Hawaiʻi Legislators Birth Midwifery Bill After 20-Year Gestation Period

Bipartisan legislation to license midwives passed the Hawaiʻi House of Representatives on Tuesday, April 9, 2019, and the Senate on Friday, April 12, 2019, according to an April 19 press release from the Midwives Alliance of Hawai‘i.

At this time, Senate Bill 1033 awaits the governor’s signature.

The legislation, introduced as part of the Women’s Legislative Caucus Package, clarifies what midwifery practice is and what the licensure requirements are for midwives. Senate Bill 1033 provides exemptions for traditional Native Hawaiian healing practices, as they are protected under the State Constitution.

A task force will investigate issues relating to traditional birth attendants, who receive a temporary
exemption from licensure while they work to define their scope and educational pathway for regulation.

“This legislation is founded on the International Confederation of Midwives definitions, education and
essential competencies, which is the global standard for midwifery,” said Leʻa Minton, board president of the Midwives Alliance of Hawaiʻi. “The United States is one of over 130 countries who adopt this criteria, and 33 states regulate midwifery.”

She noted SB1033 provides a pathway to licensure for midwives meeting these standards and Hawaiʻi midwifery students, both current and future, enrolled in programs.

Midwives were regulated in Hawaiʻi from 1931 through 1998 through the Department of Health. The
midwifery law was repealed when nurse-midwives were placed under the board of nursing, resulting in a lapse of midwifery regulation for the last 20 years.

Certified nurse-midwives have continued to be licensed as advanced practice registered nurses; certified professional midwives and certified midwives have not had licensure in Hawaiʻi despite years of legislative efforts.

Currently there is no midwifery standard in Hawaiʻi, as a lack of regulation has resulted in persons being able to provide care, including attending community birth, under the title midwife/midwifery services. without demonstrated education and proven competencies.

State Rep. Linda Ichiyama (District 32- Moanalua, Salt Lake), a co-convener of the Women’s Legislative Caucus, said, “This bill strikes an important balance by allowing those who have the
credentials and training to seek licensure and by giving an exemption to traditional and cultural
practitioners to come together in a task force to discuss the right level of regulation and accountability. We look forward to the task force’s report and hope to bring all groups together to ensure a basic level of consumer protection and safety for mothers and babies.”

Senate Bill 1033 provides the public with access to quality care and professional accountability by
integrating midwifery into healthcare, which research has shown improves maternal and infant health
outcomes.