I am a Virginia resident and was a midwifery client for both my pregnancies.  The training licensed midwives undergo is rigorous, comprehensive, and ongoing. I felt I was in excellent hands throughout my pregnancies and births.  It is upsetting our midwives are restricted from offering a full scope of practice.  My first birth I was advised to transfer to hospital after completing 95% of labor at home simply because my midwife was not permitted to administer IV fluids.  This was administered to me en route to the hospital and was the ONLY intervention needed to safely and naturally birth my daughter.  She was born within 20 minutes of receiving fluids and I had no medical emergency which required hospitalization.  Had my midwife been able to practice within the full scope of her training, I likely would have completed my birth at home.  Midwives in Virginia are an important asset to birthing women and should be treated as such with supportive legislation.  I agree with and support the following statements:

Virginia Licensed Midwives currently are not permitted to possess, prescribe, or administer potentially life-saving medications within their scope of practice. This needs to change! I ask for your support for legislation allowing Licensed Midwives the right to provide the medications within their scope of practice.

Maternity Care Desert

Maternity care deserts are areas where there is limited or no access to maternity health care services. According to a 2020 report published by the March of Dimes, 47% of Virginia counties are Maternity Care Deserts (March of Dimes, 2020)

Safety & Ethic

Maternal mortality in the United States is higher than all other highly industrialized countries. More than 700 people die each year in the United States from childbirth-related causes, and it is estimated that approximately 60% of those deaths are preventable (Maternal Mortality Review Information Application (MMRIA), 2018). Hemorrhage is the leading cause of maternal death worldwide (James, 2022), and there are basic medications Licensed Midwives can administer to prevent or treat postpartum hemorrhage. Access to life-saving medications is a human right and is essential to safe practice in all birth settings

Strain on Hospital System

Families who choose to give birth at home or at a freestanding birth center ease the strain on hospital systems. It is unnecessary to burden hospitals with the responsibility of providing basic medications that could safely be administered outside the hospital setting

Scope of Practic

Licensed Midwives in Virginia are restricted from administering the medications that are within their scope of practice*. Virginia is one of only two states that license midwives yet restrict them from accessing these medications. Providers should be able to work within their full scope of practice

Workaround

Families must jump through numerous hoops to gain access to the medications that make their birth safer. Some must drive over two hours to see a physician who would be willing to prescribe medications. Some must go to the hospital within 2 hours of their baby’s birth so that their baby can receive a potentially life-saving vitamin K injection or erythromycin eye ointment that can prevent permanent blindness due to maternal infection. Some people must choose between having to endure the pain of being sutured without the use of local anesthetic or risking permanent damage to their body by not having those lacerations repaired properly. Some must self-administer prescribed medications, while their Licensed Midwife stands by, unable to assist them due to an outdated law

I urge you to support Virginia Licensed Midwives and the people they serve. This outdated law needs to be changed to reflect the scope of practice of Licensed Midwives, and Virginia families deserve these life-saving medications wherever they choose to give birth.

Sincerely,

Emily Huffman