supreme Court Case in Missouri

There was a law passed last year in Missouri to legalize the practice of certified professional midwives (CPMs) attending homebirths in the state. After the law was passed and before it went into effect, the Missouri State Medical Association (MSMA) organized a well-financed challenge to the new law and was granted a temporary restraining order. Now the case is going to be heard on March 5 to decide if they will overturn the restraining order or not. This is a huge case for midwives in Missouri and I would hope that each of you will keep them in your thoughts & prayers. To read more details about the case you can read the following media alert from Missouri:

MEDIA ALERT
Missouri Supreme Court to hear Midwives Law Appeal
Court grants motion by coalition of midwife advocates to file a `friend of the court' brief for Mar. 5 hearing

(Jefferson City, MO) – The Missouri Supreme Court will hear arguments to reconsider the permanent injunction on the state's new midwifery law at 9:30 a.m. on Wednesday, March 5 at the Cole County Courthouse, 301 E High Street. A coalition of state and national midwife supporters, midwives and home birth families, led by Friends of Missouri Midwives (FOMM) and mobilized for the appeals process, has learned that the Court has granted their motion to file an amicus curiae (friend of the court) brief, submitted by:
* Citizens for Midwifery (CfM)
* Midwives Alliance of North America (MANA)
* National Association of Certified Professional Midwives (NACPM)
* Our Bodies Ourselves
* The National Birth Policy Coalition (NBPC)

The amicus brief submitted by the coalition supports the lifting of the midwives law injunction and makes the case that increasing access to trained and qualified Certified Professional Midwives (CPMs) and out-of-hospital birth is beneficial to Missouri citizens. In seeking to provide such access, Missouri is following the wisdom of a growing number of states recognizing the benefit of authorizing CPMs, who provide safe and high quality care, to practice.

"If the Supreme Court lifts the injunction, this law will permit CPMs to provide high quality, cost-effective care that will benefit Missouri's citizens and fill some significant gaps in the state health care system," said Susan Jenkins, legal counsel to the midwives coalition and steering committee member of National Birth Policy Coalition. "Home birth among low-risk women attended by CPMs does not jeopardize the health of mothers or infants, is authorized in 22 states, and is supported by many highly regarded international and professional organizations."

Mary Ueland, Grassroots Coordinator for Friends of Missouri Midwives, says she hopes the Court will rule to decriminalize Certified Professional Midwives and remove the threat of prosecution to professional midwives who assist families who choose out-of-hospital birth. "Missouri shouldn't drag it's feet when it comes to allowing mothers to have safer and healthier
births options."

The new Missouri Midwifery law was supposed to take effect Aug. 28, 2007, but the Missouri State Medical Association (MSMA) organized a well-financed challenge to the new law and was granted a temporary restraining order on July 3. Then on Aug. 8, Circuit Court Judge Patricia Joyce, who serves on the Board of Directors for St. Mary's Health Center in Jefferson City, disallowed the Certified Professional Midwives provision contained within HB818 regarding portability and accessibility of health insurance.

Judge Joyce ruled the provision was unconstitutional and unrelated to health insurance, despite hearing from Assistant Attorney General John K. McManus and Midwifery Coalition attorney Jim Deutsch that decriminalizing midwifery does indeed relate to health insurance as they recalled that the Missouri Supreme Court has already ruled health insurance is interdependent on health services, and the two subjects are related.

During the Circuit Court appeal to Judge Joyce on Aug. 2, Deutsch cited nine other states where Medicaid covers home births attended by Certified Professional Midwives and many others where CPMs receive private insurance reimbursement. Both McManus and Deutsch argued that families obviously cannot get health insurance reimbursement for their midwives if their providers are considered felons by the state. They agreed that legalizing Certified Professional Midwives is a first step to home birth families being able to have their maternity care providers covered by insurance. They also cited the lower cost of midwifery care, which in turn could encourage insurance companies to lower their rates for healthy women.

"We're seeing a strong shift in support of professional midwives as families become more aware of the benefits of CPMs, as well as more alert to skyrocketing c-section rates," Laurel Smith, President of Friends of Missouri Midwives, said. "Beyond the additional risks for mothers and babies that c-sections create, what effect does a c-section rate of more than 30 percent have on our insurance premiums, and how reliant are doctors and hospitals on these increasing revenues?"

Missouri is part of The Big Push for Midwives Campaign, a nationally coordinated campaign to advocate for regulation and licensure of Certified Professional Midwives (CPMs) in all 50 states, the District of Columbia and Puerto Rico, and to push back against the attempts of the American Medical Association Scope of Practice Partnership to deny American families access to legal midwifery care.

The case defendants and midwifery supporters who are listed on the appeal to the Missouri Supreme Court include:

* Friends of Missouri Midwives (FoMM). A nonprofit organization representing the interests of Missouri families who choose to have safe, alternative, out-of-hospital childbirth options. FoMM was created to support, promote and protect the rights of Missouri families to make choices about how, where, and with whom their babies will be born and to promote access to the midwifery model of care. Contact: Laurel Smith 636-209-1033.

* Kelly & Dallion Rehm, and Eric & Jessica Kerr. Two families that were expecting babies to be born after Aug. 28, 2007, the day the new law was to take effect. They were planning home births with legal, well-trained CPM's. When the new law was struck down, they had to choose between breaking the law, birthing at home without a trained attendant or the expense and interventions of a hospital birth. Contact: Kelly & Dallion Rehm 417-777-8005, Eric & Jessica Kerr 314-962-1143 or 314-248-0952

* Columbia Community Birth Center, Kim James, CPM; Ivy White, CPM; and Dr. Elizabeth Allemann, MD. Columbia Community Birth Center is the only licensed birth center in the state of Missouri. The Center is a place where families give birth in a comfortable home-like setting. James and White received their CPM credentials in 1995. Ivy White says, "As a natural childbirth specialist and professional, to have the freedom and recognition to legally practice in my state is a dream that I share with my midwife colleagues in Missouri. It wrenches my heart that there are families who long for midwifery care, and I cannot give it to them." Contacts: CCBC 573-447-2700; Ivy White 573-356-1059; Kim James 573-424-9115; Elizabeth Allemann 573-268-6946.

* Missouri Midwives Association. An organization dedicated to promotion, protection, support and education for midwives in Missouri. "Generally, parties who want to join a suit want to be on the plaintiff's side. We are an unusual group with an unusual dedication to our cause. We have joined the State of Missouri as co-defendants so we can have a say in what evidence the court will consider, and ensure our victory," says Debbie Smithey, President of the Missouri Midwives Association. Contact: Mary Ueland 417-543-4258.

Media inquiries about the Missouri Supreme Court case should be directed to Mary Ueland at (417) 543-4258. Media inquiries about The Big Push for Midwives Campaign should be directed to Steff Hedenkamp at (816) 506-4630.

Friends of Missouri Midwives
Missouri Midwives Association
Show-Me Freedom in Healthcare
Free the Midwives
The Big Push for Midwives