Mississippi Today
Advocates say licensed midwives could help Mississippi’s maternity care desert. Bills appear dead
Advocates say licensed midwives could help Mississippi’s maternity care desert. Bills appear dead
Advocates say pending legislation on midwifery could help alleviate Mississippi’s lack of maternity health care and protect mothers and babies from those practicing without proper training.
But Senate Bill 2793 and House Bill 1081 are likely going to die without a vote in committee this session, as legislative leaders say they need more time to study the issue.
More than half of Mississippi’s 82 counties are considered “maternity care deserts,” with no hospitals providing obstetric care and no OB-GYNs. Advocates say trained midwives could help this shortage of care for low-risk pregnancies, but say the state should license and regulate them.
With the overturning of Roe v. Wade and a ban on abortions in Mississippi, advocates say trained midwives could help with the expected increase of thousands of deliveries a year for a health care system that is already woefully inadequate.
Mississippi is one of 14 states that does not regulate or license direct-entry midwives, those who practice without first becoming a nurse. Certified nurse midwives in the state are licensed as advanced practice registered nurses. There are only 26 certified nurse midwives in Mississippi, and only a few deliver babies, because only three hospitals allow them to.
Mississippi prevents free-standing, midwife-led clinics for low-risk births and prohibits certified nurse midwives from performing in-home births – both of which are popular in other states and in Europe. More mothers want personalized care at home or in a small clinic as opposed to giving birth in a larger hospital, and want natural birth instead of induced labor or non-necessary C-section surgeries for delivery that have become more and more common in hospitals.
But Mississippi’s lack of licensure or regulation also results in untrained or poorly trained people claiming to be midwives providing substandard – or dangerous – care to mothers and newborns at home.
“Anybody can say, ‘I’m a midwife,’ and nobody can stop them,” said Getty Israel, founder of Sisters in Birth, a nonprofit that pairs community health workers with low-income women, primarily Medicaid beneficiaries, to provide support during and after their pregnancies. Israel hopes to open Mississippi’s first birth center. Such centers in other states serve women with low-risk pregnancies, and provide compromise between hospital births and home births.
READ MORE: Bills to watch in the 2023 Mississippi legislative session
Israel said she supports midwifery and wants to see it become a viable alternative in Mississippi, but believes they should be state regulated and licensed.
Erin Raftery is with Better Birth Mississippi, a group advocating for the midwifery legislation. The group says, “Community-based midwifery is a key solution to the challenges faced by the maternity care system in Mississippi.” Trained midwives could help with health care shortages caused by closure of rural hospitals and help save Medicaid money by “minimizing the use of costly, ineffective interventions.”
“The goal of these bills is accountability,” Raftery said. “… This would provide protection for patients, and for midwives. This would also hopefully open the door for insurance coverage for midwife services, and help with the maternity desert.”
Raftery said her group knows of at least one infant death in Mississippi overseen by an unlicensed midwife, and that a similar instance a decade or so ago had also prompted proposed legislation. Raftery said licensure would help protect patients from the “select few” midwives practicing without training.
Senate Medicaid Chairman Kevin Blackwell, R-Southaven, authored the Senate midwife bill.
“I think we need to look at all our opportunities for health care in Mississippi,” Blackwell said. “We are last, and we won’t change. We need to look at all the other states that are changing the way they do things.”
Both Blackwell’s bill and a mirror one authored by Rep. Dana McLean, R-Columbus, would create a state board of licensed midwifery.
“There are community midwives already practicing in this state, and this would help legitimize them, provide some oversight, and I think our primary responsibility is to make sure those that are practicing are doing so with some standard of care and level of experience,” McLean said. “Safety for moms and babies is the first priority. But I think there’s also an issue of allowing for reimbursement for Medicaid and private insurance. They do require some sort of certification or licensure before they would reimburse for these services.
“Rural areas are closing maternity wards, and if this is an option that can help for low-risk births, then we need to explore that.”
But many physicians and hospital groups say child delivery should be overseen by trained physicians in hospital settings. Beyond these arguments, there has been a push by conservative groups and GOP lawmakers to reduce government agencies, boards and regulations, not create new licensing and a new regulatory board.
Nurse practitioners have also struggled for more autonomy and expanded scope of practice in Mississippi – with limited legislative success – saying they, too, could help with the state’s shortage of doctors and health services.
Israel said doctors and hospitals treat child birth as a “cash cow,” and that their lobbyists and influence at the Capitol prevent “progressive, evidence-based health care.”
The House and Senate bills are now in each chamber’s public health committee, facing a deadline for committee passage next week. That passage this year, or even a vote in committee, appeared unlikely days before the deadline.
House Public Health Chairman Sam Mims, R-McComb, asked Wednesday about the midwifery bill pending in his committee, said he was unaware of it.
