The South Dakota House on Wednesday passed a bill to permit and regulate the practice of licensed certified professional midwives.

Senate Bill 136 passed on a 52-16 vote. A two-thirds margin was required because the bill contained an appropriation. The bill previously passed the Senate by a 29-6 margin and now heads to the desk of Gov. Dennis Daugaard.

The South Dakota Association of Healthcare Organizations (SDAHO) opposed the bill, saying that when things go wrong in an intended home birth, 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.

Rep. Tim Rounds urged colleagues to vote “No” on the bill, saying he doesn’t believe the bill’s language adequately provide for what’s best for the mother and child. He said the state has passed legislation to encourage more certified nurse midwives, who have formal medical training, and he’d like to give that program a chance to expand.

Supporters said the group seeking to allow CPMs to operate in the state have sufficiently addressed most legislators’ concerns, and they’re desperately needed in rural areas.