This bill is not just restricting 16 LDEMs in the state - it is placing restrictions on many women in the state who choose homebirth as a safe option for them. It is very clear the Utah Medical Association was NOT negotiating in good faith, and this bill is NOT a compromise bill. OPPOSE SB931S, and please ask the Utah Medical Association to come to the table in good faith.

1) This bill restricts unlicensed midwives as well a licensed midwives, contrary to the stated intent of its sponsor. The “practice of direct-entry midwifery” definition creates the scope of practice for ALL direct-entry midwives, licensed and unlicensed. Any restrictions placed in that section apply to ALL direct-entry midwives, licensed and unlicensed. Because the new restrictions of SB931S are inserted into the “practice of direct-entry midwifery” definition (lines 116-118), and because the definition of “normal” is referred to by the “practice of direct-entry midwifery” definition (lines 44-50), these restrictions apply to ALL direct-entry midwives. The bill goes further and applies administrative rule which currently governs only licensed direct-entry midwives to the unlicensed midwives (lines 119-120).

2) Many of the compromises reached in negotiations among the parties are not reflected in SB931S. For example:

SB93's definition of normal used terms like “low risk” which were nowhere defined, and are extremely ambiguous. The intention of the Utah Medical Association was to use the definition of normal to restrict what LDEMs could do. The parties agreed to define normal in the very concrete terms of “‘Normal’ means excluding mandatory transfer conditions as specified in section 58-77-204 or by administrative rule.” SB93S1 reverts back to the same ambiguous definition used in SB93. (Lines 44-50)

The additions on lines 128-131 regarding restrictions on the public member of the board were agreed to be deleted, but they nevertheless appear in SB93S1.

The Administrative Rules Advisory Committee was agreed to be composed of six members. SB93S1 makes it a seven-member committee (lines 157-166). It was never agreed that physicians could have a “designee” attend in their stead on this committee (a courtesy not extended to the LDEMs in SB931S, by the way) (line 158-159). Lines 160-161 require a CNM to be recommended by a non-existent association, and lines 164-166 include the same offensive language about the proposed public member of the committee as lines 128-131, which was agreed to be taken out.

The conditions listed on lines 211, 218-220 were agreed to be removed from the bill to be dealt with by the Administrative Rules Advisory Committee, yet they appear in SB931S. Lines 214-215, 222-223, 234-236, and 238-250 were agreed to be removed entirely, yet they appear in SB93S1.

Only three of the agreements we made actually show up in SB931S (lines 72-79 regarding use of oxytocin, the concept of a rules committee sort of represented in lines 151-175, and lines 186-187 regarding LDEM informed consent documents), plus four health conditions on which we agreed (lines 221, 231-232, 233, and 237).