“I’ll go look at it,” Mims said. “I will read it. I will go look at it. Thank you, though.”
Raftery said her group had met with Mims and his committee vice chair only a couple of weeks ago and outlined the bill. She said Mims told her he would be opposed because he’s against new government boards and licensing.
Senate Public Health Chairman Hob Bryan, D-Amory, said he doubts he will bring the bill up for a vote in his committee this year.
“It’s sort of late in the session, and I really wasn’t aware of this legislation before we got here,” said Senate Public Health Chairman Hob Bryan, D-Amory. “I don’t think the committee would have time to fully study this … I’ve met with two different midwife groups, and I try to listen to people. I learned that at least one group will assign someone to an individual, and they will stay with that person, work with them, throughout their pregnancy and after delivery, and be there for them to discuss other health care issues. I think that is a very good idea, that could perhaps carry over into other health care services, and I am interested in learning more.
“I am neither opposed to nor supportive (of the midwifery legislation), but I have an open mind,” Bryan said.
This article first appeared on Mississippi Today and is republished here under a Creative Commons license.
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Mississippi Stories Videos
Mississippi Stories: Michael May of Lazy Acres
In this episode of Mississippi Stories, Mississippi Today Editor-at-Large Marshall Ramsey takes a trip to Lazy Acres. In 1980, Lazy Acres Christmas tree farm was founded in Chunky, Mississippi by Raburn and Shirley May. Twenty-one years later, Michael and Cathy May purchased Lazy Acres. Today, the farm has grown into a multi seasonal business offering a Bunny Patch at Easter, Pumpkin Patch in the fall, Christmas trees and an spectacular Christmas light show. It’s also a masterclass in family business entrepreneurship and agricultural tourism.
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This article first appeared on Mississippi Today and is republished here under a Creative Commons license.
Mississippi Today
On this day in 1921
Jan. 21, 1921
George Washington Carver became one of the first Black experts to testify before Congress.
His unlikely road to Washington began after his birth in Missouri, just before the Civil War ended. When he was a week old, he and his mother and his sister were kidnapped by night raiders. The slaveholder hired a man to track them down, but the only one the man could locate was George, and the slaveholder exchanged a race horse for George’s safe return. George and his brother were raised by the slaveholder and his wife.
The couple taught them to read and write. George wound up attending a school for Black children 10 miles away and later tried to attend Highland University in Kansas, only to get turned away because of the color of his skin. Then he attended Simpson College in Indianola, Iowa, before becoming the first Black student at what is now Iowa State University, where he received a Master’s of Science degree and became the first Black faculty member.
Booker T. Washington then invited Carver to head the Tuskegee Institute’s Agriculture Department, where he found new uses for peanuts, sweet potatoes, soybeans and other crops.
In the past, segregation would have barred Carver’s testimony before Congress, but white peanut farmers, desperate to convince lawmakers about the need for a tariff on peanuts because of cheap Chinese imports, believed Carver could captivate them — and captivate he did, detailing how the nut could be transformed into candy, milk, livestock feed, even ink.
“I have just begun with the peanut,” he told lawmakers.
Impressed, they passed the Fordney-McCumber Tariff of 1922.
In addition to this work, Carver promoted racial harmony. From 1923 to 1933, he traveled to white Southern colleges for the Commission on Interracial Cooperation. Time magazine referred to him as a “Black Leonardo,” and he died in 1943.
That same year, the George Washington Carver Monument complex, the first national park honoring a Black American, was founded in Joplin, Missouri.
This article first appeared on Mississippi Today and is republished here under a Creative Commons license.
Mississippi Today
Legislative recap: 2025 tax cut battle has been joined
After relatively brief debate and questioning given its magnitude, the state House passed the first meaningful legislation of the new session: House Bill 1, a measure that would eliminate the state income tax, trim taxes on non-prepared food and raise sales and gasoline taxes.
It would mark a sea change in state tax structure, a shift from income to consumption taxation.
“We are at a place where we can finally tell the hard-working people of Mississippi we can eliminate the tax on work,” House Ways and Means Chairman Trey Lamar, HB1’s author, told his colleagues.
The measure passed the House 88-24. It gained some Democratic support in the supermajority Republican House, with nine Democrats voting in favor, 24 against and 12 voting present.
The proposal garnered some bipartisan support because it includes at least a couple of items Democratic lawmakers have championed in the past: A gasoline tax to help fix crumbling roadways, and a reduction in the “grocery” tax, or the sales tax levied on unprepared food, of which Mississippi has the highest overall rate in the nation.
It still met with some Democratic opposition in part because it is a sea change toward more “regressive” taxation. Proponents say this is just, people should pay more for state services they use, such as roadways, and for things they buy as opposed to taxing income. Opponents say this places a proportionately higher tax burden on people of modest means.
