Oregon State Represenative Mitch Greenlick has introduced House Bill 2380 to the Health Care Committee. 2380 requires all direct-entry midwives in the state to become licensed providers. If passed, this bill would replace Oregon’s voluntary licensure program for direct-entry midwifery. Bill 2380 contains an emergency clause making it effective upon signature by the Governor meaning it is not subject to referendum.
Bill 2380 would limit the freedom pregnant women in Oregon currently enjoy in selecting a provider. The options include OB/GYNs, Certified-Nurse Midwives, Licensed-Direct Entry Midwives and Direct Entry Midwives. Depending on the choice of provider, women birth at home, in birth centers and in hospitals. Under 2380, Oregonians would lose the legal right to be attended by a direct-entry midwife. These midwives practice independently of constraints imposed by the Oregon Health Licensing Agency.
Need help sorting out Midwifery Credentials and Terms? Read this Guide.
Among direct-entry midwives in Oregon, some 60 are voluntarily licensed by OHLA. Licensed direct-entry midwives practice within the scope defined by administrative rules that the Board of Direct Entry Midwifery develops. New licensure rules were recently adopted. Licensure entitles LDMs to carry legend drugs and devices and to bill insurers for reimbursement. OHP, PEBB and some private insurers reimburse.
Direct-entry midwives forego licensure for many reasons. Foremost is preserving independence in practice. Because they are not constrained by licensure, they may serve women that LDMs cannot. Women select independent midwives for many reasons including the desire to give birth in an environment free of state regulation.
A consumer-led effort is surfacing in the form of Oregon Birth Rites. This website encourages Oregonians to contact Rep. Greenlick and their own representatives to discourage moving this bill any further.
Greenlick also introduces bill forbidding bike transport for kids under six
Representative Greenlick also introduced House Bill 2228. This bill seeks to prohibit the carrying of children six years or younger on the back of a bike or in a trailer. The bill is causing an outcry.
According to BikePortland.org blogger Jonathon Maus, Rep. Greenlick introduced the legislation before identifying a strong body of supporting evidence. Maus characterizes Greenlick’s approach as proposing legislation to stimulate public debate. In the comments field for Maus’ post, Representative Ben Cannon weighs in:
“I take Mitch at his word that he introduced the bill in order to “start a conversation” about bicycle safety. It might seem strange, but this is the way the process often works: a legislator gets an idea, drafts a bill, introduces it, gets feedback, and then decides whether to try to proceed, perhaps with amendments, or whether to let it die. Remember that a bill has to pass at least two committees, plus the House and the Senate, and be signed by the Governor, in order to become law. This proposal is a long way from that. “
If the premature introduction of a bill is the best way for Oregon’s legislators to generate information about an idea’s potential to increase the public good, MotherBaby Network proposes and supports addressing this gap in non-partisan legislative analysis in the coming session.
Better Legislative Leadership Needed
In the spirit of protecting the public, MotherBaby Network looks forward to the day when a state legislator will advance legislation with an emergency clause to recognize and address issues that affect the large majority of childbearing Oregonians. Issues ripe for leadership include the lack of transparency in hospital and provider rates for induction, far-too-high rates of cesarean section as well as the paucity of facility-level information regarding the practice of evidence-based infant feeding. (The Surgeon General recently issued a Call to Action to address barriers to breastfeeding.) There is an abundance of easily accessible and relevant research to support legislative leadership on these issues.
Much needs to be done to reduce non-medically indicated inductions, cesarean section and infant supplementation. These issues are just waiting for an elected leader with the courage and fortitude to work through the barriers separating women and families from excellent motherbaby outcomes before, during and after birth. Oregon’s elected leaders would serve the greater good by building on our current system of respect for individual freedom. We need legislation that increases transparency within the healthcare system that most women are actually using. This kind of governance would dramatically address an absence of necessary information and empower consumers of maternity care to make informed decisions.
Let’s take the plunge and go where the biggest, toughest problems reside — the hospital-based system. Let’s make that better. The overwhelming majority of Oregonians receive their care in hospitals. Encouraging more transparency within this model of care would have broad and deep positive impact on the lives of Oregonians.