YARMOUTH — The state of Maine recently passed a law that will require licensure and training standards for midwives practicing outside of hospitals. For many midwives, including those of us who also practice as naturopathic doctors, we say it’s about time.

Licensure for midwives is a major step on our path toward full acceptance within the health care community, and toward ensuring that women in Maine receive the safest, most thorough care.

Certified Professional Midwife Liz Seals, left, checks on the position of Charity House's baby Friday afternoon in Fayette. Joe Phelan/Kennebec Journal

About the Author

Josie Skavdahl is a naturopathic doctor and certified professional midwife practicing in Yarmouth.

Maine’s midwives are highly skilled professionals. Most are certified professional midwives or certified midwives or have been practicing as midwives for an extended period of time. For years, they have served in a very important role, without any regulation. Because midwives in Maine have long been viewed by lawmakers as assets to their communities – and not as any threat to public safety – previous efforts to seek licensure never gained traction in Augusta. Basically, midwives were doing a good job, so the expense of overseeing them was not considered worthwhile.

This was a disappointing viewpoint. For years, midwives continued to push for state oversight, arguing that licensure was critical for legitimacy. Finally, after much hard work and collaboration with the American Congress of Obstetricians and Gynecologists, Maine Medical Association, Maine Family Planning and the Alliance for Maine Women, midwives have convinced the state that childbirth is important enough to be regulated.

Licensure not only gives midwives credit for what they do, it also extends the scope of their practice, giving them the ability to order laboratory tests and ultrasounds, bill insurance companies and use emergency medication. With this new legislation, more families will have access to out-of-hospital midwives, who will be able to provide more thorough, safer care. In addition to the improvement in scope of practice for midwives, the educational requirements for licensure will also ensure that midwives have met state and national standards in their training.

The midwifery model of care provides holistic support for women during pregnancy, childbirth, and postpartum. It is steeped in the importance of providing nurturing, hands-on care, and building a trusting relationship with the mother. In a healthy, low-risk pregnancy, out-of-hospital birth is a safe, natural, gentle, healing and rewarding option for women and their families.

As a naturopathic doctor and certified professional midwife, I’m happy to see this law pass. I graduated from Bastyr University in 2007, and have attended more than 300 births during and since my training. Standards of education and training for midwives are very important to me. With so many unaccredited courses in naturopathy and midwifery available online and in other parts of the country, I want Maine families to know they are getting care from a well trained, experienced professional who graduated from an accredited program.

I’m also concerned about safety in our profession. We do not want to limit access or options for families choosing out-of-hospital birth, but we do know that some deliveries are not as safe as others. This law will call for mandatory reporting and disciplinary action if midwives are not making safe decisions.

Naturopathic doctors faced a similar struggle to earn the right of licensure in Maine. The law allowing NDs to be licensed was passed by the Legislature in 1996. In the past 20 years, more naturopaths have moved to Maine, more patients have chosen to receive naturopathic care, and the profession has an exceptional safety record.

I would expect a similar, positive effect over the long run for out-of-hospital midwives, with the passage of the new law. The number of families choosing home birth is increasing nationally, and especially in Maine, where out-of-hospital births have nearly doubled in the last 10 years. More and more encouraging and empowering stories of out-of-hospital births are in the media, and many families feel they would be more comfortable having their baby outside of the hospital setting.

Regulation and licensure for midwives support what these practitioners are doing to naturally care for families throughout their pregnancy, delivery and postpartum period.

Congratulations, midwives, this has been a lot of hard work.

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