Illinois Establishing Midwife License

Debbie Boucher is the rare midwife who has been able to legally perform home births in Illinois.

She’s able to do so through her company, Childbirth the Way Nature Intended, Inc., without fear of running afoul of the law because she’s also a certified nurse.

Since Illinois outlawed midwives (those who are not licensed nurses or doctors) decades ago, they’ve had to operate somewhat underground – unable to purchase certain drugs or to coordinate care with doctors and hospitals.

If an unlicensed provider has to take a pregnant patient to the hospital for care, the midwife isn’t permitted to go with them.

“So the patient is going to lose that labor support,” Boucher said. Though she said she has heard of situations in which midwives risk it by pretending to be the mother’s sister or doula (a birth coach). “To avoid the risk of getting caught, they often can’t come in and get the patient through that.”

Illinois is in the process of changing course with a new law (House Bill 3401/Public Act 102-0683signed Tuesday by Gov. J.B. Pritzker. 

The measure, which takes effect in fall 2022, creates a path toward certification for midwives; licensed professional midwives will be able to attend out-of-hospital births. The proposal passed the Illinois legislature after the state’s main doctor’s organization, the Illinois State Medical Society, lifted its opposition, citing provisions that protect doctors and medical facilities from liability.

Boucher, who also leads the Illinois State Home Birth Association (which recently broadened from the Chicago area to statewide), is applying to be on the state certification board created under the Licensed Certified Professional Midwife Practice Act.

She said the law is designed with limits to protect patient safety, like requiring that a midwife coordinate care with a doctor or hospital if labor doesn’t commence within 18 hours of a patient’s water breaking.

Having more licensed midwives will help to meet a rising consumer demand that grew during the pandemic.

“It will decrease the number of unattended home births that sometimes are happening because people cannot find a licensed provider,” Boucher said.

Star August, president Holistic Collective, a community-based organization on the South Side that provides homebirth and postpartum services said demand is especially high for Black moms.

“The numbers don’t lie. They speak for themselves. Black women are dying at the rate of eight times that of white women, and it’s a scary thought of us going to the hospital knowing that we have a higher percentage, a higher rate of dying than our counterparts,” August said. “So we want a safer option.

August, a mother of four who had a bad experience giving birth at a hospital, is currently prepping for the necessary certification that Illinois will require.

If she passes, she said she will become the first Black certified professional midwife in Illinois qualified to apply for a license in Illinois, though the rank is “ironic” she said given that “my great, great grandmother was a grand midwife in the state. There’s a long history of us being ostracized and pushed out.”

She said midwives are a viable option for improving maternal health outcomes and help to reverse the trends of Black maternal mortality.

While they perform health checks like doctors, midwives also visit families’ homes, enabling them to witness if there are other social determinants that could affect a mother or baby’s health.

She says the new law will make a profound difference, given that midwives won’t have to fear prosecution and patients who want at-home births will have that as a realistic option.

Still August said the new law is but a first step given that now only those who can financially afford it can hire a midwife.

She is among those advocating for Illinois to pass another law (Senate Bill 1041), to have licensed professional midwife services covered by Medicaid.

“This will open up this open for women who don’t have the funds to pay for it. It’s a human right. It should be available to any woman who needs it and those who need it the most do not have the financial means to be able to obtain it,” August said.