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Arizona lawmaker wants to ban midwife use in certain cases

Leita Schiemann, with her husband, Dylan, and holding her son, Otto, decided to give birth in her home, aided by a midwife. (Cronkite News Photo/DiAngelea Millar)

PHOENIX -- When it came time to give birth, Leita Schiemann decided to do it in the comfort of her home, aided by her midwife. She had a birth tub delivered to her house in Gilbert, set it up downstairs and, when the time came, gave birth to her son, Otto.

"It just felt more comfortable to me," she said.

With an estimated 1 percent of births in the U.S. assisted by midwives, an Arizona lawmaker wants to bar their use by women who have had cesarean sections or are facing breech or multiple births.

Sen. Kelli Ward, R-Lake Havasu City, said that high-risk births are too dangerous to be left to midwives.

"I'm a pro-life legislator," said Ward, who is a physician. "I see the mom and the baby as two separate entities."

Her bill, SB 1157, advanced Feb. 12 on a 4-3 vote by the Senate Health and Human Services Committee. All of the panel's Democrats voted against it.

Dr. Nathan Lepp, a Phoenix neonatologist, said he supported a woman's right to choose where she gives birth but saw a need for more regulation.

"Things can go wrong," he told the committee. "Things happen very fast."

In an interview, Schiemann said she has had all three of her children with assistance from a midwife, though none of the births involved conditions covered by Ward's bill. She said she didn't want to go to a hospital.

"I see hospitals as a place to treat illness, and I don't see pregnancy as an illness," she said.

Marinah Farrell, a midwife and president of Midwives Alliance of North America, said that the U.S. doesn't like home births. However, other countries such as Mexico and those in Europe are much more accepting, she said.

Midwives are there for the mother, visit more frequently than a typical doctor and are heavily involved after birth, continually checking in on the mother, Farrell said. Home births are cheaper than hospital births, running between $1,800 to $5,000.

"There are huge knowledge gaps," she said. "There are people out there who don't really know what we do."

Farrell said many midwives are more than capable of handling a breech birth and that women who have had cesarean sections should have the option of giving birth at home. Midwives typically carry oxygen and medications in case something goes wrong, she added.

"Many women have these bad birth experiences and want to do it differently the second time and they can't," Farrell said.

Ward said she doesn't see how the bill would take away a woman's right to choose a home birth.

"Low-risk births can still be done at home," she said.

However, Tory Anderson, who addressed the committee on behalf of the Rights for Home Birth consumer group, said that the bill would limit a mother's choice.

"This is really a matter of personal liberty," Anderson said. "Women and mothers are smart, informed and educated. We have a right to choose our patient care."

Democratic Sens. Ed Ableser, D-Tempe, Katie Hobbs, D-Phoenix and David Bradley D-Tucson voted against the bill.

"I do believe this is overstepping our role as legislators and what we do," Ableser said.

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