Moving Forward – Mother/Baby Friendly Legislation

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**Licensed Certified Professional Midwife Practice Act **

(102nd General Assembly – HB3401) passed October 28, 2021.
As rules are not developed at this point we cannot say how IDFPR will choose to word rules. We can tell you what is in the bill and what it means to our understanding. This is an evolving document, so answers may change as we come to a better understanding of the text and how it may interact with other statutes.

Frequently Asked Questions

Where can I read the text of the legislation?

You can find the text and other information about the bill here in the link. The text version should say “enrolled” at the top, for the version that will go on to become statute.https://ilga.gov/legislation/fulltext.asp?DocName=&SessionId=110&GA=102&DocTypeId=HB&DocNum=3401&GAID=16&LegID=132360&SpecSess=&Session=

When can CPMs begin to practice/get a license?

The specific date will depend on when Rules are adopted. We are estimating some time in 2024, give or take a year. The state does not consider any midwife to be practicing “legally” unless they have a license or qualify for one of the exemptions.

Who makes the Rules?

The Department or Agency which administers an act (in this case, Illinois Department of Financial and Professional Regulation) will present proposed Rules to the JCAR, and rules will go through a public comment stage, and revisions, before JCAR approves and adopts the final rules. This process, according to JCAR can take 90 days to a year, but practice acts and major legislation often takes more than a year. ICCPM will be actively participating in the Rulemaking process.
The JCAR website provides information on who members are, how you can be involved in the rules process through public comment, and links for the Flinn report (summary of JCAR action), the Illinois Register (complete text of rules that are proposed or adopted), and Agendas and Minutes for upcoming meetings. There is no way to subscribe or automatically receive updates from these items, so you’ll need to keep checking back for updates.
https://www.ilga.gov/commission/jcar/

There are parts of this legislation I don’t like. Can we change it?

The bill as written will become statute when the governor signs it. There is not a way to make changes or amendments to it at this time. To make changes in the future would require filing another bill, or, waiting until the sunset review (for this bill, the next will be in 2027) when legislators have the opportunity to review, revise, and renew practice acts. The rules process cannot be used to go against or remove what is written in statute.

What are the education requirements for midwives?

All midwives who apply for licensure beginning one year after rules are adopted will be required to have MEAC education completed, in addition to receiving their CPM. For the one-year period after rules are complete, CPMs who do NOT have MEAC education will be able to apply, under the following conditions: they will need to have held their CPM for at least 3 years at the time of application, AND they will need to have completed the NARM Bridge Certificate at the time of application.

What should I do if I do not have MEAC accredited education, and I miss or am not eligible for the grandmothering window after rules are adopted?

We recommend all midwifery students explore options for enrolling in a MEAC school. Students who are near the end of their appreticeship/preparing to sit the NARM exam could consider using the CPM PEP to MEAC bridge programs offered by some schools. For current CPMs, there are several MEAC schools offer a program that allows current CPMs to receive credit for their CPM certification, and take a shorter course of study without repeating the entire apprenticeship/clinical process.

Where is the closest CPM school?

There are no MEAC schools in IL. The only MEAC school in the midwest is Southwest Tech in Wisconsin. Many schools offer distance learning for some portions of the coursework. We do not endorse any particular schools. You can find a complete list of MEAC schools here: https://www.meacschools.org/midwifery-schools/compare/

How does this law impact other traditional midwives?

This law specifically exempts some traditional midwives from licensure. We cannot advise you on if a specific midwife or circumstances would be exempted by IDFPR.
Section 25; Exemptions
(b) Nothing in this Act shall be construed to prohibit or require licensing under this Act with regard to:
(1) a traditional birth attendant practicing midwifery without a license if the traditional birth attendant has cultural, indigenous, or religious traditions that have historically included the attendance of traditional birth attendants at births and that birth attendant serves only the women and families in that distinct cultural, indigenous, or religious group;
Prior to this law, the ONLY midwives legally allowed to attend any birth, by statute, by court ruling, and by IDFPR regulation, were CNMs. ALL other midwives were at risk of cease and desist orders and fines, and prosecution.

Are VBACs illegal under this law?

This is a bit technical, but VBACs are not illegal for any birthing person – parents can choose to birth where, and with whom they wish, without legal penalty, as has always been true, and is affirmed, by this law.
HOWEVER, CPMs are prohibited from attending, as the primary midwife/provider, any VBAC. This law does not impact CNMs.

What other restrictions are there on midwives?

