The Senate has passed a bill to permit and regulate the practice of licensed certified professional midwives.

SB 136 advanced out of the Senate Health and Human Services Committee on a 4-1 vote before heading to the Senate floor, where it passed 29-6.

Pat Schwaiger, a certified professional midwife licensed in Montana and Wyoming, said CPMs provide a safe option for home birthing when the midwife is properly trained, equipped and regulated. Senate Bill 136 ensures that, she said.

Opponents testifying at a Monday morning committee hearing included representatives of SDAHO, Sanford Health and the South Dakota State Medical Association, as well as several physicians. They offered statistics showing that planned home births carry twice the risk of neonatal death as planned hospital deaths.

Before passing the bill, the committee approved an amendment that added the language “to manage and care for the low-risk mother-baby unit in an out-of-hospital setting during pregnancy, labor, delivery, and postpartum periods.” The amendment also noted the Board would have authority to discipline midwives “engaged in substandard, unprofessional or dishonorable conduct” and made some other minor language changes. Neither the amendment nor the full bill provides a definition of a low-risk birth, which is a tension point for opponents.

Debra Owen, SDAHO’s vice president of state and federal relations, said when things go wrong in an intended home birth, that mother and child could have just moments to have their lives saved. CPMs have little medical training with no formal medical education, and this could be an issue when a mother needs an invasive procedure such as an IV, she said.

Nick Kotzea, Sanford’s senior legislative affairs specialist, said a hospital provides the safest setting for childbirth.

Dr. Steve Schroeder, a family physician in Miller, said he’s concerned that CPMs won’t have the training to diagnose and treat various conditions that come up during child birth.

Dean Krogman, chief lobbyist for the South Dakota State Medical Association, said the organization had agreed to certified nurse midwives performing home births without a collaborative agreement, but the organization can’t support SB 136 because obstetric care should be under medical practice.