Ensuring greater access to certified professional midwives (CPMs) is one way to address some of the distressing challenges facing pregnant and birthing women in this country. The Big Push, specifically, is asking for the Senate bill to include an amendment that would ensure CPMs are covered under Medicaid; this would encourage a uniform certification process for midwives in this country as well as make homebirth and CPM facilitated birth accessible to all women – not just those who can afford to pay for these services out-of-pocket.

Ask that your Senator take the lead in sponsoring an amendment to provide Medicaid payment for the services of Certified Professional Midwives, who are the only type of midwife in the U.S. with specialized training in out-of-hospital maternity care.

There has been stong interest on the issue of the future of private midwifery since the Health Minsiter’s announcement that clarified the meaning of “collaborative practice”. Collaborative practice will mean that every private midwife must have a collaborative agreement with a private obstetrician who can effectively sign off on the midwife’s work. If s/he does not agree with the plan of care for the woman, the obstetrician may sever the collaborative arrangement. Furthermore, with RANZCOG and the AMA being opposed to home birth, home birth will not be an option in the private system, as it is currently. The exemption that was granted to home birth will have no meaning since collaborative arrangements will be a requirement for registration for private midwifery practice.

In March of this year, Nova Scotia became the first Atlantic province to legislate and regulate the profession of midwifery. While this move was celebrated by many as a step forward for women and families, activists with close ties to the midwifery movement feel their work is far from complete.

“All birthing women need a choice of where they birth and who their caregiver is—I think good midwife and family-led legislation could provide that,” remarks Halifax doula Lindsay Miller. “Yet here we are so tangled up in bureaucracy and old school policy that the potential benefits of legislation are not being seen by the people it is meant to serve.”

For many women in Nova Scotia, access to care based on the Canadian midwifery model—a model based on tenets of continuity of care and choice of birth place—has actually become more difficult since the introduction of legislation, rather than less.

Women do not lose their constitutional or common law rights by becoming pregnant.

Today, people who understand their rights as patients are more likely to successfully negotiate the health care system, use health insurance and managed care plans, and work with physicians and other health care professionals. Most important, a just health care system requires respect for the rights of patients.

There has been much discussion about using schools for an “all out” vaccination campaign this fall, for both the regular flu shot and the new H1N1 vaccine.1 According to authorities, students would ideally be vaccinated before school starts, but the swine flu vaccine won’t be available until mid-October, making schools a logical place to begin mass vaccination.

An OB-GYN recently reported (via e-mail) that litigation feels devastating to a physician who takes pride in their expertise and caring. Litigation is often a factor in depressive symptoms and suicide in physicians and one Texas physician is reported to have left a suicide note the day he settled a lawsuit which read, “I hope that my death will shed light on the problem of dishonest expert testimony.”

http://www.theunnecesarean.com/blog/2009/9/11/acog-releases-survey-results-ob-gyns-ultimately-hurt-patient.html

Joy Szabo, 32, said she is upset with Page Hospital’s general ruling in June prohibiting vaginal births after cesareans (VBAC). The mother of three children, she has given birth to all of her children at Page Hospital, the only hospital in the immediate area. A placenta eruption caused her to have an emergency cesarean delivering her second child, but the hospital allowed her third child to be delivered naturally two years ago.

http://www.lakepowellchronicle.com/v2_news_articles.php?heading=0&story_id=1849&page=77

A hearing is went on yesterday afternoon on a proposed rule on tamper-resistant prescriptions, but there has apparently been a push for a language change in the proposed rule that could effectively keep nurse midwives and nurse anesthetists from doing their jobs, as it would exclude them from having the authority to prescribe medications.

The problem lies in a section of the rule [PDF, 0880-02-.23 2(b)] defining who is a “prescriber”

An LA Restaurant was recently fined for firing an employee that breastfed her baby during her breaks. As you can imagine this did not go over very well with the community of breastfeeding moms or the legal department.

Jesus Acosta, the owner of Acosta Tacos, has been fined $46,000 for firing Marina Chavez.

The recommendations to come from The Senate Inquiry held last month have been published. You can read the full document in PDF here. The most relevant recommendation to homebirthers can be found on pages 18-19.

Congress Invited to Attend Issue Briefing on Maternity Care and the Role of Out-of-Hospital Birth in Reducing Costs, Improving Outcomes

Expert Panel to Address the Need to Include Services of Certified Professional Midwives in Health Care Reform

This Thursday, May 21st, at 8 am, a Congressional briefing will convene at the Sewall-Belmont House, 144 Constitution Ave. N.E., Washington, D.C. The topic of this briefing is the critical role that out-of-hospital maternity care (and the Certified Professional Midwives who are trained to provide it) can play in health care reform by reducing costs and improving outcomes.

