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1999 SESSION

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HOUSE JOINT RESOLUTION NO. 646 Directing the Joint Commission on Health Care, with the assistance of the Department of Health Professions and the State Department of Health, to examine the advisability of legalizing the practice of direct-entry midwifery in the Commonwealth.

Agreed to by the House of Delegates, February 8, 1999 Agreed to by the Senate, February 18, 1999

WHEREAS, direct-entry midwives are not currently allowed to practice in Virginia unless registered with the State Department of Health prior to 1977; and

WHEREAS, only six direct-entry midwives are currently registered under these statutory provisions, most of whom are not actively practicing; and

WHEREAS, some direct-entry midwives are currently practicing in Virginia outside of state law; and

WHEREAS, most states currently permit the practice of direct-entry midwifery in some form; and

WHEREAS, significant variation exists among states that have legalized direct-entry midwifery regarding whether and how the practice is regulated; and

WHEREAS, notwithstanding the prohibition on the practice of direct-entry midwifery in the Code of Virginia, at least 199 births in Virginia during 1996 were attended by direct-entry midwives; and

WHEREAS, access to competent care is important in both in-hospital and out-of-hospital birth settings; and

WHEREAS, at the request of the House Rules Committee, the Joint Commission on Health Care recently completed a study on issues regarding midwifery, issues originally raised by Senate Joint Resolution No. 196 (1998); and

WHEREAS, further study is necessary to examine the experiences of other states that have legalized direct-entry midwifery as well as to further examine scientific studies on birth outcomes in different settings; now, therefore, be it

RESOLVED by the House of Delegates, the Senate concurring, That the Joint Commission on Health Care, with the assistance of the Department of Health Professions and the State Department of Health, be directed to examine the advisability of legalizing the practice of direct-entry midwifery in the Commonwealth. The study shall include, but not be limited to, analysis of (i) advantages and disadvantages of legalizing direct-entry midwifery, (ii) experiences of other states that have legalized direct-entry midwifery, (iii) options for effectively regulating the practice of direct-entry midwifery to ensure, to the extent possible, the health and safety of women and infants receiving direct-entry midwifery services, and (iv) other issues as may seem appropriate.

The Joint Commission shall report its findings and recommendations to the Governor and the 2000 Session of the General Assembly as provided in the procedures of the Division of Legislative Automated Systems for the processing of legislative documents.