- Special Projects
Dozens of mothers and their children crowded a hallway at the Hawaii State Capitol on Monday afternoon hoping to shoot down a proposal to increase government oversight of home births.
The measure, Senate Bill 2569, creates a regulatory framework for people who help women give birth at home. Home births currently aren’t regulated in Hawaii and advocates for the bill say that it would make such births safer for women and their babies.
The Senate committees on health, consumer protection and the judiciary considered the bill in a joint hearing on Monday afternoon. The measure is backed by more than half of the Senate, including Senate Majority Leader Brickwood Galuteria.
Hawaii Sen. Josh Green, himself a physician, introduced the bill, one of several proposals this session that seeks to exert more state control over the traditional healing community.
SB 2569 requires midwives to be licensed and creates a board that would establish rules, investigate complaints and take disciplinary action against home birth providers when necessary. It also limits home births to women with low-risk pregnancies and saddles home birth providers with record-keeping requirements.
The bill attracted hours of emotional testimony on Monday from doctors, midwives and traditional healers. Green said the level of passion in the testimony took him by surprise; he hasn’t heard testimony that emotional since he considered a bill on physician-assisted suicide three years ago.
“I think, to be honest, what we were debating was sacred to people,” he told Civil Beat after the hearing. “Those who want to deliver at home have a sacred trust that shouldn’t be broken. The medical community has a sacred obligation to do everything in their power to make sure everything is safe for mothers and babies. When those two worlds collided, it created an explosive discussion.”
Green decided to put off voting on the bill until Wednesday afternoon.
Instead of moving forward with the original proposal, the senator from the Big Island plans to modify the bill to establish a working group to study and make recommendations on how best to regulate home births.
Many doctors supported Green’s original bill because of the safety risks associated with delivering babies outside of a hospital. The Hawaii Medical Association said in its written testimony that Hawaii doctors have received many phone calls from midwives when there are medical complications during home births.
“If you have to get a license to cut hair, you should have to get a license to deliver a baby,” the association argued.
The American Congress of Obstetricians and Gynecologists also supported SB 2569, listing in its written testimony terrible examples of home births gone wrong. The organization pointed to a study that said babies delivered at home are four times more likely to die than those born in the hospital.
But to the mothers who waited for hours on Monday with their children to testify against the measure, Green’s proposal is a gross overreach of government power.
Several of the hundreds of people who testified against the bill were Native Hawaiians who said the measure would infringe on their cultural rights. Others characterized it as a feminist, or even human rights issue.
Elisa Spring, a 36-year-old mother of three, said the bill violates a woman’s right to choose where to give birth to her children.
Spring went to the hospital to have her first two kids but decided to give birth to her youngest child at home for spiritual reasons.
“We’ve made an assumption that hospitals are the best place to give birth and that’s not the truth for many women,” she said. “It’s a natural thing to birth a baby and we’ve forgotten that.”
Rebekah Stewart Botello, a 38-year-old mother of two with a third baby on the way, was angry at the idea that the government would challenge her decision to give birth at home. Her mother, a midwife, helped her give birth to her first two children and is planning to assist with her third.
Botello said that if the law passed and she got pregnant again, she wouldn’t obey it, even though, because of her age, hers might be considered a high-risk pregnancy. She challenged the notion that home births are more dangerous than procedures at the hospital.
“Why are you treating a natural process of life as a medical procedure?” she said. “It’s so unnecessary.”
Serena Green, a certified professional midwife, worries that Green’s bill would make her livelihood illegal. She has been working as a midwife since 2005 and is currently president of an organization called the Midwives Alliance of Hawaii. Green said regulations, if any, should originate from the community of midwives rather than through a top-down approach.
If the senator decides to move forward with a working group, Green said that it is “mandatory” that she and other midwives have a voice.
Sen. Green said after the hearing that he is hopeful that the different health care providers will be able to come to some consensus if he convenes a task force on the issue.
“I would never legislate against people who believe they have something spiritual at stake,” he said. “But even one death is too many. We have to find a way to bridge this gap.”