Background: A recent study commissioned by the Washington State Department of Health found that Licensed Midwives saved taxpayers and private insurers approximately $2.7 million per year. A similar study conducted for Florida would prove that number much higher. In 2007, we welcomed 239,143 babies into the Sunshine State, as opposed to 88,958 in Washington. Medicaid currently covers about 49.6% of all Florida births (37.2% of which are cesarean sections) vs. 45.6% in Washington (29% c-section rate). Using these statistics, mathematics tells me that Licensed Midwives in Florida save taxpayers and private insurers over $10 million ANNUALLY.

There are only about twenty certified professional midwives in Ohio, but a group that represents them says there are many more people who are working as midwives without any sore of certification or license. The group is pushing for legislation that would give midwives more credibility under the law. Stephanie Beck-Borden is the chair of Ohio Families for Safe Birth, and says right now there’s no definition of midwives in the law and no guidelines for what they can and can’t do.

For the past 25 years, women in North Carolina who wanted to deliver their babies at home have had very little choice in health care practitioners. Because independent midwifery is illegal here, with few exceptions, families are primarily served by practitioners licensed in other states or not licensed at all.

A bill pending in the N.C. General Assembly aims to change that, allowing for the first time in a quarter-century for midwives who operate independently from physicians to practice legally and seek licensure.

While the legislation as currently drafted is unlikely to provide women with any more choice in practitioners, the bill’s very existence represents a significant step toward normalizing midwifery care in the state, as it recognizes there is a large underserved population—as well as the fact that many midwives are meeting that need by practicing illegally.

A historic moment is upon us. House Bill 333 will be heard in the House Health Committee within the next week and in time to pass the North Carolina House of Representatives in time to meet the cross-over deadline of May 14th.

Your mission is to:

Send an e-mail to every member of the House Health Committee urging their support of HB333, and Call their offices reinforcing the e-mail.

Please continue to read for additional important information.

A little history…after last year’s House Select Committee on Licensing Midwives concluded, a report was issued containing recommended bill language. That bill language automatically gets filed (this is standard process) and the Chairs of a study committee are automatically established as primary sponsors of the recommended (in our case with HB333 , Dr. England and Rep. McLawhorn) bill. Since December when the report was issued, we recognized some amendments are needed to make HB333 really work for us; however, there are several opportunities to make our changes as the legislative process unfolds.

Initially, we were informed that HB333 would first go to the Legislative Committee on New Licensing Boards. Well, to make a long story short, that didn’t happen. So, our bill (HB333) will go directly to the House Health Committee to be heard.

Our primary objective is to pass favorably through the House Health Committee. To be successful, we need to:

Successfully pass the House Health Committee, then Pass the second committee meeting (probably not hard unless we get surprised), and finally Pass the floor of the House of Representatives.

After this, if it happens before May 15th, we will go to the Senate and Sen. (Dr.) Purcell’s Health Committee and then the Senate floor. We can amend HB333 in the Senate Health committee, or the Senate floor if need be.

So, we need to focus on our next step, which is to make the members of the House Health Committee understand how important it is to support HB333.

Your mission is to:

Send an e-mail to every member of the House Health Committee urging their support of HB333, and Call their offices reinforcing the e-mail.

If you are a constituent, it is really important that you say so. Please use your own words and the key message is to urge their support for HB333. You can find the contact information (e-mail and phone number) for each member of the House Health Committee here:

http://www.ncga. state.nc. us/gascripts/ Committees/ Committees. asp?sAction= ViewCommittee&sActionDetails= House%20Standing _26

Our bill could be heard as early as Thursday, May 7th (day after tomorrow), so if at all possible, please send your messages tomorrow (Wednesday) to the House Health Committee members. You do not need to mention amendments as we will be working on that with our supportive legislators to determine whether to amendment now or later.

It’s time to run up the hill one more time.

Russ

Russ Fawcett
Legislative Co-Chair, NCFOM

While physicians can certainly establish and/or work at birth centers, the birth center is commonly associated with midwifery care. We have about 300 midwives of both CNM and CPM credentials. About 50 of these midwives attend now, or have attended, homebirths in Minnesota.

Should the bill pass, the appearance of many birth centers in our state would make many midwives needed here.
The first birth center, Morning Star Womens’ Health and Birth Center, opens June of 2009 in St. Louis Park, MN. The new birth center is independent of the bill and opens coincidentally. Several midwives are needed now. Paula is looking for midwives with out-of-hospital birth experience.

http://spinningbabies.blogspot.com/2009/04/chance-to-promote-midwifery.html

The commission was established in response to more nurses and midwives having greater responsibilities in most areas of clinical care. It aims to consider how to build upon their expanding roles to help them contribute further to delivering high quality health care.

