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Minnesota legislation to let midwives obtain, administer medication

Traditional midwives help provide medical care and attention to pregnant women.
Image by Gather Birth Photography (courtesy)
From left to right, Executive Director of Roots Community Birthing Center Rachel Voigt and owner Rebecca Poltson. The new law clarifies that midwives can obtain and administer drugs as part of their medical care for pregnant women.

Midwives received help on March 3 when the Minnesota Legislature passed and edited former laws to allow traditional midwives to obtain and administer drugs for pregnant women in hopes it may cut down on the Black maternal mortality rates.

Midwives are a form of health care provider for pregnant women during pregnancy, childbirth and postpartum care. 

Since ancient times midwives have existed in some form, according to the International Confederation of Midwives. However, during the 1900s, midwives were ostracized by the medical community. In 1915, Dr. Joseph DeLee called midwives incompetent and suggested the use of sedatives and forceps on pregnant women. 

It was not until 1925 when Mary Breckenridge founded the Frontier Nursing Service that midwives could become professionally licensed. 

Representation among midwives 

Midwives play an important role in underrepresented communities, especially in advocating for Black women’s health, according to the Urban Institute

Black women account for 13% of the population, yet they represent 26% of the pregnancy mortality rate, according to the Minnesota Department of Health. 

One cause for the disproportionate representation is how Black women are perceived by the healthcare industry, according to the Associated Press. Some healthcare providers falsely believe Black women have a higher pain tolerance and recommend less pain relief help. 

Ciana Cullens, the program director for Nubian Moms, said Black midwives help give a more individualized experience for Black women. 

“I do think women place a value on seeing a provider where maybe this person can understand where I’m coming from and understand my culture, then you can build trust,” Cullens said. 

The bill clarification: Why it’s important

The need to change past laws came when pharmaceutical companies noticed the law did not clarify if traditional midwives could obtain and administer medication, according to bill author Sen. Sandy Pappas (DFL-St. Paul).

Pappas, who worked with midwives when she had her three children at home, worked with judges and midwife lobby groups to push legislation forward when a provider said they would stop selling medication to midwives. 

The unanimous decision to pass the bill marks a step in the right direction, according to Pappas. 

“Midwives are considered essential partners in providing healthy care for women, and I’m not even feeling a stigma against people who choose to work with a traditional midwife at home,” Pappas said. “It was very different from when I, in the ’90s, was working.”

The new law ends the confusion by clarifying licensed traditional midwives can receive and administer medications, like those to prevent hemorrhages, according to Pappas

Hemorrhages are one of the leading causes of maternal deaths, according to  Rachel Voigt, a practicing midwife and the executive director at Roots Community Birthing Center. 

“Having access to those anti-hemorrhagic meds, Pitocin side attack, ensures safety for the people choosing to give birth in our centers or Homebrew settings, and for the providers choosing to be in those settings,” Voigt said. 

For Carrie Ann Terrell, division director of obstetrics, gynecology, midwifery and family planning at the University of Minnesota, the bill clarification comes at an important time for women’s health. With the recent IVF ruling in Alabama, women are afraid of unwanted pregnancies, according to Terrell. 

“What I see is women are afraid of becoming accidentally pregnant and women are afraid of having access to reproductive health care,” Terrell said. 

Voigt said with the law passed, midwives can get back to providing necessary medical care.

“I think it’ll help us do our job better because it was disruptive to the way we were doing our job for almost 20 years, and now it’s resolved,” Voigt said. “We can continue to just do our jobs.

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  • Sam
    Apr 1, 2024 at 3:54 pm

    Awesome story Maya! I liked your thorough analysis!