After three days of debate, members of the House Health and Human Services Committee sent Salt Lake City Democratic Rep. Jackie Biskupski's "Direct-Entry Midwifery Act" to the House floor Friday.

Biskupski's bill would set up criteria for midwife education and training, list prescription medicines certified professional midwives could administer and gives examples of emergency situations when midwives would have to take their patients to the hospital.

Although Utah law allows women to choose to give birth at home, certified nurse midwives and doctors will not deliver babies outside a hospital because their insurance will not cover home births. And lay midwives are prevented from doing anything more than "catching" the baby - with no use of drugs, forceps or fetal heart monitors.

"Without this bill, a midwife cannot order an ultrasound or basic labwork. We can't even feel a woman's belly to determine if her baby is breech," said midwife Suzanne Smith.

"It's madness."

Each year in Utah, about 600 babies are born at home with lay midwives or doulas - midwives with less training - caring for their mothers. Utah's history of midwifery dates to pioneer times.

But lawmakers threw the practice into question in 1993, when they revised the state's medical statutes. Since then, at least one midwife has been prosecuted for illegal practice of medicine.

"I want a midwife who is free to practice appropriate care without having to worry about going to jail," said Laura Lund, holding 3 1/2 -month-old Eva, who was born at home, in her arms.

The young Riverton mother of three added: "Women did have babies before doctors got involved. And they didn't all die."

Four years in a row, lawmakers have considered legislation to legalize the practice.

But the Utah Medical Association, Utah Section of the American Society of Obstetrician/Gynecologists and some lay midwives who do not want to be regulated oppose the bill.

The doctors argue midwives should not be able to administer some drugs like pitocin and methergen to stop hemorrhaging.

Anecdotally, they say they see mothers and babies in crisis show up in hospital emergency rooms after midwives have made mistakes.

And they question the makeup of a proposed midwife licensing board, whose membership would be dominated by midwives.

Obstetrician/gynecologist Stephen Lamb said House Bill 25 essentially gives midwives authority to practice medicine and legitimizes "dangerous" home births. "This will create an illusion that [lay midwives] are well-trained. It will lend credence to this practice," Lamb said. "We're not going to keep people from doing home deliveries. But I would hope we would not encourage them."

Certified nurse midwife Rebecca McInnis said the doctors' opposition is due to misplaced pride.

"We as professionals do not want to believe that someone with less training can provide safe care," McInnis said.

After amending the bill to require collection of statistics about midwife-assisted births for five years, lawmakers sent the bill to the full House.

Biskupski's bill passed the House last year, but died in a Senate committee.