The Commission will report to the Prime Minister by March 2010.

http://www.nursingtimes.net/whats-new-in-nursing/pms-commission/commission-on-future-of-nursing-and-midwifery-meets-for-the-first-time/5000936.article

A recently revised Position Statement from the ACNM seeks to limit recognition of midwifery providers to those who have received their training through government accredited programs. NARM oversees the credentialing of midwives who have received their training through time honored and evidenced based systems that emphasizes clinical competency over all other criteria. This letter seeks to unite US Midwifery under the common goal of increasing access for women to the provider and setting of their choice.

http://www.thepetitionsite.com/1/support-evidenced-based-midwifery-education

But work is ongoing to find a solution that permits women to safely give birth at home.

http://www.wyomingnews.com/articles/2009/04/12/news/20local_04-12-09.txt

It describes the Nursing and Midwifery Student Bursary ( NMSB) Scheme in Scotland, who is eligible for it, what it is (including current rates) and how you can apply for it. This booklet is for guidance only. It cannot cover all individual circumstances. The scheme is administered by the Student Awards Agency for Scotland ( SAAS).

http://www.scotland.gov.uk/Publications/2009/04/01091610/0

House Bill 226, which died March 4 in the Health Care Availability and Accessibility Committee, would have expanded child birth options for expecting mothers and prevented pregnant women from hiring unqualified midwives or giving birth at home without medical supervision, said Colette Bernhard, legislative chairwoman for the Coalition for Illinois Midwifery.

http://www.chicagotalks.org/2009/03/24/midwives-will-not-receive-illinois-licensure-to-assist-in-home-births-anytime-soon/

A bill that would have made licensing voluntary died in the Legislature last year after objections from doctors and hospitals.

The Senate voted 32-3 Wednesday for the measure, which requires midwives to be licensed by the North American Registry of Midwives, a national organization that governs the profession. It would also require them to get extra training in suturing and pharmacology.

The bill now awaits approval from Gov. C.L. “Butch” Otter. Senate sponsor Shawn Keough, R-Sandpoint, said the governor has indicated his support and willingness to quickly appoint a governing board.

The bill also defines scope of practice, which would forbid people without proper training from handling drugs like oxytocin during deliveries.

The roughly 40 midwives currently operating across the state would have one year to qualify for a license. The bill also contains a clause to waive the license if a midwife has been practicing in the state for five years and has been the primary midwife for at least 75 births within the last 10 years.

http://www.theolympian.com/northwest/story/798401.html

The Midwifery Act comes into effect Wednesday, March 18.

“We are moving towards teams of health-care professionals working together to provide care to Nova Scotians in their communities,” said Health Minister Karen Casey. “Midwives are key team players in providing the right care to mothers and their families.”

http://www.gov.ns.ca/news/details.asp?id=20090316004

The Midwifery Act comes into effect Wednesday, March 18.

“We are moving towards teams of health-care professionals working together to provide care to Nova Scotians in their communities,” said Health Minister Karen Casey. “Midwives are key team players in providing the right care to mothers and their families.”

http://www.gov.ns.ca/news/details.asp?id=20090316004

LaNisa Allen, a former general laborer at a Totes/Isotoner Corp. warehouse in West Chester, is suing the company, saying it engaged in illegal gender discrimination by denying her extra restroom breaks to relieve pain caused by breast milk engorgement. She said other Totes workers weren’t required to seek permission for extra restroom breaks to relieve discomfort from menstrual symptoms or the need for frequent urination.

http://www.daytondailynews.com/n/content/oh/story/news/local/2009/03/05/ddn030509breastweb.html

http://blogs.babycenter.com/momformation/2009/03/09/another-state-law-supporting-breastfeeding-mothers-takes-effect/

The fact that it did this in the face of having received the majority of its submissions from homebirth parents is galling and speaks volumes for the way “public consultation” occurs in this country. But the fact that the report’s recommendations, if accepted by the Government and made law, would criminalise the high quality care currently delivered to women who choose to give birth at home by registered, professional, independent midwives to their clients is radical and dangerous.

http://www.sydneymidwife.com.au/2009/03/homebirth-ban/

Legislation to legalize midwifery died in a House committee Wednesday.

But members of the House Labor, Health and Social Services Committee had a mixed reaction to Senate File 141.