“I would say the people hurt the most with this would be working people who have to put gas in their car to go to work or those who have to purchase materials to do a job,” House Democratic Leader Robert Johnson said.
Beyond that concern, opponents or skeptics worry that the foundation of the proposed tax overhaul would be built on shifting sands — a state economy that has been so rosy primarily from the federal government dumping billions of dollars in pandemic spending into Mississippi. With the federal spigot being cut off, some worry, the state economy could slump, and the massive tax cuts in this new plan could provide a state budget crisis, of which Mississippi has much experience, and underfunding of crucial services such as schools, roads, health care and law enforcement.
The largest hurdle Republican House leaders face in seeing their tax plan through to law is not in garnering bipartisan support. It’s internecine disagreement with the Senate Republican leadership, which still appears to harbor abovementioned concerns about overhauling tax structure in uncertain economic times and betting on growth to cover massive tax cuts.
Senate leaders have said they want to enact more tax cuts, but their plan has not yet been released. Lt. Gov. Delbert Hosemann has provided some details of what he wants to see, but it would appear he wants a more cautious approach on cuts. He has not publicly opined on the tax increases in the House plan.
Quote of the Week
“Have you ever worn a belt and suspenders, lady? It’s a belt and suspenders approach.” — Rep. Trey Lamar, R-Senatobia, to Rep. Omeria Scott, D-Laurel, during floor debate on Lamar’s bill to eliminate the state income tax and raise other taxes.
“No. I have not worn a belt and suspenders. I don’t know anyone who has worn a belt and suspenders,” Scott replied.
In Brief
House will renew push to legalize mobile sports betting
House Gaming Committee Chairman Casey Eure, R-Saucier, told Mississippi Today he plans on taking another crack at legalizing mobile sports betting in the state. In 2024, the House and Senate passed versions of legislation to permit online sports betting, but never agreed on a final proposal. Some lawmakers raised concerns that gambling platforms would have no incentive to partner with smaller casinos, and most of the money would instead flow to the Mississippi Gulf Coast’s already bustling casinos. Proponents say legalization would undercut the influence of illicit offshore sports betting platforms.
“I’ve been working on this bill for many years and I’m just trying to satisfy any concerns that the Senate may have so we can pass this and start collecting the tax dollars that the state deserves and not allowing everyone to place bets with these offshore accounts,” Eure said. “I feel like the state is losing between $40-$80 million a year in tax revenue.”
Sports wagering has been permitted in the state for years, but online betting has remained illegal amid fears the move could harm the bottom line of the state’s brick-and-mortar casinos. Mobile sports betting is legal in 30 states and Washington, D.C., according to the American Gaming Association. — Michael Goldberg
Hosemann makes Senate committee chair changes
Republican Lt. Gov. Delbert Hosemann last week named new chairmen of committees, after former state Sen. Jenifer Branning was sworn into office as a new justice on the Mississippi Supreme Court.
Sen. Chuck Younger, a Republican from Columbus, previously led the Senate Agriculture Committee and will replace Branning as chairman of the Transportation Committee. Sen. Neil Whaley, a Republican from Potts Camp, previously led the Senate Wildlife, Fisheries and Parks Committee, but will now lead the Senate Agriculture Committee.
Here are the other changes to Senate committees:
Sen. Ben Suber, a Republican from Bruce, will be the new chairman of the Senate Wildlife, Fisheries and Parks Committee
Sen. Bart Williams, a Republican from Starkville, is the new chairman of the Senate Public Property Committee
Sen. Scott DeLano, a Republican from Gulfport, will lead the Senate Technology Committee
Sen. Robin Robinson, a Republican from Laurel, will chair the Senate Labor Committee
Sen. Angela Turner Ford, a Democrat from West Point, will lead the Senate Drug Policy Committee. — Taylor Vance
What’s in a name? Democratic Rep. Scott hopes GOP majority will pass ‘Donald J. Trump Act’ bills
Perhaps tired of seeing many measures she authors ignored or shot down in flames by the Republican supermajority in the Mississippi Legislature, Democratic Rep. Omeria Scott of Laurel is trying a new strategy: naming bills after Republican President-elect Trump.
For this session, Scott has authored: House Bill 61, the “Donald J. Trump Voting Rights Restoration Act;” House Bill 62, the “Donald J. Trump Ban-The-Box Act … to prohibit public employers from using criminal history as a bar to employment;” and House Bill 249, the “Donald J. Trump Early Voting Act.” — Geoff Pender
More bills filed to criminalize abortion
Since the 2022 Dobbs Supreme Court decision overturned the constitutional right to an abortion, Mississippi lawmakers have proposed bills to criminalize workarounds to the state’s strict abortion ban – including criminalizing the abortion pill and out-of-state abortions. The 2025 legislative session is no exception.
