As the 2025 legislative session comes near to its end, midwifery advocates continue to sound the alarm after continued claims that legislation originally intended to expand the scope of midwife care was hijacked by Alabama's medical special interests.
Senate Bill 87 (SB87), sponsored by State Sen. Arthur Orr (R-Decatur), was initially supported by the state's midwives and midwife organizations, such as the Alabama Midwives Alliance (ALMA).
In addition to revising technical language, the bill initially allowed midwives to perform newborn screenings for specific diseases and to provide care in freestanding birthing centers.
However, the birthing center provision was removed at the request of several regulatory agencies, according to ALMA. Midwives are currently not permitted to assist in hospital births.
Despite removing the birth center language, ALMA and others continued to support the bill. Support waned only after State Sen. Larry Stutts (R-Tuscumbia) offered a substitute allowing midwives to conduct the blood spot testing, leaving the other two tests outside the scope of practice.
The bill also cleared the House Health Committee last week with Stutts' amendment, despite pushback from midwives and other advocates.
Currently, parents have to secure testing within 48 hours at a pediatrician, which birthing advocates such as ALMA claim is unrealistic and often leads to parents not doing the screenings early enough, especially in cases of home birth. SB87 sought to allow midwives to conduct three at-home tests that advocates believe are crucial to obtain as soon as possible.
"The original intent of SB87 — to ensure critical newborn screenings for babies born at home — no longer exists," ALMA said in a statement. "After being replaced by a hostile substitute bill from Senator Larry Stutts and advanced through both chambers' health committees without amendment or debate, SB87 now represents not a step forward in infant health, but a strategic move by powerful medical groups to restrict access to midwifery care in Alabama."
"That amendment, filed by Rep. Ben Harrison, was quietly removed from committee packets overnight—without explanation—and blocked from consideration by Representative Paul Lee, despite previous commitments," ALMA continued. "The amendment would have allowed midwives to administer all three newborn screenings (blood spot, critical congenital heart defects pulse oximetry, newborn hearing screening), while using the state's public health reporting forms to keep open communication between Alabama's licensed midwives, physicians and the Alabama Department of Public Health."
State Rep. Ben Harrison (R-Elkmont) confirmed to 1819 News that Lee did prevent the amendment from receiving a vote in committee.
Advocates argue that midwives performing these simple tests drastically aid in catching potentially life-threatening issues early, pointing out that nurse practitioners, not pediatricians, frequently administer the tests in the office.
Opponents, such as the Alabama Chapter of the American Academy of Pediatrics (ALAAP) and the Alabama Hospital Association, claim midwives lack the proper training and skills to conduct these tests outside of a clinical setting.
"At a time when we are striving to reduce infant mortality, we must not compromise the quality of care provided to newborns. Lay midwives attending homebirths do not have the equivalent training or clinical experience as pediatricians or neonatologists," said a letter from ALAAP legislative chair Nola Jean Ernest that was read in the House Health Committee.
ALMA legislative chair Nancy Megginson responded to the claims of midwives' credentials, taking umbrage with the description of midwives as "lay midwives" and other alleged misrepresentations of their credentials.
"No, we are not defacto pediatricians," Megginson said. "But when a pediatrician misstates a midwife's credentials—not once, not twice, but three times during a public hearing—how can they possibly claim to understand our scope, our skills, or our training? Physicians repeatedly speak against midwives without facts, boldly flaunting their ignorance —and yet their misinformation is accepted without challenge."
The bill is not scheduled on Tuesday's House calendar. However, advocates are still holding out hope that the undesired amendment will be removed on the House floor.
"The truth is simple: This bill is not about safety," ALMA concluded. "It's about power. And in that pursuit, Alabama's newborns—especially those born at home—have been sacrificed. SB87 can NOT PASS as engrossed."
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