Representatives Patrick Goggles, D-Ethete, and Kathy Davison, R-Kemmerer, said they were originally in favor of the legislation, but a couple hours of public testimony raised too many concerns to move SF 141 forward.

http://www.wyomingnews.com/articles/2009/02/26/news/19local_02-26-09.txt

Midwives and Birth Centers in Washington State can obtain Professional Liability Insurance from only one place: the JUA (Joint Underwriting Assoc, http://washingtonjua.com/). The JUA was set up by state law in 1994, and is funded primarily through midwife premiums. Senate Bill 5588 has a list of State Boards and Commissions that will be shut down as part of cost-cutting efforts, and for hard-to-fathom reasons, they’ve included the JUA in that list despite the fact that the JUA receives no state funding of any kind.

Without the JUA, midwives will not be able to get liability coverage, and therefore their services will not be covered by your health insurance. This will put midwives and birth centers immediately out of business.

We need you to call and email your representatives and senators in Olympia TODAY to tell them that this move will cost far more money than it saves, whilst also eliminating a much needed resource for women and their families. A recent Department of Health study found that midwives save the state $250,000 per year, and (if you include private insurance too) that number climbs to $1.3million per year. So clearly it makes no sense to eliminate midwifery in the pursuit of saving money.

Click here to find who your legislators are: http://apps.leg.wa.gov/DistrictFinder/Default.aspx

Please forward this email widely. It is going to take a lot of voices to get this bill altered.

http://community.livejournal.com/naturalbirth/1237791.html

Starting Sunday, mothers will be able to breastfeed their babies in any public space.

The law also gives women the right to claim civil rights violation, if they are prevented from breast-feeding in public.

http://www.wpri.com/dpp/news/local_news/local_wpri_new_breastfeeding_law_to_go_into_effect_20090227

The citizenship of hundreds, possibly thousands, of people who insist they are Americans is being called into question because they were delivered by midwives near the U.S.-Mexico border. The federal government’s doubts have arisen as many people in the border region try to meet a June 1 deadline to obtain U.S. passports so they can freely cross from one country to the other.

http://latinainstitute.wordpress.com/2009/02/24/discrimination-against-latinos-born-to-midwives-soon-to-have-big-impact/

Voices decided to do some investigating and found that a group called South Dakota Safe Childbirth Options was a part of the influx in letters.

http://www.argusleader.com/article/20090116/VOICES/901160305/1052/OPINION01

http://www.babble.com/CS/blogs/strollerderby/archive/2009/02/11/South-Dakotans-Don_2700_t-Support-Home-Birth-Or-Do-They.aspx

The bill that died in the legislature last year would have made licensing voluntary and drew the ire of groups such as the Idaho Medical Association. Currently Idaho requires no license or certification to be a midwife, but midwives are recognized by state law.

http://www.argusobserver.com/articles/2009/02/20/news/doc499efaaeed92e447989098.txt

It recommends appropriately-qualified midwives being able to access Medicare and the Pharmaceutical Benefits Scheme and suggests the government provides professional indemnity insurance support to midwives, however it rejects Commonwealth funding for home births.

http://topnews.us/content/23783-review-suggests-greater-role-midwives

http://www.medicalnewstoday.com/articles/139810.php

Crystal Everitt says she was asked to leave Denny’s on Patton Avenue Sunday because she was breastfeeding her child. Denny’s Regional Director Rick Pate tells News 13 complaints poured into management and some patrons left. He says a manager asked Everitt to cover herself or go somewhere more private.

http://www.wlos.com/shared/newsroom/top_stories/wlos_vid_2111.shtml

Today midwives from around the state showed up to the state capital to thank legislators with homemade cookies for the recent change in law that legalizes midwifery.

“We’re not asking for more,” Missouri Midwives Association former president Debbie Smithey said.

She said the next step for them is to “see what it’s like to practice legally.”

http://www.stltoday.com/blogzone/political-fix/political-fix/2009/02/midwives-babies-hit-missouri-capitol/

However, a bill before the General Assembly might bring them into a closer working relationship. At least, that’s the hope of certified professional midwife, Brynne Potter.

Del. Matt Lohr, R-Harrisonburg, has introduced a bill that would amend the regulation of midwifery.

It would require that midwives inform patients of potential risks associated with delivering at home, “including but not limited to special risks associated with vaginal births after a prior C-section, breech births, births by women experiencing high-risk pregnancies, and births of twins or multiples.”

http://www.nvdaily.com/lifestyle/2009/02/legislation-would-impose-new-r.html

Now, Rep. Mike Talboy, D-Kansas City, is trying to repeal the provision.

Talboy has introduced HB476, which would repeal a single sentence. That sentence allows people who hold “ministerial or tocological certification by an organization accredited by the National Organization for Competency Assurance” to provide services dealing with obstetrics.

http://www.stltoday.com/blogzone/political-fix/political-fix/2009/02/rep-mike-talboy-tries-to-repeal-midwives-law/

http://www.latimes.com/news/opinion/commentary/la-oe-block9-2008jul09,0,3357453.story