There are some conditions that a CPM is prohibited from attending. These can be found in section 85; Prohibited Practices. They include things such as clients with “significant” cardiac, pulmonary, renal, or hepatic disease; active malignant disease; diabetes controlled by insulin; active tuberculosis, syphilis, gonorrhea, or genital herpes; alcoholism or drug abuse/addiction; confirmed AIDS status; and some other conditions relating congenital, pelvic, and uterine abnormalities. We strongly encourage you to read the complete list for yourself.
This law does have, in statute, a long list of conditions for which a midwife must consult with another provider, such as a physicians or nurse-midwife. The law does NOT require the pregnant person to be seen by another provider or for another provider to approve or sign off on a pregnant person birthing at home. The complete list of conditions requiring midwives to consult can be found in Section 75; Consultation and Referral.

What restrictions are there on mothers or pregnant people?

This law does not govern client autonomy or choices. In section 25, Exemptions clearly states:
“(d) Nothing in this Act abridges, limits, or changes in any way the rights of parents to deliver their baby where, when, how, and with whom they choose, regardless of licensure under this Act.”
This law regulates what licensed providers are allowed to do under their license. That will have an impact on clients, in that local providers may not be willing or able to attend their births, due to the condition of the client.

What reporting requirements are there?

Midwives must make annual reports about their clients, in a de-identified way – no names, birthdates, or address of clients are required. You can view the specific reporting requirements in Section 90; Annual Reports.

Are midwives required to carry malpractice insurance?

No, the statute does not require malpratice insurance coverage. No provider in Illinois is required, by statute, to carry malpractice insurance. Midwives are required to disclose to the client if they have coverage and the amount of coverage if they do carry it.

Does this bill allow CPMs to be Medicaid providers?

No. The process to add CPMs as eligible providers is different from a licensing or practice act. That will be addressed in early 2022, and we hope/anticipate that by the time CPMs can get a license, they will also be listed in as a category in the Illinois Medicaid provider enrollment system.

How You Can Help

Throw a Fundraiser

In order to maintain a lobbyist in Springfield, we must raise a few thousand dollars each month. The lobbyist keeps us informed of relevant bills, initiatives in congress. They also advises us on the best strategies to use in pushing forward legislation. Throwing a fundraiser is a great opportunity to get creative and spread the word about the benefits of increasing access to midwives in our communities, and works with us through the rules and regulations. Here are some ideas to get your started: have a yard sale; host a film showing; get a local theater group to perform the play “Birth” by Karen Brody and donate the proceeds to ICCPM, start a silent auction, or host a bake sale.

Contact Your Representative

Find out who your legislator is by following this link, clicking on the map and then entering your address. Once you’ve identified your legislator, check out this wonderful page, published by Citizens for Midwifery, for tips on how to write an effective letter advocating for midwives. You can also set up an in-person meeting with your legislator to talk about licensing CPMs in Illinois (see talking points in next section).

Here are some informational fliers about midwifery in Illinois that you may distribute to your state representatives and senators

Talk to your friends and family

Share with your friends and family about the benefits of licensing CPMs, as well as about the benefits of out-of-hospital, midwife-attended birth. Many women are unaware that homebirth is a valid option in today’s world! Talking with friends and family about the benefits of normal birth with minimal intervention is a great way to normalize homebirth and midwifery in our culture. Here are some talking points, specific to Illinois, to get you started:

  • Women in Illinois are already having homebirths. Even though it is difficult, sometimes impossible to find a homebirth provider throughout many parts of the state, women in Illinois are already having homebirths. Nationally, the number of women seeking homebirth services has risen in recent years, and Illinois is no exception. Women sometimes search into their third trimester to find a provider! Still others never find a provider and opt to leave the state to have a homebirth (albeit, in someone else’s home!).
  • There are more women in Illinois who want a homebirth than there are midwives to serve them. Nationally, DEMs attend the majority of homebirths. Because the legal environment in Illinois criminalizes these providers, their numbers have shrunk drastically in the last decade. Many midwives either leave the state or simply stop practicing due to legal pressure.
  • Licensing CPMs is the answer! If the state of Illinois decides to recognize the national CPM license, it will make the legal environment more welcoming to aspiring providers and increase the access mothers have to their services. CPMs are a safe, cost-effective option for low-risk women AND they are specially trained to work in an out-of-hospital setting.

Interested in additional volunteer opportunities with the Midwives of Illinois? Contact iccpmidwives@gmail.com

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