House Bill H. 3731, the “South Carolina Lay Midwife Act”

There’s a lot of noise going on in the state of South Carolina around this bill. As there should be. If passed, it will place a de facto ban on homebirths and make any midwife attended birth an impossibility.


Stop House Bill H. 3731, the “South Carolina Lay Midwife Act”

I’ve been wondering what I could say about this that hasn’t already been blogged about by much better bloggers than I, but I think maybe I can contribute by highlighting why this bill would restrict the public’s access to midwifery. I’m sure on the surface the notion of midwives and obstetricians working in tandem sounds like a good idea, but there are many reasons why doing so under the conditions of this bill would not be feasible in practice.

There’s also the issue of the language of the bill. There’s a world of difference (and a good deal of training) between a licensed midwife and a lay midwife. Julie at Inexplicable Ways does a grand job of explaining the differences.

Currently, if you want to be a licensed midwife in this state to be allowed to deliver babies in people’s homes or a free-standing (not part of a hospital) birth center, you have complete a state-approved midwifery course, apprentice under a licensed midwife and obtain a specific amount of clinical experience (it usually takes 2-4 years), and pass state examinations. You’re then able to practice, but you have to maintain fairly constant contact with the state in terms of quarterly reports, incident reports, continuing education requirements, peer reviews, and renewing of your license every 2 years. 

What they are proposing is that we must complete all that, but also be sponsored and backed by a practicing obstetrician. Here are some of the reasons why this won’t work:

  1. If women wanted an OB supervising their pregnancy and birth, they would have hired one in the first place.
  2. Backing a midwife means being responsible if something goes wrong. No malpractice insurer is going to allow one of their policy holders to do that. None.
  3. The hospital the OB is contracted to work in isn’t going to allow it, either.
  4. Agreeing to back a midwife means you’re potentially on call for her patients as well as yours if she needs to transport. OB’s are already carrying a heavy patient load, they are not going to agree to take on more.
  5. There are a number of obstetricians that just don’t want to work with midwives. They don’t know or understand what we do, how we’re trained, and some refuse to learn. They are trained to be scared of birth and think what we do is dangerous.
  6. If, by some miracle, an OB found a way around all these problems and wanted to help us, he/she would likely be shunned from their peers, become unemployable, lose privileges at his/her current hospital, and would no longer be able to back us by default.
  7. Probably the crux of the issue – Money. Hospitals and doctors don’t like losing money to us. A hospital birth brings in anywhere from $10k to upwards of hundreds of thousands per birth if the NICU is utilized. A homebirth midwife or birth center birth charges from $2-5k per birth. Chances are doctors and hospitals aren’t going to be volunteering to lose out on some of that profit to midwives.

Unfortunately NONE of these reasons are considering the best interest of moms and babies, much less their rights. Again, much better writers than I have already laid out why maintaining access to midwifery in this state is good for everyone, so I’ll keep redundancy to a minimun and instead just ask you to please help. I humbly plead for your assistance in keeping my profession legal and preserving the rights of childbearing women in this state. Homebirth and midwifery might not even be the right option for you, but it’s an incredibly important choice for many of your neighbors. Here’s how to help:

  1. Go sign this petition. Please. Right now.
  2. Contact your state representative and tell him/her that you do not support Bill H. 3731, and ask them to please vote no. No fancy language needed, just those few words would do it.
  3. Contact the sponsors of this bill and tell them you oppose it.
  4. Make some noise. A lot of it, actually. Share all this information on your social media outlets. Join South Carolina Friends of Midwives on Facebook to keep up with our progress and share what’s posted there. Keep checking for official updates as well.

Thank you. ♥


  1. Adrienne says:

    “What they are proposing is that we must complete all that, but also be sponsored and backed by a practicing obstetrician. ”

    Actually–they’re not proposing that exactly. Current Licensed Midwives licensed under DHEC may begin initial licensure under the Medical Board. But the entire process: route of entry, educational requirements and skill set are not defined whatsoever. Probably because the Medical Board has zero intention of actually granting any new licenses.

  2. Gretchen says:

    While talking to my husband last night he made a great point. Allowing this to take place is just as wrong as making a Chiropractor be under the supervision of a “regular” medical physician. They compete for clients/patients. IMO a Chiropractor has a much better understanding of the nervous and muscular skelotal system than your General physician. In this case a LM or CPM has a greater overall understanding of Pregnancy and Birth becasue of the more personal connections they make with the families they serve. Especially homebirth MW’s. OBs are a Surgical specialty in women’s helath care. Surgical!

Speak Your Mind