Summary of HB2184 & SB2294
HB2184 & SB2294: Relating to the Licensure of Midwives
These bills are companion bills meaning they are exactly the same language but have been introduced in both chambers - the House and Senate. They create a midwife licensure program within the Department of Commerce and Consumer Affairs to be administered by the director. The director currently administers 25 other programs; they are separate from the boards (ex: Board of Physical Therapy, Board of Dentist and Dental Hygienist, etc.).
These bills do not prohibit a woman’s right to choose where and with whom she wishes to birth. These bills are not about home birth; they are about licensing the profession of midwifery.
Licensure of the profession of midwifery can expand access to health care for women throughout the state as midwives will be licensed professionals who are able to more easily practice in a collaborative health care system. These bills affect the neighbor islands more than Honolulu County as the majority of certified professional midwives (CPMs) currently live and practice on neighbor islands and in more rural communities.
These bills set forth in statute the definition of a midwife, which is in accordance with the International Confederation of Midwives (ICM) definition (http://internationalmidwives.org/who-we-are/policy-and-practice/icm-international-definition-of-the-midwife/). The United States Midwifery Education, Regulation and Association (US MERA http://www.usmera.org), which is comprised of all United States national midwifery certifying bodies, education accreditation and professional organizations along with International Center for Traditional Childbearing) developed guidelines for US regulation of midwifery. US MERA’s recommendations are based on the ICM global standards for education and competencies for midwifery practice.
HB2184 & SB2294 allow for midwives who have met the minimum education and certifying requirements, as agreed upon by US MERA, to become licensed in Hawaii. These bills recognize that midwives are independent providers and that certified midwives (CMs) have the same scope of practice as certified nurse-midwives (CNMs), except that they are not nurses and can’t work as registered nurses. These bills recognize that certified professional midwives’ (CPMs) scope of practice is similar in many ways to CMs and CNMs except that they cannot prescribe medications to clients nor assist in surgeries. CPMs are trained to administer certain medications that are either routine or life saving during pregnancy and newborn care.
Traditional Hawaiian healers are exempt from this licensure bill as they are recognized by Kupuna Council. Licensed providers practicing within their scope are also exempt because they are regulated under their respective board or program.
These bills seek to regulate and license the profession of midwifery, which was previously regulated in Hawaii up until 1999. Moving certified nurse midwives from the Department of Health to the Board of Nursing in 1999 left a gap in Hawaii where the profession was no longer regulated; only CNMs have continued to be regulated. These bills seek to define the basic minimum competencies a professional must demonstrate in order to be licensed to practice midwifery in Hawaii. There are currently five different pathways a person could go through to become a midwife and be licensed in Hawaii if this bill passes. In 2020 there will be three pathways available for a person to become a midwife to be licensed to practice in Hawaii.
To view our frequently asked questions regarding the bill please click here.
To view our frequently asked questions regarding midwifery please click here.