Senate panels pass midwifery bill with DCCA changes; lawmakers say unpaid, invited birth attendants should not be criminalized

A joint meeting of the Hawaii Senate Committee on Commerce and Consumer Protection and the Senate Committee on Judiciary voted April 1 to pass House Bill 1194, HD2, SD1, a measure that updates licensing provisions for midwives and adopts specific changes proposed by the Department of Commerce and Consumer Affairs (DCCA).

The committees adopted amendments that delete an exemption to licensing the committees identified in the DCCA submission and create new language limiting use of the title "midwife" and the practice of midwifery to those licensed under the chapter. The committees also deferred the bill's effective date to July 1, 2050.

Why it matters: HB1194 reshapes which attendants may legally practice midwifery in nonfacility births, clarifies a licensing exemption the committees removed, and affects midwives, doulas, and families who use home- or community-based birth services.

Committee discussion focused on the scope of the deletion adopted from the DCCA recommendations and whether the change would criminalize persons who are invited to assist at a birth. Committee members said the intent of the adopted amendment is not to criminalize invited, unpaid birth attendants who do not hold themselves out as midwives or use the title "midwife." Lawmakers noted the change will be addressed further in conference.

Senator McKelvey, a Commerce and Consumer Protection member, recorded a reservation on the measure and said her community asked for further conversation. Senator Atwal, another committee member, said some midwives oppose the measure as overregulation. Senator Allah asked whether an invited, unpaid attendant who helps at a birth would commit a crime; committee discussion stated the intent is that such individuals would not be criminalized provided they are invited, unpaid and do not claim the title or engage in licensed practice.

Action taken: The committees voted to pass HB1194 with the DCCA-recommended amendments and the deferred effective date. The Commerce and Consumer Protection committee recorded the chair and vice chair voting aye; Senator McKelvey recorded a reservation; Senator Richards voted aye; Senator Owa recorded a no vote. The Judiciary committee also passed the measure; members recorded no votes from Senator Waugh and the committee vice chair. The committees will carry the adopted language into conference for further negotiation prior to final readings.

Background and next steps: The adopted language deletes a provision the committees said likely would have allowed some persons to assist at births without a license so long as they were invited and uncompensated. The committees replaced that provision with a new subsection clarifying that being present at a nonfacility birth by invitation is not a license to use the title "midwife" or to practice midwifery unless licensed. The bill will proceed to conference committee for reconciliation before final passage in the Senate and any transmittal to the governor.

Ending: The committees closed the agenda item after recording the vote and indicating the matter will be considered again in conference.