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Pat Schwaiger calls it poetic justice. More than 20 years ago, Schwaiger, a registered nurse and licensed midwife, lived in Sheridan. The state obtained an injunction to prevent her from practicing midwifery in Wyoming. 

Today, Schwaiger is owner and senior midwife at Mountain Midwives in Billings, Mont.  She has been delivering babies in their parent's homes since 1982 and has attended more than 700 births. She also is chairman of the new Wyoming Board of Midwifery.

The move to make the practice of midwifery legal in Wyoming has had an usually long gestation period. After years of rejection, the legalization happened because the Legislature in 2010 finally passed a bill to license midwives to practice in the state. The Wyoming Medical Society, which had opposed the lay midwives for years, relented as a group and that is how the bill got through and became law.

It's taken a while for the infant board to get its rules written, offered for public comment and adopted. "The irony--I just think it is poetic justice," Schwaiger said in an interview last week.   "The state issued an injunction against me way back then and 20 years later I'm sitting as chair of the Wyoming Midwifery Board."

"It's long overdue," she said, adding that the licensed midwives have excellent statistics on birth outcomes. "There's no reason to make it illegal."

She attributes the bill's success to a new and different perspective with the younger doctors or the good statistics the proponents could offer on home births in other states. A major concern of the medical community was high risk pregnancies and emergency transportation of home-birth mothers who experience complications. The new law addressed these concerns by prohibiting a lay midwife from attending a home birth if the pregnant woman has any of a long list of medical conditions. It also requires lay midwives to give advance warning if she must move a patient to the hospital because of birth complications and to bring along complete records.

The board started issuing midwife licenses as of July 1. Now 3 women are licensed midwives in Wyoming. But none is from Wyoming. Over the years when lay midwives could not practice here legally, they either left the state or got in trouble with the law and were shut down, Schwaiger said. "There also may have been midwives working quietly but that's just a guess," she said.

She hopes those midwives who are still in the state will come forward and get licensed. When midwives were illegal here, Wyoming couples crossed state lines to Idaho, Colorado or Montana so they could have midwife attended births. Schwaiger said she had a house in Billings for the sole purpose of accommodating Wyoming couples who wanted home births. "So they would drive for 2 hours, often in labor, to have their babies," she said. "That happened all over the state."

To be licensed in Wyoming, you have to be a graduate of an accredited midwifery school or have been licensed or certified in another state for a minimum of 5 years. New students have to enroll in an accredited school. Schwaiger said there are about 10 in the nation, including one in Utah, and several offer online courses in addition to campus residency. The student also needs to contract with a preceptor and attend births to get training.

Schwaiger said she has an apprentice now who lives in Powell. She said she will be delighted when the apprentice gets her license because there are a lot of families in the Powell area who would prefer home births. Because they are new and have such a tiny roster to date, the license fees are high -- $1,200 for 2 years. The money is needed to support the board's operations. The board still has one slot open but enough members to have a quorum.

Schwaiger believes that home births not only build the bonding relationship between parents and their infant but gives the parents confidence in their own parenting skills. "I believe personally that it makes for strong families," she said.


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