Legislation passed in 2017 in South Dakota opened the door to licensing of a new classification of “professional midwives,” who can become certified to perform home births with far less training and education than “nurse midwives” who have been regulated in South Dakota for 40 years.
While midwives with the new professional certification have successfully delivered 10 babies since then (two of whom required transport to a hospital), one top medical official in South Dakota is concerned the new certification may legitimize lay midwives who can put mothers and children at risk.
A main concern is that the new classification of legal midwifery, the Certified Professional Midwife, demands far less education and clinical training than a Certified Nurse Midwife, a classification that requires a nursing degree and which has been regulated in South Dakota since 1979.
Some supporters of home births say CPMs are fully capable of delivering babies safely and that midwives in general create needed birthing options for prospective parents, particularly in rural areas where access to hospitals may be limited. They also note that lay midwives have been working outside the law for years and that at least now they must be certified.
But opponents of the CPM license law, including Dr. Robert J. Summerer, president of the South Dakota State Medical Association, cite studies showing higher neonatal mortality rates in home births than in hospital deliveries.
Summerer, a Madison, S.D. surgeon, also noted the discrepancy between the hours of clinical training demanded of Certified Nurse Midwives (1,040 hours) versus Certified Professional Midwives (about 50 hours depending on the program) before they can deliver babies independently.
“It is very clear that their training is inadequate and it’s putting two people at risk: the mother and the child,” he said. “We still think it is unsafe that the state would sanction something that is so risky for our residents in the state.”