Say Goodbye to Home Birth? A New Bill Pushes Too Far

It’s hard not to appeal directly to fiscal conservatives these days – the old school conservatives – the ones who appreciate how to save money long term without the neocon knee-jerk reaction to slash everything and anything in this time of economic difficulty. If this country wants to save money, it’s not enough to simply cut government funding for programs, brush off our hands, take a deep breath and say, "well, that’s that" and walk away.

So it is with a bill in the Washington state Senate (SB 5588) that seeks to shut down various State Boards and Commissions throughout the state in an effort to cut costs. Inexplicably, the bill has targeted the JUA (Joint Underwriting Association) for closure – despite the fact that the group does not even receive state funds. The bigger issue, however, is that this is the association that ensures liability coverage for certified professional midwives throughout the state. Without the JUA, midwives will not be able to obtain malpractice insurance and will effectively be put out of business in Washington state. 

But here’s the part to try out on your fiscally conservative pals (old-school, remember):

A recent Department of Health report revealed that in Washington state, professional midwifery services saves the state $250,000 a year – a number which increases to $1.3 million a year when you factor in private insurance.

JUA is the only place where professional midwives in Washington state can obtain liability insurance so it’s critical to make sure JUA is not closed by this bill. 

Though it is likely you will read impassioned attacks on professional, certified midwifery in the comments section of this post (or any other on this site), the facts tell the real story. Certified, professional midwifery is safe for the mother, for the newborn baby, saves money for both the consumer and insurance companies, and results in better heath outcomes with significantly reduced rates of c-sections.  In addition, midwifery services for pregnant and birthing women offer another safe and (in some states) legal option for prenatal, childbirth and postnatal care. 

If you live in Washington state, here’s a copy of the letter you can send to your legislator whom you can find here:

Senate Bill 5588 includes a list of State Boards and Commissions that will be shut down as part of cost-cutting efforts, and they’ve included the JUA in that list despite the fact that the JUA receives no state funding of any kind.

Without the JUA, licensed midwives and birth centers will not be able to get liability coverage. Without liability coverage, they will lose their credentialing with insurance companies. The effect will be to put most licensed midwives and birth centers out of business.

Please exempt the Joint Underwriting Association from SB 5588. Closing down the JUA would cost far more money than it saves, whilst also eliminating a much needed resource for women and their families. A recent Department of Health study found that licensed midwives save the state $250,000 per year, and (if you include private insurance too) that number climbs to $1.3 million per year. Clearly it makes no sense to eliminate licensed midwifery in the pursuit of saving money.

Thank you for your time and for your support of Washington State midwives and families.


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  • http://www.seattlehomebirth.vpweb invalid-0

    Just received word that the Senate took the JUA off of the bill! Many people wrote to their legislators over the last 2 days regarding this issue and it worked to exempt the JUA. Thanks for this insightful article. It really shows what an asset licensed midwives are to maternity care. Now our next battle will be to prevent our annual $450.00 licensing fee from being jacked up to $2000.00 per year. Yes. That’s not a typo. $2000.00 per year. By far the highest annual licensing fee of any health care provider in Washington State, including all doctors, nurses, and any other health care provider you can think of. Clearly, paying a $2000.00 annual fee to remain licensed will be a barrier to practice for many midwives. I know it will be for me.

  • amie-newman

    It’s great news that so many are willing to make their voices heard when midwifery is in jeopardy. I hope those voices remain loud and clear with this next battle over licensing fees. I cannot fathom why licensing fees for professional midwives are higher than for any other health care provider. It’s an outrageous sum of money. 

    I’d like to know more about what’s happening on that front so we can inform our readers.  

    Amie Newman

    Managing Editor, RH Reality Check

  • invalid-0

    Goodbye liberal East Coast country club Republicans who love their job, but no so much their country. … In a new bill introduced the first day of the present session of Congress, … You quote, “The patient was just too far gone… …. headlines after a tearful moment with President Obama has a new home. …

  • aspen-baker

    Thanks Amie!  I was born at home, literally in a trailer, in San Diego in 1976.  My mom’s doctor was named Dr. Butcher.  My sister was born at home, this time in an appt., two years later, also in SD.  The doctor that time was Dr. Repair.  This is totally not a joke.  Totally true.  If it wasn’t for home birth stories, I would have no funny jokes to tell at parties!

  • invalid-0

    Dear Amie,
    As the Chair of the Washington State Midwifery JUA, I want to say thanks to you and your readers for your quick and effective support in securing and exclusion to SB5588 for the JUA.
    Keep your eyes open for an appeal to legislative action from MAWS (Midwives Association of WA) to address the issue of equitable licensing fees.
    Valerie Sasson
    Licensed Midwife
    JUA Chair

  • amie-newman

    I am stunned and thrilled :). Now I also have a funny joke to tell at parties. Dr. Butcher & Dr. Repair?! It’s great to hear that you were safely born at home even if it was with the facilitation of a doctor named Dr. Butcher. 


    Amie Newman

    Managing Editor, RH Reality Check

  • amie-newman


    I’m relieved and so happy that our voices were heard. We’re ready for the licensing challenge  – I know this has come up before in the Washington state legislature – so we can fight it back again!

    Thanks for the comment, Valerie. Keep up the amazing work!


    Amie Newman

    Managing Editor, RH Reality Check

  • invalid-0

    Congratulations on getting the Senate to take this initiative off of the bill!

    Keep up the good fight :)


  • invalid-0

    really grate good work keep going on

  • invalid-0

    I guess all the money went to war and to the banks, so now we have to pay more for everything

  • ernestp

    There are some who are not comfortable in giving birth at hospitals. They would rather prefer delivering their babies at home where she could be taken cared of well by her family. Besides the expenses at home is lesser than in hospital.A lot of people are looking to start saving money. Well, CNN has some easy tips to start saving money, and they are simple and very smart. First, pay cash for groceries instead of using a debit card. It sets a concrete limit on funds, and if you keep under budget, it’s almost like a payday loan to yourself. Another tip is to use a scooter in lieu of a car for short trips. They are electric, have little upkeep and don’t cost much to get. Another good one is to bring your own wine to restaurants. You’ll pay for corkage, but a $20 bottle with $5 corkage beats a $40 bottle of theirs. What gets leftover can be used for debt relief if you start saving money.

  • invalid-0

    Midwives are so important to the society, they give people birth! I do hope that you politician will not dear to close JUA.

    Best of luck!