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The Alabama Midwives Alliance has come out against substitutions to a state Senate bill they argue would severely restrict midwifery.
Senate Bill 87, sponsored by Sen. Arthur Orr, R-Decatur, seeks to expand the powers of the state board of midwifery.
The original version of the bill sought to allow the board to accept gifts and grants, as well as allow authorized licensed midwifes to provide midwifery care in freestanding birth centers. Additionally, the bill authorizes licensed midwifes to administer certain newborn screening tests.
During the regularly scheduled March 19 Senate Health Committee meeting, Sen. Linda Coleman-Madison, D-Birmingham, presented a substitute bill on behalf of Orr and ALMA which removed language regarding midwives working in birth centers.
Coleman-Madison’s version of the bill, however, would have authorized midwives to conduct at-home tests, including Critical Congenital Heart Disease screenings, hearing screenings and blood spot testing for newborns.
It would also require test results to be sent to a licensed physician or nurse practitioner “for interpretation and follow-up care.”
During the committee meeting, Coleman-Madison described her version of the bill as a “negotiated agreement” met between ALMA and the Medical Association of the State of Alabama.
“There are some things that both sides have conceded to,” Coleman-Madison said.
ALMA similarly wrote in a press release that the negotiated version of the bill presented by Coleman-Madison included concessions from ALMA representatives and MASA Director of Public Affairs Niko Corley.
“While removing the birth center language was not what we wanted, we knew conceding on anything except the screenings was a win for the babies, and we had to keep their health and safety at the highest priority, so we accepted Mr. Corley’s verbal offer in negotiations,” said ALMA Legislative Committee Chairperson Nancy Megginson. “This process has been full of deception, secrecy, and political maneuvering at the expense of Alabama mothers and babies.”
ALMA alleges the second sub-bill, introduced by Sen. Larry Stutts, R-Sheffield, during the March 19 meeting, and approved at a committee meeting the next day, incorporated amendments at the request of the MASA, which ALMA oppose.
State Sen. April Weaver, R-Brierfield, asked the committee on March 19 to delay voting on the bill in order to review the two versions.
“Mine’s the good one,” Stutts told Weaver.
Committee Chair, state Sen. Tim Melson, R-Florence, also said he had been told not all parties had agreed upon Coleman-Madison’s bill and carry over voting.
Stutts is a physician and the owner of Colbert OB-GYN in Sheffield.
ALMA alleges the committee meeting held March 20, in which Stutts’ sub-bill was approved, was held without a designated time or “reasonable notification for ALMA to attend.”
ALMA also said Stutts’ version of the bill was filed with the Alabama Legislative Services Agency before ALMA’s meetings with Coleman-Madison and MASA.
Stutts’ version of the bill only authorizes midwives to conduct newborn blood spot screening, conducted by drawing a small amount of blood from the child’s heel.
ALMA described the sub-bill as “a coordinated effort between Senator Larry Stutts and Niko Corley,” and accused Corley of being dishonest in his support for Coleman-Madison’s version of the bill when Stutts’ bill was already being filed.
Stutts said his version of the bill responded to concerns about midwives not being able to perform blood tests raised during a February public committee hearing regarding SB87, but “does not expand the scope of practice to other types of examination of the newborn.”
ALMA has argued that healthcare disparities in Alabama make it important for midwives to be able to perform infant tests that are not included in Stutts’ sub-bill.
“Alabama continues to suffer from one of the highest maternal and infant mortality rates in the nation,” ALMA wrote. “In Alabama, 43 counties lack a hospital providing obstetric care, and 23 counties do not have a single pediatrician. Licensed Midwives have served 61 of Alabama’s 67 counties.”
“Homeborn babies are being delayed and missed due to physician logistics, so MASA ‘gave us’ heel lances to look like they care, but then tied our hands tighter in other areas, thus increasing risks to the newborns,” Megginson said.
“A bill that could have improved access to care was deliberately sabotaged to prioritize physician-led preferences over real solutions,” Megginson said. “In Alabama we do a good job of that; promoting physicians. Alabama families deserve better. They deserve physician leadership that looks beyond the paper and into what’s actually happening in the community.”
