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~ Upholding Standards for Midwives in Minnesota ~

 

 

What is the Minnesota law on Traditional Midwifery?

There are two types of midwifery that are regulated in Minnesota. That is not to say there are only two types of midwives, however. The two types receiving regulation are Certified Nurse-Midwives who are regulated by the Minnesota Nursing Board and the Licensed Traditional Midwives who are regulated by the Board of Medical Practitioners.

To become a Licensed Traditional Midwife, one must first become a Certified Professional Midwife, a process taking some years and cumulating with both a written and a skills demonstration test. Then the midwife goes through the licensing process which asks a few additional requirements, such as informing parents of common pregnancy screening tests, etc. 

In Minnesota, Traditional Midwifery licensing is voluntary. This means that a midwife can still be legal without licensing. Midwifery is not the practice of medicine. However, the state law books have had a midwifery licensing statute since the early 1900s putting Midwifery under this Board. It was revised and became active again in 1999 after the last previous license was given in 1936.

You can read the Minnesota Law at https://www.revisor.mn.gov/statutes/?id=147D&view=chapter

The value of voluntary licensure is that Minnesota midwives have an option to practice without being "under" the Board of Medical Practitioners. This way there is a reduction in restrictions to midwifery placed by the medical or physician model of care. There is protection from restraint of trade by another profession. Unlicensed midwives may also be Certified Professional Midwives or not. With any traditional midwife, expect an informed consent, disclosure of training and background, initial and ongoing health assessment (check-ups, and possibly referrals, for mother and baby's well being, in pregnancy and for the first 6 weeks); and a contingency plan (medical consultation plan) in case hospital birth becomes necessary.

Every midwife, whether licensed or not has a responsibility to continue care with families that move on to medical care. 

The value of licensure is an increase, but not universally, in third-party reimbursement for families with insurance. Some unlicensed midwives are able to bill. No type of midwife consistently gets full reimbursement. Another value is increased communication with physicians and medical personnel during combined care or transfer of care or during a home birth transport. With licensing the medical professionals have more sense of ease talking with all midwives. 

Minnesota has a good law. What is listed is brief. What is not listed in the statute allows the midwife community to determine standards of care and change with evidence-based care and needs of the community. There are few restrictions in the statute, but many guidelines in the Standards. In this way, the traditions of midwifery are protected in the state of Minnesota.

The Standards are not the law, they are not policy or rules. The Standards are guidelines and midwives sometimes do have families in their care that choose to have a birth that is somewhat outside of the guidelines. Midwives will typically consult with one another and/or with physicians in such cases, when time allows (birth is not imminent). The breadth of the midwife's experience and the family's support is wisely considered.  

Most of our state's midwives gather together regularly to discuss issues of practice. Coming together like this improves care for families and is an important, if not formalized, method of education and transfer of midwifery wisdom.