Midwives in Montana : historically informed political activism

Abstract

States contiguous to Montana legalized direct-entry midwifery only in the 21st century, while the Montana legislature exempted lay midwives from the Medical Practice Act during the 1989 legislative session and approved a licensing protocol for Certified Professional Midwives in 1991. Midwives in Montana examines the historical context of the legalization of midwifery in Montana and identifies significant individuals, groups, and events in the confrontation over home birth in the state. Based on oral histories of legislative participants and drawn from primary and secondary source materials held by individuals and institutions throughout the state, this research compiles scattered documentary evidence to present the history of Montana midwives from territorial days through the legislative events of 1989 and 1991. The efforts of midwifery supporters in the Montana legislature prevailed over organized and well-funded opposition from individual physicians, medical organizations, and hospitals, and resulted in statutory changes that enabled the licensing of homebirth midwives. With a strong rural representation, the 1989 legislative body supported the availability of midwifery care for constituents unable to access urban medical centers. The lobbying strategy employed by midwifery advocates embodied a sophisticated understanding of the conflict between midwives and institutionalized medicine and utilized beliefs about gender and Montana identity to enable legislative success. Additionally, the individuals most closely involved in the lobbying process remained committed to a clearly defined agenda. As a result of their efforts, Montana became the ninth state in the nation to legalize and license homebirth midwives and remains a national leader in homebirth midwifery care.