Thirty-seven states license midwives and, if a bill that cleared the Iowa House becomes law, Iowa would join that group. Bethany Gates of Vinton is a certified professional midwife, one of about a dozen working in Iowa.

“Midwives are leaving the state because there are a lot more states that offer licensure, which allows us to practice within our full scope, which makes births safer,” she said.

The maternal mortality rate in Iowa has nearly doubled in the past 20 years and Gates, who was at the statehouse to lobby for the bill, said the time has come for Iowa to start licensing midwives.

“We rank 49th in the nation in terms of the number of maternity care providers to the number of women in the state,” she said.

A recent study found mothers and babies in states which have integrated midwives into the health care system had better outcomes compared to the states that have the most restrictions on midwives. Without a state license, Gates and other midwives cannot administer certain medications while assisting in a birth, and in most instances midwives cannot order an ultrasound or lab work for a client.

“There’s about five (health care facilities) that I can send those orders into without a license,” Gates said, “so this will allow our clients access to those screening procedures that are standard of care in Iowa.”

Representative Ras Smith, a Democrat from Waterloo, said the bill responds to the need for access to health care.

“Iowa is ranked as the third worst state for people of color, specifically African American people, in the nation. One of the reasons is there’s a six-to-one ratio for black women who die in childbirth compared to their white counterparts,” Smith said. “I think this bill goes a long way in solving those problems.”

Representative Bobby Kaufmann, Republican from Wilton, said the bill “helps bring an established profession out of the shadows.”

The bill passed with 93 yes votes and only two House members voted against it. The bill to license midwives now goes to the Senate for consideration.