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Senate advances first‑substitute bill to regulate direct‑entry midwives after hours of debate
Summary
The Utah Senate adopted a first substitute for Senate Bill 93, establishing state licensure, a WHO‑based definition of “normal birth” for licensed direct‑entry midwives, mandatory‑transfer rules and administrative oversight after extended floor debate; the measure passed third‑reading 28–1.
Senator Jim Dayton, sponsor of Senate Bill 93, told the Senate the substitute reflects hours of negotiation with medical and midwifery stakeholders and is intended to set parameters for state licensure and regulation of direct‑entry (home) licensed midwives. "There have always been home deliveries and there always will be," Dayton said, and the bill, he added, "addresses the regulation that comes with licensure."
The substitute defines "normal birth" by reference to the World Health Organization and limits the bill to midwives who seek state licensure; Dayton said parts of the midwifery community declined to accept some definitions but that the substitute represents the areas where agreement was possible. "One of the areas with which there has not been agreement" was the definition of normal birth, Dayton told senators during questions.
Lawmakers pressed the sponsor on safety and liability. Senator Walker asked who makes the call if a newborn is "in distress" and whether a midwife could face sanction if a birth changes from low risk to high risk during labor. Dayton pointed to mandatory‑transfer provisions and rulemaking: the substitute requires a direct‑entry midwife to terminate care and initiate an immediate transfer by calling 911 when mandatory‑transfer criteria are met. "We have in rules what mandatory transfer is required in case an unexpected problem arises," Dayton said, and when a transfer occurs the medical community that assumes care carries responsibility for the patient.
Dayton summarized stakeholder support on the floor: "The Department of Health supports it for purposes of public safety. The Utah Medical Association endorses this bill and asked me to run it. The certified nurse midwives who do home deliveries have endorsed this bill. The pediatricians who care for the children that are brought to them have endorsed this bill. The obstetricians and gynecologists endorse this bill. The emergency room physicians endorse this bill and the Attorneys Association also endorses this bill."
After discussion and a call of the Senate to secure a quorum, senators voted to substitute and then to read the first substitute for third reading. The Clerk announced the roll‑call result for third reading: 28 yeas, 1 nay, 0 absent; the first substitute will be read for the third time (floor tally reported on the record).
The measure establishes a regulatory framework for licensed direct‑entry midwives, including definitions tied to the WHO standard, mandatory transfer triggers and a role for rulemaking and an administrative advisory committee. Implementation details — including the specific text of administrative rules that will govern transfer procedures and committee membership — will be resolved in subsequent rulemaking and practice guidance. The bill now proceeds under the Senate’s third‑reading process as recorded on the floor.
