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Working Paper

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Midwives, Lobbying, Legislative "Tucks, " Stealth Provisions, Legal Challenges to Legislation; Standing to Sue.


Two decades after the Missouri Supreme Court upheld an injunction against the practice of midwifery, two midwives became lobbyists for the cause and, with the remarkable cooperation of friendly legislators and lobbyists, got a provision inserted in a health bill legalizing the practice of tocology, a synonym for midwifery that went unnoticed by legislators who voted for the lengthy bill in which it was inserted. Medical associations sued to invalidate this "stealth" provision but their efforts failed when the Missouri Supreme Court declined to grant standing to the doctors to "protect" the interests of the public. Thirteen years later, the practice of midwifery in Missouri remains legal.

Part I "Mastering the Legislative Game With Stealth and Faith" tells the story of lobbying the legislation; Part II "The Physicians Go to Court; the Midwives "Lawyer Up'" tells the story of the legal fight to uphold the validity of the legislation.