Senate sends House bill to have Medicaid cover midwife services

By Sarah Ladd
Kentucky Lantern

Kentucky Medicaid would begin covering licensed certified professional midwife services under a bill the state Senate sent to the House Thursday by a vote of 34-3, after little discussion.

The primary sponsor, Sen. Shelley Funke Frommeyer, R-Alexandria, said the legislation is a chance to “innovate” in Kentucky.

Under her bill, she said, a Medicaid-insured patient with a low-risk pregnancy could have the costs of using a certified professional midwife for a home birth covered by the federal-state program, which already pays for about half of all Kentucky births.

Funke Frommeyer, who is also an advocate for freestanding birth centers in Kentucky, cited previously reported numbers showing the state recorded 177 home births in 1988 and 900 in 2021, said mothers should have “maternity care options,” and gave some:

“We see people doing one of the following: They may forego the care truly desired and plan a hospital birth, which is covered by Medicaid. They may make sacrifices and find a way to pay out of pocket for LCPMs. They may have a home birth without a trained provider — or sometimes without anyone at all.”

Sen. Karen Berg (D-Louisville), a physician, asked if a midwife could do an episiotomy if needed, and Funke Frommeyer said the procedure is within the scope of their practice. An episiotomy is an incision in the tissue between the vagina and the anus, which may be necessary if the baby’s shoulder is stuck behind the pelvic bone, among other reasons. Midwives may also suture the incision.