Oklahoma legislators pursue midwife regulations

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Oklahoma legislators pursue midwife regulations

Lecye Doolen plays with building blocks with her son Dutch Lippoldt at her home. Sarah Phipps | The Oklahoman

After at least two failed attempts to regulate Oklahoma’s non-nurse midwives in recent years, two state legislators told GateHouse Media they plan to author bills in the upcoming session to do just that.

At least three others said they would support the effort.

“We need to be more aware of who we’re choosing to deliver our babies,” said state Sen. Brenda Stanley, R-Midwest City.

Stanley and Sen. Mark Allen, R-Spiro, both plan to author legislation. They are backed by Rep. Lundy Kiger, R-Poteau, Rep. Jason Dunnington, D-Oklahoma City and Rep. Collin Walke, D-Oklahoma City.

“This issue needs to be looked at,” Dunnington said. ”And policy (should be) put in place to be more protective of women and newborn children.”

The lawmakers’ remarks come one week after an investigation by GateHouse Media and The Oklahoman found seven babies had died during or after attempted midwife-assisted out-of-hospital births last year alone. Four of those deaths were deemed preventable by experts.

Oklahoma does not license or regulate non-nurse midwives, so anyone can call themselves a midwife and practice as one. They are not required to report their outcomes to any state agency, nor is there an official oversight body to set standards or investigate incidents, the investigation also found.

It’s among some one dozen states without such regulations.

Non-nurse midwives also provide prescription medication to mothers and babies, even though they are not licensed medical professionals, GateHouse Media also uncovered. The Oklahoma attorney general filed felony charges against one such midwife, Debra Disch, in September.

Other states that regulate non-nurse midwives have established minimum education and qualification standards for licensure, created oversight bodies to set rules and procedures to discipline midwives for violations. Most also require midwives to report annual outcomes on deliveries, hospital transfers and deaths.

Oklahoma lawmakers are not yet sure what will be included in the legislation. Stanley said she plans to include language requiring midwives to report their outcomes, but nothing that would deny mothers the choice of a home birth overseen by a midwife.

“I don’t want to limit anybody’s choice,” Stanley said. “It’s about helping people make good choices.”

Legislators must request to draft a bill by Dec. 13. The legislative session begins Feb. 3.

A group of Oklahoma women also launched a Facebook page called “Regulating HOME BIRTH in Oklahoma” to educate the public and start a discussion about regulation.

The page has received more than 300 likes since its launch Tuesday.

The Oklahoma Midwives Alliance, the Midwives Society of Oklahoma and the National Association of Certified Professional Midwives Oklahoma State Chapter did not respond to email requests for comment. None of the organizations list phone numbers on their websites.

The organizations worked to block previous attempts to regulate out-of-hospital births.

‘This isn’t about politics to me’

Stanley, a former educator, said she decided to author legislation after learning that Lecye Doolen lost a baby during an attempted home birth. Doolen was a student at the elementary school Stanley taught at.

“What guided me through my whole career is I always made decisions based on what’s best for children,” Stanley said. “This isn’t about politics to me. This is about protecting babies and mothers.”

Doolen’s son, Shepherd, was delivered via emergency cesarean on Nov. 7, 2016, 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 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 continues to deliver babies in the state.

Doolen’s story was also detailed in GateHouse Media’s investigation.

“I’m eternally grateful that people are understanding that our goal is to protect mothers and babies in the state of Oklahoma,” Doolen said. “I don’t want another mother to have to go what I went through, if it is avoidable.”

As for Allen, he said his decision to spearhead legislation came after hearing about a constituent’s traumatic out-of-hospital birth experience. Oklahoma mother Suzie Bigler’s account of her botched home birth went viral after she posted her story on Facebook in August. Her baby survived.

“We’ve got to protect the mothers and the children from what happened over here,” Allen said. “We’ve got to take care of the babies and mothers.”

Bigler’s midwife, Debra Disch, began delivering babies in Oklahoma after running into trouble for practicing without a license in Arkansas, which regulates non-nurse midwives. Bigler said she did not know about Disch’s past troubles.

She now is calling on the state to regulate non-nurse midwives like Disch.

Beyond legislation

Oklahoma City midwives Dawn Karlin and Taryn Goodwin told GateHouse Media in October that they support regulation despite having opposed previous legislative attempts.

“Midwives should be able to practice to the full capacity of their scope and be part of an integrated system,” Goodwin said. “I am looking forward to support (sic) well-thought-out laws and fair regulations relating to midwifery care. I have no opposition to that.”

Goodwin refused, however, to answer questions about whether a legislation should include restrictions on deliveries such as those involving twins, breech babies or babies born vaginally after previous C-sections, all of which are against American College of Obstetricians and Gynecologists — or ACOG — guidelines for home deliveries.

John Stanley, an Oklahoma City obstetrician and vice chairman of the Oklahoma Section of ACOG, said he plans to assist the legislators. He is unrelated to the lawmaker with the same last name.

“I think legislation is really to help to get information and help prevent the problems that we’re having now,” Stanlely said.

But Stanley said legislation alone isn’t enough.

“You still have to find a way to serve these women,” Stanley said. “Knowing there’s a large number of women that want the low intervention birthing experience puts the impetus on us to work with hospitals to find a way to offer that experience.”