(BIVN) – A bill to register and license midwives in Hawaiʻi stirred things up at the Capitol recently.

SB1033 SD2 HD1 relating to the licensure of midwives, already approved by the Hawaiʻi State Senate, passed second reading in the House of Representatives on March 22.

The bill seeks to “establish the licensure of midwives practicing in the State,” and “temporarily exempts birth attendants and exempts Native Hawaiian healers from licensure requirements.”

An earlier version of the bill included “penalties for violations of license and registration requirements and regulations”, proposed to “prohibit traditional midwives and others with a certification but who do not meet licensing criteria from practicing or advertising as a midwife,” and “require registration by all practicing midwives and full licensure of all qualified midwives by January 1, 2024.”

The bill received a hearing on March 19 before the House Health Committee, where state representatives heard passionate views on the proposed law.

2,239 pages of testimony were received by the committee, and many individuals and midwifery organizations testified in opposition to the bill.

Clare Loprinzi, a traditional midwife and indigenous practitioner from Hawaiʻi Island, made the trip to Oʻahu to voice her concerns. “My kuleana is to preserve traditional midwives,” Loprinzi said.

Loprinzi was a force to be reckoned with at the committee hearing. She stood to speak, beginning with a Hawaiian chant, and eventually made her way to the microphone, where she told the lawmakers that being a traditional midwife “is number one for me. That’s who I am. That’s what I carry genealogically.”

“Let me tell you that we are strong fighters. We’re not gonna just sit back and go, okay, well you guys can have your way. That’s not gonna happen. We’ve been doing this since the beginning of time,” Loprinzi said.

“Why are you trying to outlaw and get rid of midwives?” Loprinzi asked the lawmakers. “Do you want more deaths?”

After a few tense exchanges between Loprinzi and the state reps, the committee called for a recess. When the meeting was called back to order, a more relaxed discussion took place.

On March 21, the committee recommended the bill be passed, with amendments. According to a committee report, the changes were:

(1) Amending the definition of the scope of practice of midwifery;

(2) Changing the composition of the Director’s advisory committee to include a Certified Nurse Midwife;

(3) Granting the Director the authority to modify the list of authorized non-controlled legend drugs and devices that may be used by midwives;

(4) Clarifying that birth attendants may practice and advertise their services provided they do not claim to be a licensed midwife and subject to certain limits and disclosure requirements;

(5) Inserting language excepting individuals from licensure requirements for providing care to immediate family members;

(6) Expanding the authorized legend drugs or devices that a licensed midwife may use or administer;

(7) Appropriating $146,000 from State general funds and $73,000 from the Compliance Resolution Fund to implement the licensure of midwives as required by this measure, including the hiring of staff; and

(8) Establishing a task force within the Hawaii State Commission on the Status of Women to investigate issues relating to home births and direct entry midwives.

The bill has been referred to the House Committee on Finance.