We are seeking safer standards for direct entry midwifery in utah. There are several problems with the current legislation model:
1. Midwives do not have to be licensed to practice legally
This means they are basically not accountable to the state, parents, or anyone for their outcomes or practices. They can kill or injure countless patients without any consequence. If you can sue them (which is unlikely because attorneys do not like to sue uninsured medical practitioners), you are unlikely to collect any of the debt.
2. Informed consent for out of hospital births is not complete
The informed consent standards for out of hospital births (again, something only licensed midwives have to adhere to) is severely lacking. There is no requirement that midwives accurately represent the risk of out of hospital birth to patients. It is impossible for patients to meaningfully consent without scientifically unbiased information. Midwives are not currently willing to provide that information, and are quite comfortable lying or misrepresenting the risks of out of hospital birth with a lay midwife. I have not found a single midwife that admits that home birth represents an increased risk to patients, despite an extensive search for this information. Unfortunately it seems that most people who would acknowledge an increase in risk would not attend home births in the first place.
3. There is a loophole in the current birth center legislation
Currently a birth center can avoid state accountability by only having one birthing room. Of course, the business can open a chain of these one room centers (effectively having a multi-room birth center) without any oversight for safety or infection control. The public health implications of such a loophole are obvious- it is an accident waiting to happen.
4. Negligent midwives from other states can set up shop here
Midwives from other states who owe judgments for negligence or malpractice, or who have killed patients in the past, can simply move to Utah and set up shop here without any interference from the state. There is no way for patients to check the background of these midwives unless their previous patients or the media posted information online. Midwives can simply lie about how many babies they have lost if they would prefer to not take responsibility for their outcomes. Unfortunately, a lot of mothers who lost their babies to negligence believe their midwives when they declare that nothing could have been done- regardless of the truth. These babies will never be known to the public or prospective patients.