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A stealth bill has legalized midwifery in Missouri — for now.


Missouri's home-birth advocates hit the jackpot when State Senator John Loudon, a Republican from Chesterfield, took up the banner for legalizing midwifery — a perennial issue in Missouri, where practicing without a doctor's oversight is a felony.

Loudon employed some sly tactics on behalf of his new friends, but he never expected his success to bring down the wrath of the entire Legislature.

Senate President Pro Tem Michael Gibbons pulled Loudon's chairmanship of the Small Business, Insurance and Industrial Relations Committee after it was discovered that both chambers had unwittingly voted for it as an amendment Loudon had slipped into the broad health-insurance package last week.

The provision Loudon inserted did not mention midwives or midwifery. It allows any person with a "tocological certification" to provide services. "Tocology" — from the Greek tokos, meaning "childbirth" — is the practice of obstetrics or midwifery.

Loudon was stunned by the backlash. "It's very unusual. I don't know a senator who's had his chairmanship yanked," Loudon says. "More than that, I created the committee."

As for his procedural sleight-of-hand, says Loudon: "The procedure I used — it may have been used very effectively, but I didn't invent it."

Gibbons could not be reached for comment by press time.

Loudon and his wife, Gina, credit the birth of their son Robert Brewster III to advice they received from a would-be midwife. Mary Ueland, director of Show Me Freedom in Healthcare, a nonpartisan political action committee, was sitting in Loudon's office in January 2006 when she struck up a conversation with Gina, who had endured two miscarriages and was trying to prevent a third.

When Ueland's advice paid off, Loudon says, he felt obligated to reciprocate.

"I had come around to supporting it, but I hadn't handled the bill or co-sponsored," Loudon recounts. "I guess you could say I was intimidated by the doctors. After this experience I took on a new zeal."

According to the advocacy group Citizens for Midwifery, Missouri is one of eleven states in which lay midwives — those who aren't also doctors or nurses — are outlawed. Missouri is the only state where midwifery is a felony.

In opposing the measure, doctors' groups, principally the Missouri State Medical Association, have cited lay midwives' lack of medical training and the potential liability to doctors who associate with them.

Loudon has co-sponsored tort reform legislation, and he says he has plenty of doctor friends. When it comes to midwifery, he says, they "agree to disagree."

Loudon managed to slip his bill past his chief opponent, Senator Chuck Graham, a Democrat from Columbia, twice on voice votes. But Graham successfully blocked the legislation from passing openly.

"You learn certain tricks; we just employed some of them," Loudon says. "The opposition was paying less attention to kill it, and I was paying more attention to pass it."

Loudon says the maneuvering was a team effort. The tocological touch was supplied courtesy of a home-schooler whose family was on hand lobbying for the bill: The teenager had a college test prep guide, and "tocology" was among the listed vocabulary words.

The triumph, though, might be short-lived, as Loudon might see his work undone — perhaps fittingly — by a new amendment nullifying his own. As of press time Tuesday he continued to hold out hope for a compromise.

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