Testimony in Support of H. 2080, An Act Relative to a Board of Registration in Midwifery

Type:  Testimony 


Chairwoman Fargo, Chairman Sanchez, and Members of the Committee I would like to thank you for the opportunity to submit testimony before the Committee. I am writing in support of H. 2080, An Act Relative to a Board of Registration in Midwifery. This bill has been given a favorable report by this Committee in the past session.
H. 2080 would set standards for the practice of midwifery with the goal of improving the quality of midwifery care to Massachusetts consumers. The bill would create a Board of Registration of Midwifery, which would regulate the practice of three categories of midwives - Certified Nurse Midwives (CNMs), Certified Midwives (CMs), and Certified Professional Midwives (CPMs). Currently, the Commonwealth only regulates the practice of CNMs, through the Board of Registration in Nursing. There is currently no state oversight of CMs and CPMs. In other words, midwives doing home births in Massachusetts are currently not regulated by the Commonwealth at all. A Midwifery Board that regulates all midwives would ensure that all women have access to qualified maternal health care providers.
There has been a considerable amount of concern voiced by physicians that allowing Midwives to practice independently would lower the standard of maternity care provided for women in the Commonwealth. Although this concern is laudable, it has little basis in fact. Although midwives attend less than 10 percent of births in the United States, they attend 70 percent of births in Europe. Most of the developed world, including Europe, has lower rates of maternal and infant mortality than the United States does. 
A Midwifery Board would be especially important as the proportion of women’s health care and maternity care provided by midwives in the state of Massachusetts continues to grow.  Midwives care for vulnerable, underserved populations, and have a record of excellent outcomes for mothers and babies with a dramatically lower C-section rate and fewer birth complications.
 In addition to their proven safety record, nurse midwives have an excellent record for providing low cost maternity care.  This fact is especially important because childbirth is the leading cause of hospitalization in the United States and is one of the most costly areas for Medicaid. Any efforts at reducing the cost of health care must address the high cost of maternal care, especially the high cost of cesarean sections. Studies from 2005 indicate that the cost for a cesarean section delivery is, on average, 50 percent more than the cost for a vaginal delivery. The rate of cesarean section delivery in Massachusetts is 33 percent and rising.
Given the tract record midwives in Massachusetts have of providing our citizens with safe, cost-effective maternity care, and given our critical shortage of obstetricians and gynecologists, we should be doing everything possible to encourage safe midwifery practice and to promote the midwifery model of care in Massachusetts. This bill would take a step in that positive direction.
Thank you for your consideration on this important matter. I respectfully request that the Committee adopt a favorable report for H. 2080 as expeditiously as possible.