July 1, 2008

Ruling Legalizes Midwifery

This week, the Missouri Supreme Court overruled a circuit court's decision on the practice of midwifery in Missouri. The case of Missouri State Medical Association, et al. v. State of Missouri and Missouri Midwives Association, et al., challenged legislation passed in 2007 by the Missouri General Assembly.

Although the majority of House Bill 818 related to health insurance, a one−sentence section legalized the practice of midwifery. The wording was obscure at best, reading "Notwithstanding any law to the contrary, any person who holds current ministerial or tocological certification by an organization accredited by the National Organization for Competency Assurance (NOCA) may provide services as defined in 42 U.S.C. 1396 r−6(b)(4)(E)(ii)(I)."

A lawsuit from the Missouri State Medical Association challenged the validity of the midwifery enactment in June 2007. The circuit court found the tocology section was invalid because it violated several provisions of the Missouri Constitution, including the single subject requirement for legislation and clear title requirements. Because of the constitutional nature of the issues, the case was appealed directly to the Missouri Supreme Court. In a 5—2 decision, the Missouri Supreme Court overruled the circuit court's decision on procedural grounds; it did not address the issue of the constitutionality of the enactment. Rather, the court found the medical association lacked legal standing to bring the lawsuit. Because the circuit court's decision was reversed, the statutory section authorizing the practice of midwifery in Missouri is valid and effective.

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