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1998 SESSION

986825655
SENATE JOINT RESOLUTION NO. 196
AMENDMENT IN THE NATURE OF A SUBSTITUTE
(Proposed by the Senate Committee on Rules
on February 10, 1998)
(Patron Prior to Substitute--Senator Edwards)
Establishing a joint subcommittee to study legislative reforms related to improving consumer access to professional maternity care in out-of-hospital settings.

WHEREAS, pregnancy and childbirth are normal life events; and

WHEREAS, citizens in this Commonwealth want access to midwives, nurse midwives, and physicians who provide maternity services in the security and comfort of their own homes; and

WHEREAS, thirty-three other states currently allow direct-entry midwives to practice in out-of-hospital settings; and

WHEREAS, the large majority of home-based births that occur in the United States are attended by direct-entry midwives; and

WHEREAS, out-of-hospital births can be achieved with comparable safety and at significantly lower costs than hospital births; and

WHEREAS, studies comparing the costs and benefits of midwife attended out-of-hospital and physician attended hospital births are available for review; and

WHEREAS, the World Health Organization (WHO) notes that, outside the United States, the preferred site for births is either in the home or in a free-standing birthing center; now, therefore, be it

RESOLVED by the Senate, the House of Delegates concurring, That a joint subcommittee be established to study legislative reforms related to improving consumer access to professional maternity care in out-of-hospital settings. The joint subcommittee shall be composed of 13 members as follows: four members of the Senate, to be appointed by the Senate Committee on Privileges and Elections; six members of the House of Delegates, to be appointed by the Speaker of the House according to Rule 16 B of the Rules of the House; one direct-entry midwife, to be appointed by the Senate Committee on Privileges and Elections; and one certified nurse midwife and one family physician, to be appointed by the Speaker of the House.

The joint subcommittee shall consider: (i) criteria to identify those practitioners who have the appropriate knowledge, skills, and abilities to provide competent care and services in out-of-hospital settings; (ii) a comparison of the costs of the obstetrical services provided in hospitals and the costs of services provided by midwives, nurse midwives, and physicians in out-of-hospital settings; (iii) a comparison of birth outcomes as related to the health status of the mother and time of seeking prenatal care; (v) existing studies of hospital and home-based births; and (v) the provisions of other states' laws.

In its deliberations, the joint subcommittee shall receive information and data from the American College of Obstetricians and Gynecologists, Midwives Alliance of North America, the American College of Nurse Midwives, the North American Registry of Midwives, the International Association of Parents and Professionals to Promote Safe Alternatives to Childbirth, the Midwifery Education and Accreditation Council, the Department of Health, and the Department of Health Professions.

The costs of this study shall not exceed $9,000.

The Division of Legislative Services shall provide staff support for the study. All agencies of the Commonwealth shall provide assistance to the joint subcommittee, upon request.

The joint subcommittee shall complete its work in time to submit its findings and recommendations to the Governor and the 1999 Session of the General Assembly as provided in the procedures of the Division of Legislative Automated Systems for the processing of legislative documents.

Implementation of this resolution is subject to subsequent approval and certification by the Joint Rules Committee. The Committee may withhold expenditures or delay the period for the conduct of the study.