In the US out of hospital birth is growing at a rapid rate and many do not know the nuances between providers that attend out of hospital birth. 

In Texas licensed midwives attend most out of hospital birth and we have found inconsistencies in regulation, education, ethics, and accountability in comparison to other health profession. This leaves pregnant mothers vulnerable and susceptible to preventable outcomes.

We know with professional progression we can improve outcomes for all mothers in out of hospital settings.

Currently is not a consistent educational pathway for licensure and a lack of high-risk clinical training led by maternal and neonatal experts that would consistently prepare professionals to recognize and assess life threatening and abnormal conditions. Our goal is to bring more consistency to the profession while facilitating growth that allows midwifery to be safe and accessible to every woman. 

The American College of Obstetricians and Gynecologists endorses the International Confederation of Midwives (ICM) and reports that two thirds of Licensed and Certified Professional Midwives do not meet the standards of the ICM, a globally recognized organization, for science and evidence-based standards for midwifery. This lack of standardized education leaves huge gaps in quality care and while birth is a natural physiological occurrence, mothers need midwives who recognize complications and can consistently provide the right course of care for those complications.

Currently in Texas, licensed midwives are regulated by a licensing agency called TDLR (Texas Department of Licensing and Regulation), who is responsible for the licensing of professions such as cosmetology and towing. They do not hire public health workers or medical expertise to regulate or decide on educational protocols for licensed midwifery. This is a major issue in the progression and growth of the profession. A regulatory body needs to have the proper resources and expertise available to them to understand the professions they regulate.

We believe it is time for a change. We are asking for health workers on from all sides of birth work to come together for maternal and neonatal healthcare advancement in Texas. Mothers in Texas need modernization in licensed midwifery from a healthcare organization that has expertise in the field and would be dedicated to overseeing this profession - ensuring that midwives are all brought up to deliver consistent, high standards of care in all aspects of health care associated with maternal and neonatal health.

Here are some things we would like to see changed:

• Removal of the PEP apprenticeship or self-study pathway 
• 3 year MEAC accredited program requirement giving state approved courses the opportunity for accreditation
• Continued education course work for currently licensed midwives who do not meet International Confederation of Midwives educational standards
• Adopting International Confederation of Midwives core competencies and standards
• Written ethical laws to protect patient to midwife relationships
• A recording system that tracks every licensed midwives' transfers, reason for transfer, negative outcomes, and death. (Review California’s CA-PMSS)
• State prompted investigations for demise and near misses.
• Clinical hours in hospitals to observe high risk conditions
• Informed consent documents that clearly outline a licensed midwife’s scope of practice and education
• Standardized charting protocols and approved systems for patient charting
• High risk conditions continued education
• Required accountability meetings
• Root cause and review meetings for death and negative outcomes
• Improve insurance accessibility 
• Address burn out and workplace abuse 
• Facilitate smooth and nurturing collaborations with obstetrics teams, EMS and midwives
• Incorporating community health workers to help navigate relationships between providers to ensure patient health and timely care

This movement is not just about improving standards; it's about saving lives - both mothers' lives and those of their unborn children. Please sign this petition if you agree that The State of Texas should have consistent and advanced standards for licensed and certified professional midwives.