When you are talking to legislators, it is good to ask them questions that make them think about the issues, rather than asking a yes/no question. Handouts are good, mainly as a physical reminder of your visit, but many don’t read them at all. You rarely change their minds by giving them facts, anyway. They change their minds when they see things differently, and they do that by exploring issues and deciding for themselves. Rather than talking at them for 15 minutes, ask questions and listen intently to what they say. Ask leading questions that take them where you want them to be. Here are some sample questions to get started with:

Families in our state have been having home births for many years. They are going to keep having home births. Do you think it is safer for them to give birth at home unattended, to give birth with an unlicensed midwife, or to give birth with a licensed midwife?

Try to have some facts about who else is providing home birth services in your state. Do any doctors attend home births? Do any CNMs attend home births? [Currently in SD, there are no CNMs with collaborative agreements with physicians that allow them to do home births. We don’t know of any physicians willing to do home births.] Use this info if their answer is that home birth midwives should have a doctor or CNM with them. Don’t run down docs or CNMs, emphasize that they work in hospitals, also that the CPM and CNM credentials are accredited by the same accrediting body and have undergone the same rigorous evaluation.

Do you know how many counties in our state do not have any public health maternity care? Or any maternity care providers? (Only 23 counties in SD provide birth services. That leaves 43 counties with no birth services.) Follow this up with a question about what they think these mothers should do if there are no physician maternity care providers. Wouldn’t a licensed midwife who comes to the home be a better option than driving several hours in labor to find a hospital?

What do you see as the primary advantage of licensure? (help them see the value of setting standards for
education and training, and for accountability to the state; also that the license, if based on the CPM, would be portable to other licensed states)

What do you see as the primary disadvantage of licensure? They will probably mention the cost, but you can bring up the savings to the people from using midwives. Also, that using the CPM minimizes the expense to the state by having a nationally-accredited credential to use as the basis for licensure. They may also mention that they don’t want to encourage home births by seeming to endorse it. Tell them that mothers are already choosing home birth, and will continue to do so. Licensure does not encourage home births, but it provides a mechanism for the state to set standards for licensure, etc.