08-04-2025
Alabama midwives pull support from bill after addition of ‘hostile language'
Sen. Larry Stutts, R-Tuscumbia, walks across the floor of the Alabama Senate on April 25, 2024 at the Alabama Statehouse in Montgomery, Alabama. A group representing Alabama midwives withdrew its support for a bill updating their practice regulations after Stutts introduced a substitute that they said was too restrictive. (Brian Lyman/Alabama Reflector)
A group representing midwives in the state has withdrawn its support for a bill intended to update their practice regulations after a Senate committee made significant changes to it.
As originally filed, SB 87, sponsored by Sen. Arthur Orr, R-Decatur, would have allowed midwives to administer three parts of newborn screenings: heel stick, hearing screening, and Critical Congenital Heart Disease (CCHD) screening, which can provide early detection of genetic or metabolic conditions.
These screenings should be completed within 24-48 hours of birth, according to the Alabama Department of Public Health. Midwives currently have to recommend their patients to a pediatrician's office, often delaying the time-sensitive screenings. Alabama allows a birth attendant to administer them if a physician is absent but has not allowed midwives to acquire them.
Nancy Megginson, legislative chair with the Alabama Midwives Alliance (ALMA), said in a phone interview Monday that midwives have faced ambiguity regarding their ability to conduct newborn screenings. While existing law requires midwives to instruct clients about these screenings, it only explicitly allows them to order the tests. This has led to midwives being denied the screening kits, particularly the blood spot test cards collected via heel sticks.
'Our issue has been once we were licensed, we started ordering the newborn screening cards from the Department of Public Health, because our law says a midwife shall order the newborn screening. We were actually told to stop trying to order them, that they weren't going to give them to us because they didn't know who would be administering it,' Megginson said.
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The substitute version introduced and adopted in the committee would authorize licensed midwives to administer a heel stick but explicitly states that a midwife 'is prohibited from interpreting any tests or screens under this subsection and shall cause any results to be referred to a physician of the mother choosing who is licensed to practice medicine in this state.'
Midwives say the new language in the bill is too restrictive, particularly concerning newborn care and screening.
Sen. Larry Stutts, R-Tuscumbia, who introduced the substitute, said in an interview Monday that saying midwives 'are not qualified' to interpret results.
'They're not pediatricians. They're not qualified to interpret the results and provide newborn care,' Stutts said.
Under the substitute bill, Stutts said midwives 'can collect the sample and then send it to somebody that is qualified' but that the bill 'does not expand anything else that they can do.'
Megginson said that the new language stating midwives are prohibited from providing any newborn care was 'hostile language that had never been discussed.'
Midwives are trained in newborn care for up to six months, Megginson said, but they are not trying to interpret test results or diagnose conditions. Restricting their ability to perform state-mandated screenings or assist with basic newborn needs is 'absolutely absurd,' Megginson said.
She is now actively lobbying legislators to amend the bill on the Senate floor.
'We are encouraging anyone to place an amendment, to put it back on track, where all three screenings would be included, where no language about newborn care to be written. We'd like that to be completely struck through,' Megginson said.
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