Several Oklahoma lawmakers have introduced legislation seeking to regulate or altogether ban certain midwives in the state.

Those bills, and the lawmakers sponsoring them, vary in their approach of regulating non-nurse midwives, whose businesses have grown in the past decade as out-of-hospital births have gained popularity.

Sen. Brenda Stanley, R-Midwest City, and Reps. Cynthia Roe, R-Lindsay, and Lundy Kiger, R-Poteau, each authored legislation to license and regulate non-nurse midwives, who currently practice without oversight in the state.

A separate bill introduced by Sen. Mark Allen, R-Spiro, would ban unlicensed midwives altogether.

The lawmakers’ efforts come on the heels of a USA TODAY Network investigation published in October that found seven babies died during or after attempted out-of-hospital deliveries overseen by Oklahoma midwives in 2018 alone. At least four of those deaths were deemed preventable by experts who reviewed the cases at the request of journalists.

While Oklahoma regulates certified nurse-midwives, who hold nursing degrees and primarily work alongside physicians in clinics and hospitals, non-nurse midwives deliver babies outside the hospital with no license or regulation. They are not required to report their outcomes to any state agency, and there is no official oversight body to set standards or investigate incidents.

It’s one of around a dozen states without such regulations.

Former state Sen. Ervin Yen, an Oklahoma City anesthesiologist, tried for two consecutive years to pass legislation restricting or banning midwives. None of his bills made it out of committee, and he lost his bid for re-election in 2018.

Yen hopes this year will be different.

“There needs to be some kind of legislation to keep these babies from dying,” Yen said.

Banning non-nurse midwives

Allen’s bill is the most restrictive of those filed this month.

If signed into law, SB 1233 would allow only certified nurse-midwives to practice in the state.

Many non-nurse midwives are certified by the North American Registry of Midwives, which requires no nursing experience, health-related background, bachelor’s or graduate degree. They are credentialed as “certified professional midwives.”

Under Allen’s bill, such midwives would be banned.

The senator said he became interested in the issue after learning about the traumatic home-birth experience of his constituent, Suzie Bigler.

Bigler’s midwife, Debra Disch, now faces criminal charges in Oklahoma for her handling of that birth. Specifically, the state Attorney General charged her with a felony for administering drugs and performing an episiotomy — both of which require a medical license, which she does not possess.

Regulating midwives

Kiger and Stanley’s legislation would recognize non-nurse midwives but would require them to obtain a license.

Kiger’s bill would require anyone “assisting or supervising the prenatal, labor and delivery, or postpartum care of a woman outside of a hospital or licensed medical facility” obtain a license from the Oklahoma Board of Nursing.

HB 3070 also requires that midwives be supervised by a physician and have an emergency plan for each client.

Stanley’s bill, called “Shepherd’s Law,” would create a nine-member Advisory Committee on Midwifery to advise Oklahoma Commissioner of Health Gary Cox on all matters pertaining to midwifery.

The advisory committee would be made up of licensed midwives, two physicians who are supportive of midwifery and two members of the public, at least one of whom gave birth to a child with the help of a licensed midwife.

Roe filed a shell bill called the “Lay Midwifery Practice Act” with details of the legislation to likely be added later.

Stanley declined to comment for this story, but previously told USA TODAY that she wanted to create more public awareness of the issue.

“We need to be more aware of who we’re choosing to deliver our babies,” Stanley said.

Stanley said she decided to author legislation after learning that Oklahoma City Realtor Lecye Doolen lost a baby during an attempted home birth in 2016.

After complications during delivery, Doolen’s son, Shepherd, was delivered via emergency Cesarean section and died the next day. Doolen had hired then-nurse midwife Dawn Karlin for the planned home delivery, and the midwife’s nursing license was later revoked in part due to her handling of it.

Oklahoma licenses and regulates certified nurse-midwives through the Board of Nursing. But because it does not regulate non-nurse midwives, Karlin was able to keep practicing. She removed the word “nurse” from her title, changed her business name and continued to deliver babies in the state.

“I don’t want to take anybody’s rights away,” Doolen said. “I want to make sure ultimately we’re coming up with a way to ensure these women are held accountable in some capacity. Hopefully something will get through to allow us to better protect our children.”

The legislative session begins on February 3. The bills will then have to make it out of their assigned committees, and be passed by both the House and the Senate to make it to the governor’s desk. The legislature adjourns May 29.

“I think something will pass,” said John Stanley, an OBGYN and vice chairman of the Oklahoma Section of the American College of Obstetricians and Gynecologists. “I’m optimistic.”