I am contacting you in regards to HB 496. If this bill were to pass there are unintended consequences such as the criminalization of unlicensed midwives, government overreach into the practice of midwifery in home births, elimination of a large percentage of currently available midwives for families, discriminatory actions against non-religious families and increased risk for families who will have fewer options and choices for safe birth. I would like to know what actions you will take to ensure these consequences will not get passed into law to add increased risk for midwives and childbearing families they serve in home birth?

I am writing to you to urge that you Oppose HB496, as introduced and Support critical amendments that 1. decriminalize the practice of unlicensed midwifery 2. Assign any licensing structure to a non-medical board 3. Uphold the freedoms/rights of childbearing parents to birth in the place of their choice and with the provider of their choice As it is written, HB496 would dramatically alter homebirth and negatively impact women’s choice. Amendments must occur in order to retain basic birth freedoms and bodily autonomy.

I am concerned about how HB496 will affect my family and our ability to birth in the place and with the midwife of our choice. I urge you to consider the grave consequences this may have on us should the bill be enacted, as introduced. Consider how many midwives may lose their client base and practice. Consider how many women will lose the choice to birth at home with the provider of their choice. I ask that you do your due diligence in representing the people of this state by discussing these consequences of the bill when it reaches the floor for discussion and suggesting amendments that better serve childbearing families of Ohio and the midwives who serve them.

The part of the bill (Sec. 4723.54-2) that states an unlicensed midwife is a criminal and prohibited from practicing and further guilty (Sec. 4723.99-A) of felony charges for serving families in home birth as she always has done. This is particularly concerning because it will interfere with my freedom of choice of birth place and care provider and will increase risks for those unable to utilize a midwife as they deem appropriate. The concerns I have about this bill are the government overreach into the bedrooms of birthing women/families will decrease access to quality care and options that are currently available to us. Please Oppose HB496, as it is currently written and support amendments that will protect unlicensed midwifery and preserve my full freedom of choice of birth place and care provider.

I have taken some time to read over the bill and have some questions I hope you can answer or ask when this bill reaches the floor for discussion regarding whether HB 496 will uphold my birth freedoms or eliminate important care providers that I may decide are best for me. Questions: ● If midwives have been serving Ohioans since time began, why are we now creating additional barriers for midwives to provide care to women and babies? ● Why would the Ohio legislature pass a bill that will increase costs to the uninsured family and make it harder for them to find a midwife due to the criminalization that HB 496 will create? ● Who will be held liable for parents having no other option but to birth unassisted when HB496 eliminates a large percentage of midwives? ● How will this bill impact the rural, Amish, and Mennonite communities of the State? ● What are the barriers for midwives to become licensed? What are the unintended consequences for those midwives who find this process too burdensome? Will they lose their practice? Will they lose their clients? How many midwives will be eliminating their services as a result of this bill? Please consider these questions and oppose HB496 unless critical amendments are made. Thank you for your time.

What is the real intent of HB496? If this bill is trying to expand access to midwives for families, it seems to actually be restricting access through licensure with the criminalization of unlicensed midwives. Birth is a normal life event, not a medical event. Midwives have been safely and satisfactorily serving families choosing to birth at home for many decades in Ohio. Consumers are capable of choosing the best birth place and care provider for their individual family/circumstances. In his introductory testimony, the primary sponsor of HB496, Rep. Kyle Koehler revealed the following. "This bill is not brought about to fix a problem. The midwives providing care in Ohio are not causing problems. They do not need to be fixed." Please oppose HB496 as it is written and support critical amendments that give parents full ability to choose the birthplace/provider of their choice, and assign a more appropriate board for any regulatory oversight of licensed midwives. We must maintain the personal childbearing freedoms we currently possess.

Midwives have been safely and satisfactorily serving families choosing to home birth for many decades in Ohio as unlicensed practitioners. Maternal and Infant mortality rates for unlicensed midwives providing home birth services are extremely low. Satisfaction of families choosing to birth at home with a currently unlicensed midwife is extremely high. Per the Midwives Alliance of North America (MANA), “The largest study of planned, midwife-led home birth in the U.S. to date, reported outcomes for nearly 17,000 women who went into labor intending to deliver at home between 2004 and 2009. Safe Outcomes with Positive Benefits -High rate of completed home birth (89.1%) -High rate of vaginal birth (93.6%) -High rate of completed vaginal birth after cesarean (VBAC; 87.0%) -Low intrapartum and neonatal fetal death rate overall: o 2.06 per 1000 intended home births (includes all births) o 1.61 per 1000 intended home births excluding breech, vbac, twins, gestational diabetes, and preeclampsia. -Low rate of low APGAR scores -Extremely high rate of breastfeeding (97.7%) at 6 weeks” If HB496 passes without amendments, many of the midwives servicing Ohio women and families would be eliminated and/or criminalized for non licensure. Please use your voice to amend HB496 to preserve access to midwifery care and uphold my birth freedoms.

I am concerned about how HB496 will affect midwives and the future of homebirth in the State of Ohio. If midwives have been serving Ohioans since time began, why are we now creating additional barriers for midwives to provide care to women and babies? Why has the State of Ohio not offered registration, rather than licensing of non-nurse midwives, as was recommended by the Direct-Entry Midwifery Study Council of 1998? There are negative impacts that would occur if HB496 were to pass. This bill creates barriers for midwives in their successful and safe care of Ohio citizens. In addition, this bill will eliminate highly experienced, unlicensed midwives through new restrictive regulations curtailing the Midwifery Model of Care™.

In 2020, there was a 22% increase in the rate of home birth as we faced unprecedented times in our world, and especially hospitals in Ohio. Women and families had the freedom to choose their providers and place of birth during these times. Homebirth practices across the state grew exponentially as childbearing families were searching for alternatives to the restricted and potentially unsafe hospital environments. Given the recent restrictions and COVID-19 protocols enforced in hospitals over the last two years, this is not the time for a bill to further restrict women’s rights. In addition, trust in the medical care system is fractured. There is a growing desire for individualized care, and direct-entry midwives have proven to demonstrate professional, safe, and individualized care. I urge you to make critical amendments to HB496 that would allow women and families the freedom to choose their provider and place of birth, without restrictions.