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Former ADHS director recalls scope of practice changes for midwives
See: Families demand action against midwife after multiple deaths | 12news.com
Will Humble was the state’s health director when the scope of practice for midwifery was expanded. Midwives used to be prohibited from conducting VBAC births, or vaginal birth after cesarean delivery, in Arizona.
There was a strong push to change that. Humble recalls it wasn’t an easy decision.
“We had the home birth enthusiasts and the midwives pushing for an expanded scope of practice to include VBAC. And on the other side, we had OBGYNs who had spent years in medical school and then a residency practicing how to manage births, including VBACs,” Humble recalled. “And they thought it was just outrageous that midwives, who had almost no medical training, really hadn’t been a medical school, that they would be allowed to do this practice.”
Ultimately, after extensive research, Humble said the state sided with midwives. They did, however, add additional criteria and limitations for VBACs to try to minimize risk.
“If the midwife doesn’t follow those criteria, the risks go from manageable to extreme. Same goes for the agency. If the state agency isn’t doing a good job overseeing the midwives, those risks go from manageable to really, really bad,” Humble said.
Humble said transparency from the health department is critical to ensure parents are making the best and safest decision for their family.
“The health department has two-fold responsibility. Number one, to hold the midwives to the letter of their regulations and to ensure that there’s disciplinary action when those criteria aren’t being met. The second piece is to make that information known,” Humble said.
