Meeting Public Comments

Sarah Costello [University of Iowa]

Please vote yes to HF265 to license Certified Professional Midwives.My name is Sarah Costello and I am from Solon, Iowa. I am a third year Medical Student at University of Iowa apply to Family Medicine. I am also a mother to three children aged 8, 5 and 3 all born at home in Solon. I am asking you to support the passage of HF 265 because it will increase access to safe maternity care for families who chose to give birth out side of the hospital setting. This is important to me both as a home birth mother and as a future primary care provide who hopes to stay in Iowa. When I found out I was pregnant with my first child, I was overwhelmed with stories from colleagues and acquaintances who had had traumatic birth experiences in the hospital. I am privileged to have been raised by a midwife in both Australia and the UK, where midwives are the primary maternity care providers for most pregnant people, and I knew that giving birth could be both a safe and empowering experience when done at home with the support of a qualified midwife. However finding a home birth midwife was not easy in my area of Iowa! I learnt that there are two kinds of certified midwives, Certified Nurse Midwives (CNM) and Certified Professional Midwives (CPM), and only CNMs are licensed in Iowa. There were only two CNMs in my area who attended home births at the time of my first pregnancy. By the time I had my third baby, there were no licensed midwives in my area at all. The most recent report from the Center for Disease control and prevention indicates the number of home births in Iowa are continuing to increase. There is strong evidence that home births are safest when attended by a licensed midwife who is integrated into the larger healthcare system. We need more licensed providers to care for these Iowa families. As a medical student, I have been an active member of the medical community, joining specialty, state and national medical societies. I have spoken to physicians, midwives and families about directentry midwife licensing as well as becoming familiar with the evidence in the literature. I have heard concerns from the medical community, my community, that CPM education is not adequate to ensure safe maternity care. This concern is not based on evidence and merely stems from the fact that CPMs do not require nursing training. Globally, training in nursing is not a requirement for midwifery education. My mother currently teaches at a directentry midwifery program at Griffith University in Australia and their program is ranked 2nd in the world. The International Confederation of Midwives sets standard for midwifery education, and HF 265 will require that midwives practicing in Iowa meet those education standards. This bill also provides protections for physicians accepting consultations, collaboration and emergency transfers of licensed midwife clients. These protection could improve relationships between out of hospital midwives and hospital providers. As a future family physician I hope to collaborate with licensed midwives to work together to ensure the highest quality maternity care for Iowans. When a family comes to me asking about options for home birth, I want to be able to recommend a licensed midwife who I can trust is qualified, whose practice is regulated by a licensing board, and who I can be confident will provide the best quality care to my patient. Please help me make this happen by voting yes for HF 265. Thank you for your time!