Midwifery & the Democratic Process

March 28th, 2012 by Will Humble Leave a reply »

Here’s a short story about using the democratic process to get things done.  Some of you might remember a protest last December in front of our 150 Building.  About 100 folks or so were carrying placards in front of our building asking us to make it easier to have a home-birth in AZ. 

Many of you probably didn’t know that ADHS licenses 60 Midwives who practice in Arizona.  Our licensing rules for Midwives were last revised in the mid 1990’s and are out of date; the application is too complicated.  That day last December, Colby Bower and I met with 2 community folks, Allyson Fernstrom and Sarah Macklin, and 2 midwives including Connie Canada, during the demonstration- and we had a productive discussion.  We set up a dialog so we could come up with a solution together.  Allyson and Sarah followed through with flying colors, built an effective coalition, worked with our team (Colby and Rohno Geppert) and the state legislature- and shepherded a bill through the process that will go a long way toward solving some of the issues they were concerned about. 

The Governor signed the bill yesterday- providing us with exempt rulemaking authority to overhaul our rules for licensing AZ Midwives and setting up an advisory committee and process to review the official “Scope of Practice” for AZ Midwives.  You can check out the final bill online. We’ll also have some information up on our Midwife website shortly that will highlight where we go from here.

It just goes to show you that the democratic process works…  that ordinary folks, like Allyson and Sarah, can get together, organize, and petition their government and elected officials to get things done.  The key is working within the process, staying involved, and applying the most important skill anybody can have- working well with others (the most important grade any of us get in our academic career).  Well done all.

P.S. There was a study published in the British Medical Journal recently suggesting that there’s little difference in complications among the babies of women with low-risk pregnancies who delivered in hospitals vs. those who gave birth at home with a midwife.  Of course- the article is more complicated than that- so visit the journal website.



  1. Matthew says:

    You are so full of (explicit language removed by editor) that it is sickening!!! You’re trying to make yourself and your department look good while you are actively trying to take away women’s choices in Northern Arizona by removing one of the few midwives we have here. You pretend like you are so democratic and transparent, yet your dealings with midwives who dare to go outside your (ill informed) box anything but. You don’t care about women, babies, or midwives you care about your own political career and maintaining the oppressive status quo.

    How about this for a rule change –



    • Will Humble says:

      Matthew, we have a long history of supporting women’s and children health at ADHS. Our maternal and child health priorities include: teen pregnancy prevention, injury prevention, oral health, children’s preventive health services, obesity prevention, behavioral health, preconception/prenatal health, and children with special health care needs. Our Women’s & Children’s Health has prenatal and home visiting programs for parents with young families as well as a Pregnancy & Breastfeeding Hotline that helps callers find prenatal care and address a variety of issues.

  2. wendi cleckner says:

    Thrilled that our democratic process is not completely broken! Allyson and sarah worked some long hard hours! Well done women! Can not wait to work on these rules to make out of hospital birth safer and more availible! Congrats!

    • Brenda Newhouse says:

      I am a relative newbie to the midwifery community. I came into contact with it through making friends with practicing midwives.

      As I learn more about the midwifery practice, I am continually touched by the passion and dedication they provide the families they serve.

  3. Sarah Macklin says:

    Hard work has paid off! There is a lot of scientific evidenced based research that we are excited to be able to use to back up the changes we would like to see happen. Midwives are amazing…AMAZING people and I am looking forward to them being able to give women and babies the BEST possible care they can give.

  4. Ella says:

    Thank you for your support! Midwifery care is amazing and all of this hard work will lead to many good things:)

  5. Tia Thompson says:

    What a blessing to be a part of this move and to see it have a beautiful ending. I thoroughly support the midwifery model of care because IT WORKS and has done so for hundreds of years. Moving forward, I hope that you will create a well balanced board in order to have the best outcome in the scope of practice changes: CPM’s, LM’s, CNM’s, and Consumers. A board of their peers.

  6. Ida Darragh, CPM, LM says:

    Congratulations on making this very significant progress in creating good regulations for midwives in Arizona. It is so important to update regulations at least every ten years, or sooner. The regulatory changes, if consistent with national standards, will allow midwives to better serve the families of Arizona.

  7. Margie Kline says:

    I am thrilled that midwifery and a woman’s right to have an educated, licensed provider of her choice at the birthplace of her choosing is being addressed. With all the evidence based care information that is currently in the news I would say this is timely indeed. As a third year midwifery student I look forward to the day when I can serve the women of Arizona in a state that seeks the best for mothers and babies.

  8. Sylvia says:

    Thank you for being willing to take an objective look at these rules. As someone who has had a birth center birth, a hospital birth and two home births, I was so grateful for the choice and each setting was right for what I needed at the time. I wish you success as you make changes to reflect best practices and protect all parties involved in home birth.

  9. Since the state, nor any midwifery organization, owns birth, it seems to me that the parents who DO own it, should be able to have anyone they choose attend their births. Birth is a normal function of biology and not a medical event in most cases. If there are going to be changes made, ownership has to be addressed. There is no reason for a woman with a previous cesarean to be denied a home birth attended by a midwife. There is no reason for midwives to be regulated as a medical subspecialty.

  10. Christy says:

    Its a step in the right direction, but I feel AZ still has a long way to go. I had my first baby in WA state at home with a midwife. In WA, hospitals are very cooperative with midwives & so is health insurance (including state provided insurance programs). Wish AZ would get on the ball already.

  11. Justin says:

    Geting such a large amount of work done in such a short amount of time is simply amazing! If only everyone really knew what it takes to accomplish what has been done here. Thanks to Will, Colby,and Rohno (and I am sure many others) for making yourselves accessible to those who supported the bill; what a great example of citizens and government working together in a productive way to achieve an outcome that wil benefit so many!

  12. Amy Whipple says:

    Way to go ladies and all those involved!! Applauding these efforts to make things more honoring of women’s sacred birth rights that are GOD GIVEN and inalienable.

  13. Skip says:

    It is a shame when those supposedly fighting for the rights of midwives see any legislative action as position thing.

    As a father of 8 – including 3 home births, I am outraged that anyone believes they have the right to tell me who I can and cannot have in attendance at the birth of my children.

    Allowing the government to license also allows them to make rules and restrictions and control who can or cannot become a midwife. If they so choose it can be list of no one.

    Any law restricting or regulating the practice of midwifery is a bad law.

  14. Miranda Mackey says:

    Thank you for your recognition of the value of midwifery to Arizona families. I am a certified nurse-midwife with home, birth center and hospital birth experiences. I would like to participate in your committee work to update the regulations. I can be contacted via my email address.

    Thank you so much.

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