Rep. William Tracy Arnold, R-Booneville, filed House Bill 616 that would make it a felony to manufacture or make accessible medication abortion. Anyone convicted of the crime would be subject to a fine between $1,000 and $5,000, as well as imprisonment between two and five years. Last year, about 250 Mississippians each month requested medication abortion from Aid Access, the only online telemedicine service supplying medication abortion via mail in the U.S.
Helping a minor receive an abortion would also be criminalized under House Bill 148 filed by Rep. Mark Tullos, R-Raleigh. That would include transporting a minor out of state to undergo an abortion, as well as helping a minor procure a medication abortion – both of which would be punishable by not less than 20 years in prison or a fine of not less than $50,000. — Sophia Paffenroth
By the Numbers
$1.1 billion
The estimated net annual cost of the House plan to eliminate the state income tax and raise sales taxes, once fully phased in. Proponents say economic growth would allow the state budget, currently about $7 billion a year, to absorb the cut. Eliminating the income tax would cost the state $2.2 billion in revenue, but the House plan would raise about $1.1 billion in other taxes in offset.
0
The amount of income tax Mississippians would pay after a 10-year phased in elimination of the state income tax. With previous cuts being phased in, state income taxes next year will already be reduced to 4%, among the lowest rates in the nation.
8.5 %
The new Mississippi sales tax, up from current 7%, under the House tax plan assuming most local governments would not opt out of adding a new 1.5% local sales tax.
13 cents more a gallon
The cost of the House’s proposed new 5% gasoline tax, based on last week’s average cost of gasoline in Mississippi of $2.62. The new 5% tax would be on top of the flat 18.4 cents a gallon current state excise on gasoline.
4%
The tax on unprepared food once a reduction of the current 7% would be phased in over a decade under the House plan. The state would over time reduce its sales tax on such groceries to 2.5%, but local governments would add a 1.5% sales tax to such items unless they opt out.
Full Legislative Coverage
Lawmakers must pass new legislation to improve access to prenatal care
Lawmakers will file another bill this session to help low-income pregnant women get into the doctor earlier – after the federal government rejected the program set up under last year’s law, because of discrepancies between what was written into state law and federal regulations for presumptive Medicaid eligibility. Read the story.
Proposal: eliminate income tax, add 5% tax on gas, allow cities, counties to levy local sales tax
House leaders last week unveiled a sweeping tax cut proposal that would eventually abolish the state income tax, slash taxes on groceries, increase local sales taxes and shore up funds for state and local road work. Read the story.
A new Mississippi law aims to limit jailing people awaiting mental health treatment. Is it working?
Officials say a new law to decrease the number of people being jailed solely because they need mental health treatment has led to fewer people with serious mental illness detained in jails – but the data is contradictory and incomplete. Lawmakers plan legislation to make more counties report the data. Read the story.
How soon we forget: Mississippi House push for record tax cuts revives fear of repeat budget crises
Eight years ago, from a combination of dozens of tax cuts the Legislature approved and a slumping economy, the state saw a budget crisis that resulted in severely underfunded schools, government layoffs, a near halt to building new roads and highways and problems maintaining the ones we have, too few state troopers on the highways and cuts to most major state services. Read the story.
NAACP legislative redistricting proposal pits two pairs of senators against each other
The Mississippi chapter of the ACLU has submitted a proposal to the courts to redraw the state’s legislative districts that creates two new majority-Black Senate districts and pits two pairs of incumbent senators against one another. Read the story.
Legislation to send more public money to private schools appears stalled as lawmakers consider other changes
Some top lawmakers in Mississippi’s Republican-controlled Legislature are prepared to make it easier for students to transfer between public schools but remain skeptical of sending more public money to private schools. Read the story.
House passes $1.1 billion income tax elimination-gas and sales tax increase plan in bipartisan vote
A bill that phases out the state income tax, cuts the state grocery tax and raises sales taxes and gasoline taxes passed the House of Representatives with a bipartisan vote on Thursday. Read the story.
Tate Reeves and other top Mississippi Republicans owe thanks to President Joe Biden
The tremendous cash surpluses that some state Republicans cite when defending their plan to eliminate the state’s income tax would not exist if not for the billions of dollars in federal funds that have been pumped into the state during Biden’s presidential tenure. Read the story.
Podcast: Mississippi transportation director discusses proposed new gasoline tax
Mississippi Department of Transportation Director Brad White tells Mississippi Today’s Geoff Pender and Taylor Vance he’s staying “in his lane” and out of the politics of a House tax overhaul that would eliminate the income tax and raise sales and gasoline taxes, but that he’s pleased lawmakers are trying to address the long running need for a steady new stream of money to help cover highway maintenance needs. Listen to the podcast.
This article first appeared on Mississippi Today and is republished here under a Creative Commons license.
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