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On April 23, 2026, the Board of Registration in Midwifery opened a voice call to the public to comment on the upcoming temporary licensure for midwives in Massachusetts. Because midwives and the public can only listen to Board of Registration in Midwifery meetings and not comment nor speak to members of the Board re: midwifery licensure, the opportunity to show up and let our voices be heard was something many midwives and the public could not resist. While this "public comment call" was supposed to be about the temporary licensure, most commenters used the space to comment about their concerns currently and for the future in the licensing of MA home birth midwives. 

Here are the words I wrote, submitted in writing to the Board and read on the public comment call on April 23, 2026:

Hi my name is Joyce Kimball. I’ve been a Massachusetts home birth midwife for 26 years. I vehemently opposed licensing Massachusetts home birth midwives as I believe the act of licensing us has done exactly what I thought it was going to do - restrict access to home birth midwifery as a profession and reduced choices and options for birthing folks in Massachusetts.

When I watched the Mass board of midwifery members vote on rules and regulations and 7 out of 8 of them chose the most restrictive, conservative, non-autonomous midwifery limits in an effort to be palatable to Massachusetts medical associations and to move the licensing forward as quickly as possible, it confirmed for me that Mass home birth midwives have been thrown under the bus.

The exclusive-to-CPMs only, Mass Chapter of NACPM, was created recently, and in direct response to pushing the licensing of MA home birth midwives through. All stakeholders are not at the Mass board of midwifery table, nor are home birth midwives the biggest influence on the Board of Midwifery. I wonder if my midwife sisters thought that the state lawyer and the ob on the Mass Board of Midwifery would speak the most and have the most influence on the rules and regulations of Mass home birth birthing bodies. 

There is no recognition on the Board of Midwifery, of Massachusetts Midwives Alliance - the Mass home birth midwives inclusive trade organization that has been in existence since the 1980s. The kind, cohesive group of MA home birth midwives, connecting and attending each others births, is no more. We have had our cohesive, supportive home birth midwifery culture stolen from us and given over to state control.

The information sent from the Mass Chapter of NACPM says that this phone call is about temporary licensure. Temporary licensure that “makes possible”:  

“Entry into formal health care system conversations”

“jobs and employed roles can begin to emerge”

“masshealth coverage is expected”

“prescriptive authority becomes accessible”

These are meaningless highfalutin words.  “Entry into formal health care system conversations” means that a few license-happy folks can talk to the mass department of public health officials about how they want to structure licensed Mass home birth midwifery.

“jobs and employed roles can begin to emerge” means that maybe 5 out of the 35 home birth midwifes in Mass will be able to work at the currently non-existent birth centers.

“masshealth coverage is expected” means that maybe masshealth will cover home birth in the future. But please know this – masshealth does not currently cover any health service in Massachusetts well enough for a solo provider to live off of. And, please, for the love of *od, we cannot take on more clients to make up the poverty-level money that Mass Health may reimburse us.  There are 70,000 births in Massachusetts every year – 69200 of them in the hospital. The average Mass home birth midwife attends 20 home births per year (800 home births per year/35 midwives). It’s not the midwifery model of care to behave like the obstetrical industrial complex of taking as many clients as possible with no continuity of care.  Mass home birth midwives will not be compensated enough by mass health or any insurance company in order to accept more than 1 or 2 mass health clients per year, at a loss.

Just fyi, the birth center in western mass takes mass health. 60% of their clients are on mass health. The western mass birth center does 100+ births per year. They received, appropriately I think, close to 1 million dollars from the state to stay open; and the birth center may close soon because it does not get reimbursed enough from Mass Health and insurance.  The “masshealth coverage is expected” statement is a red herring.

“prescriptive authority becomes accessible” means that we will need to get and pay $300 - $400 per year for state permission to carry the anti-bleeding medications we currently carry to care for our clients.

Mass NACPM writes that they are wanting the Board of Midwifery to “bend” to the Midwifery Model of Care and that this molding of the licensure will happen if midwives are “engaged” and “involved”; that there are “opportunities to shape what’s next”. Bull. Do birthing folks know that board of midwifery members do not receive correspondence from constituents or other midwives? That midwives observing the board of midwifery meetings may not speak or be seen or provide any feedback to the board of midwifery? That emails to the board of midwifery are usually not answered and if they are answered, are answered by state employees? We are not allowed to contact board members directly. Board members may not speak to each other between meetings. Board meetings are stilted and overtaken by the lawyer and ob. Heck, with 26 years of experience and attending over 1200 births, I’m not allowed to be a Board of Midwifery member because my Certified Professional Midwife certification has been deemed less than and not allowed on the Board.

It’s over. We are licensed. We have a board of midwifery that ices out input, is stiff and formal and quiet and has already started to over-regulate us. We have had autonomous midwifery taken from us in exchange for a piece of paper that says that we can do what we’ve been doing for the past 50 years but only if we follow what the state says. And we will be punished if we don’t follow the state’s rules. The system has won. The humans have lost.

I agree with every specific recommendation in the Mass Midwives Alliance letter.

I sure would love to see my midwife sisters on the board hold firm and never let go of autonomous Midwifery Model of Care. Only 9 states in the U.S. have no restrictions on abortion. I hope Massachusetts can be the state that has no restrictions on home birth midwifery.

My only personal ask is that we keep the spirit and provision in the rules and regulations that with documented informed choice, birthing folks can choose to accept or decline any provision in the statue. Protect the Midwifery Model of Care. Protect birthing peoples’ choices.

Thank you.