CULLMAN, Ala. (WHNT) — A bill in the Alabama Senate is taking a look at what type of medical care licensed midwives can provide to newborns after they assist with birth.
Since it was introduced, the bill has undergone some changes that midwives in the state say raise concerns.
Laura Reeder, a licensed midwife who works for Farmhouse Midwifery in Cullman, said part of her job is offering women the freedom to choose how they want to give birth and making the process as safe as possible for the mother and baby. She said the language added to an Alabama Senate bill is going to make that job difficult.
“Women want that continuity of care all the way through their birth,” Reeder said. “They want the same provider that is doing their prenatal to be there when they deliver their baby and to help them through the postpartum as well.”
Reeder offers a service that is increasingly being sought out by expectant mothers in Alabama.
“Midwives are able to go to people’s homes in rural communities,” Reeder said. “We have a lot of counties where women are having to drive over an hour to get access to their pediatrician and that’s just really hard when you’ve just had a baby.”
In 2024, only 16 of Alabama’s 55 rural counties have hospitals that offer obstetrical services, according to the Alabama Department of Public Health.
Reeder, like other licensed midwives, has only been able to legally practice in Alabama for the past few years. Midwifery was legalized in the state in 2017. The Alabama State Board of Midwifery was established in 2018, and licenses were first handed out in 2019.
Senate Bill 87, written by Sen. Arthur Orr, was originally designed to update language from the 2017 legislation. It initially allowed midwives more freedom to provide newborn screenings and other care needed shortly after birth.
“You can’t determine when a baby’s going to come,” Reeder said. “Sometimes they come on weekends or holidays and, for that newborn, especially the heel prick, needs to be done within 24 to 48 hours, up to 72. Sometimes moms can’t get an appointment with their doctors.”
Changes were made to SB 87 during a meeting of the Alabama Senate Health Committee. Sen. Larry Stutts introduced a sub-bill that would only allow midwives to administer a heel lance, which is a blood sample taken shortly after birth used to screen babies for disorders. The bill limits other types of care.
“It prohibits us from any other care of the newborn unless an emergency,” said Reeder. “After a baby’s born, we’re doing newborn exams head to toe. We’re weighing the baby, measuring the baby and we send all of that information to the pediatrician after the birth. It’s a real problem if we’re prohibited from any newborn care at all.”
The modified bill would restrict midwives from providing care that is not specifically granted by this legislation, including newborn screenings. Midwives are instead required to refer newborns to a doctor, and then, parents need to bring the baby to a pediatrician within 48 hours to receive a newborn screening.
Reeder said the hours after birth are critical for assessing a baby.
“When we are caring for mom throughout pregnancy, we’re caring for that mom and that baby both throughout the pregnancy,” Reeder said. “So, we’re not trying to be pediatricians. We’re not trying diagnose or treat the babies. We’re just trying to be able to do the assessments so that we can give the parents information on when to seek help for their babies.”
Newborn screenings assess for conditions that are life-threatening or could impact a baby’s development, like congenital heart defects, early hearing loss and metabolic and genetic disorders.
Reeder said that newborn screenings are meant to make sure babies are healthy, and she has concerns about how placing limitations on the care midwives can provide will impact the safety of babies.
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