Missouri Supreme Court upholds midwifery

November 1, 2008

The Missouri Supreme Court voted 5 to 2 to leave intact a state law allowing certified professional midwives to practice without physician or state oversight.

In response to a challenge by four physician groups, the Missouri Supreme Court voted five to two to leave intact a state law allowing certified professional midwives to practice without physician or state oversight. According to American Medical News (8/11/2008), the midwife provision had been inserted at the last minute into a 2007 bill that addressed portability and accessibility of health insurance. The physician groups argued that since the midwifery provision had nothing to do with health insurance, it violated constitutional requirements that a bill have a single subject. They also contended that allowing unlicensed midwives to practice medicine could result in physicians being subject to professional discipline because they would have to deal with birth complications. But in rejecting the physicians' lawsuit, the high court disagreed with this assertion, saying that physicians would not be subject to discipline for working with midwives. The physicians therefore did not have the legal standing to bring a challenge to the provision, according to the judges. As a result, the court did not rule on the constitutional issues the suit raised.

The case reached the Missouri Supreme Court after a trial court ruling invalidated the statute in question, blocking it from taking effect. In the wake of the high court's decision, independent midwifery is once again legal in Missouri.