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House Bill Introduction Defines Midwives as Maternity Providers in South Carolina

January 10, 2023


DHEC previously instigated a regulation that neglected to categorize Licensed Midwives and Birth Centers as maternity providers in South Carolina. When DHEC would not remedy their error, SC midwives rallied the legislators for a solution.

DHEC regulations provide a detailed process that streamlines transfers between providers and facilities which should apply when midwifery patients need to transfer to a higher-resource facility or hospital. However, by neglecting to designate midwives as maternity providers, midwifery consumers could be sent to wait in the Emergency Room instead of being directly admitted to the appropriate department. Not only does this oversight cause unnecessary interventions and added expense to consumers and the State for Medicaid recipients, it also wastes precious time in cases of emergency.

This bill is known as the Perinatal Integration Act. It improves access to emergency services, allows midwives to access educational opportunities available at obstetrical hospitals, and requires data collection to evaluate the effectiveness and safety of hospital transfers.

Audrey Trepiccione, LM CPM, President of the Palmetto Association of Licensed Midwives (PALM), commented: “Perinatal integration of midwifery clientele into the health care system is extremely important as more families choose the community setting for childbirth. Rural populations are better served with access to local hospital systems and especially with the population of our state growing. I personally work in an area that has three hospitals that serve obstetric patients, yet clients of the midwives are only allowed services that are over 1-2 hours’ drive away. Our parents want safety, convenience and respect for their chosen care providers.”

Since midwives are not currently included in SC DHEC’s definition of maternity providers, a pregnant mother under the care of a midwife who needs to transfer to a hospital could be categorized as having no prenatal care. Women with no prenatal care are often considered high-risk and their treatment routinely consists of more testing than would be appropriate for midwifery clients who are traditionally considered low-risk in other regulations.

Midwives, PALM, and DHEC’s own Midwifery Advisory Council have requested that DHEC voluntarily repair the faulty regulation.

“It’s unfortunate that we’ve had to create a bill that forces DHEC to remove discriminatory practices. All women and babies should have equal access if an emergency arises. As a midwife and the owner of a Licensed Birth Center, I will say that licensure is a detailed and difficult process. I am appalled that The Department has chosen to ignore our licenses,” says Sandy Glenn, midwife and legislative liaison for the Palmetto Association of Licensed Midwives.

Ratification of this bill will improve the safety and experience of consumers of midwifery care during those rare events when a hospital visit becomes necessary.

A duplicate of this bill unanimously passed the Senate last session but was delayed in the House Medical Committee due to scheduling.

For more information, contact PALM ,, or Audrey Trepiccione, President, at, 843-273-6304.

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