Senator loses leadership post after sneaking midwifery legalization into health insurance bill

JEFFERSON CITY, Mo. -- A state senator got stripped of his committee chairmanship Monday after sneaking contentious language legalizing lay midwifery into a health insurance bill passed by the House and Senate.

Sen. John Loudon defended his shrewd move, even as other lawmakers decried him for violating one of the most important unwritten rules of lawmaking -- trust.

Loudon, R-Chesterfield, was the Senate handler of one of Gov. Matt Blunt's priority bills intended to expand private health insurance to some of Missouri's 700,000 uninsured, particularly those employed by small businesses.

On Thursday, Loudon outlined a new, 123-page version of the bill -- purportedly one agreed to by key House and Senate members, the governor's office and trade groups for small businesses and insurers.

But while explaining the bill, Loudon never mentioned that it also included an obscure sentence allowing certified midwives to help with home births. Under current Missouri law, midwifery is considered the illegal practice of medicine when done by anyone other than a physician or certain specially trained nurses.

The Senate passed the bill 31-0 Thursday night with virtually no debate -- its last act before heading home for a three-day weekend.

On Friday, the House passed the bill 106-41, sending it to Blunt. It was only after the final vote that Democratic Rep. Sam Page, a Creve Coeur doctor, noticed the midwifery language and brought it to colleagues' attention. By then, it was too late to debate.

As word spread of what Loudon had accomplished, many lawmakers became irate.

The bill's lead sponsor, Rep. Doug Ervin, R-Kearney, said Monday that Loudon had deceived him. The midwife language was not part of the agreed-upon package, Ervin said, and he never would have brought the bill to a final vote had he realized what was in it.

"We have a serious issue in regards to trust," Ervin said.

Senate Majority Leader Charlie Shields, R-St. Joseph, who decides what bills get debated, also said he never would have brought up the health insurance bill had he realized the midwife language was included.

Senate President Pro Tem Michael Gibbons on Monday removed Loudon as chairman of the Senate Small Business, Insurance and Industrial Relations Committee until further notice. Gibbons said he also was tricked by Loudon's midwife language.

"To me, it appears like it was a situation for him where the ends justifies the means, and I don't support that," said Gibbons, R-Kirkwood.

Loudon said loss of his leadership position was worth it.

"There's really not much I wouldn't do to make sure people get this critical freedom" to decide how and where to give birth to their children, he said. "It's not like I enriched a donor or set child molesters free; I put a new freedom for people into a bill."

For Loudon, it's a personal issue. The senator said a would-be midwife helped identify a medical problem during his wife's pregnancy last year that threatened the life of both his wife, Gina, and their unborn child. Their son, Robert, was born safely Aug. 25 -- though not delivered by the midwife.

Whereas Loudon believes midwives and home births can actually increase safety, opponents argue they can put lives at risk.

Page points to the March 2002 death of infant Ethan Criswell, who was born prematurely at his Mansfield home and suffered from multiple birth defects. Victoria Kocher later pleaded guilty to a charge of unauthorized practice of midwifery and was sentenced to five years probation.

"When you present yourself as someone who can deliver a baby at home, and the people receiving those services don't know enough to investigate your qualifications and skills, then someone's going to get hurt," Page said.

Another opponent, Sen. Chuck Graham, D-Columbia, had blocked a separate Loudon bill legalizing lay midwifery from coming to a final vote in the Senate. Loudon and Graham had engaged in a kind of cat-and-mouse game this year, with Loudon repeatedly attempting to pass his midwifery bill when Graham was out of the Senate chamber, prompting Graham to rush back.

After the health insurance bill passed, Graham said Loudon told him he would stop pushing the lay midwifery bill and was "done being sneaky, sneaky."

"I think he deceived the entire Senate, and there is a fair amount of furor over that," Graham said Monday.

A lobbyist for midwives defended Loudon's tactics, noting lawmakers and lobbyists had more than several hours to review the bill and notice the language. Supporters fully expected that someone would pick up on their move, said Mary Ueland, of Mansfield, the legislative chairwoman for the Missouri Midwives Association.

"Nobody lied, nobody was dishonest, and nobody asked any questions," Ueland said.

Gibbons said legislative leaders are looking for ways to reverse Loudon's language -- likely through passage of another bill. But the legislative session ends Friday.

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Midwives language in HB818.

On the Net:

Legislature: http://www.moga.mo.gov