Prior to the modern era of specialization in medicine -- particularly in prenatal care -- there was always a woman in the village, the small town, or somewhere in the family that people went to for sore throats, who knew a lot about herbs and home remedies, and who was willing to assist in the birth of a baby. Parteras serving the Spanish speaking population and "granny ladies" in rural Texas are part of the traditional folklore and cultural legacy of Texas history, from the time of the Texas Republic and before. In 1925, more than 50 percent of the babies born in Texas were delivered by midwives. This reflected the rural and working poor population in Texas, among whom low income was a barrier to institutional medical care.
Historically, Acts of the legislature regarding such public health practices as eye care at birth, registration of birth, detection of sexually transmitted disease, and newborn screening for phenylketonuria or diabetes, have recognized midwives as practitioners. Yet prior to 1983, Texas did not regulate midwives. However, two cities along the Texas-Mexico border, where economic conditions and tradition made lay midwifery a widely accepted practice, adopted municipal ordinances requiring a permit to practice lay midwifery. In Banti v Texas, 1956, a midwife was accused of practicing medicine without a license (the baby was stillborn) and unlawfully treating the mother "for a disease and physical disorder". Mrs. Banti argued that childbirth is not a disease or a disorder, but nevertheless was convicted by the local court. However, on appeal, the court overturned the conviction because the state legislature had "not defined the practice of medicine so as to include the act of assisting women in parturition or childbirth".
In 1983, the Texas legislature passed the Texas Midwifery Act, because of rising concern among legislators over the lack of regulation of direct entry midwives. (Certified Nurse Midwives are regulated by the Texas Board of Nursing
.) Please see additional information on this website regarding the Texas Midwifery Board, which regulates licensed midwives, including the Texas Midwifery Act and Midwifery Rules. Please see additional information on this website regarding the Texas Midwifery Board, which regulates licensed midwives, including the Texas Midwifery Act and Midwifery Rules.
Birth certificates must be registered with the county clerk in the county of birth or residence within 5 days. Only licensed midwives are authorized to obtain birth certificates and file them with the clerk.
As prescribed by Texas law, the licensed midwife:
- Assists only in normal childbirth
- Does not perform Caesarean sections;
- Does not use forceps or surgical instruments for any procedure other than cutting the umbilical cord or providing emergency first aid during delivery;
- Does not perform an episiotomy;
- Does not remove the placenta by invasive techniques;
- Does not advance or retard labor or delivery by using medicines or mechanical devices;
- Does not assist at childbirth other than normal childbirth except in an emergency situation that poses an immediate threat to the life of the mother or newborn;
- Does not administer a prescription drug except as an agent of a physician licensed by the State of Texas (other than eye prophylaxis for the newborn and oxygen in accordance with board rules).