The Family Journey

Are you following the CO Midwifery DORA Sunset Review? Here’s a great birth story/article from Westword featuring a local homebirther and midwife.

A PUSH ALERT from the Big Push For Midwives

http://www.thebigpushformidwives.org/index.cfm?fuseaction=enews.signup

NOV 15, 2010 — There is amazing pushing afoot! It is URGENT that we all push together to help Illinois fill the terrible shortage of home birth providers. Together, we can do it!!

The Home Birth Safety Act (SB 3712) to license CPMs in Illinois is being voted on in the House of Representatives this week, even as early as Wednesday, Nov. 16!

We need everyone in Illinois to call their Representatives and to forward this message to their family and friends in Illinois TODAY.

Here is the message that every Representative in Illinois needs to hear:

“I want to let the Representative know that Speaker Madigan has just reviewed the Home Birth Safety Act and improved the bill with an amendment. The bill is definitely going to be called this week. Will the Representative vote Yes for the bill on the House Floor?”

If anyone tells you “this is not the right act,” tell them the Home Birth text is in House amendment 001.

* Legislators can be looked up (Legislator Lookup) here: http://www.elections.il.gov/DistrictLocator/DistrictOfficialSearchByAddress.aspx
* If you can call Monday, please call the Representative’s district office, and if Tuesday is better, call his/her Springfield office.

The Illinois State Medical Society has been spreading misinformation saying the bill will not be voted on. NOT TRUE. House leadership has assured us a vote, but we need the grassroots to bring it home.

So make the call today and spread the word to everyone you know in Illinois!

After you make your calls, please send a text to report the results to me at the phone number below. Otherwise, please send an email to the email address.

Thank you from all of us Pushers in Illinois!

Rachel Dolan Wickersham, CD(DONA), LCCE
President, Coalition for Illinois Midwifery
Vice President, Illinois Council of Certified Professional Midwives
Jiandra@aol.com
630-750-9444

P.S. Again, please spread this far and wide – to your friends, family, and to all other lists! Even to folks outside of the birthing community. We look forward to keeping you informed of our progress thanks to your support!

The 2011 legislative session will have the opportunity to expand midwives’ responsibilities and further ensure they have adequate tools and permission to provide optimal care for their clients. See the DORA summary for details, then contact the CO state government with your support for broadening midwives’ scope of practice.

This just came in my inbox from The Big Push for Midwives Campaign:

Guess Who’s Coming to Dinner? ……

INA MAY GASKIN!

Donate $25 or more to The Big Push for Midwives Campaign before 6:00 a.m. Monday, September 14 and you could have dinner with Ina May Gaskin!

All you need to do is make a donation of at least $25 via the website and share a word or phrase that describes what having access to out-of-hospital birth options with CPMs means to you. See directions at the end for where to enter your word or phrase.

If you are selected, Ina May will come to your home to break bread with you. She will also make herself available for a public event while she is in town to raise funds for your work on behalf of CPMs and out-of-hospital maternity care.

While you tell all of your friends what you’re doing to win dinner with Ina May Gaskin, The Big Push for Midwives team will be putting your donation to good use to keep ACOG on the defensive by:

* Reframing the debate around homebirth in major media outlets by continuing to develop compelling talking points and cultivating relationships with key reporters and bloggers
* Applying consistent pressure to legislators to make sure that Certified Professional Midwives are incorporated into healthcare reform at the state and federal levels
* Providing assistance to leaders in states who are pushing back against the well-financed and coordinated opposition to licensure legislation across the country.

You have until 6:00 a.m. on Monday, September 14 to make a minimum donation of $25 and share a word or phrase that describes what having access to out-of-hospital birth options with CPMs means to you. The winner will be announced on Tuesday. If you have any questions, please contact Katherine Prown, Campaign Manager for The Big Push for Midwives Campaign.

Secure online donations can be made through the Big Push for Midwives Contribute page as well as through Paypal by clicking on the Donate button on the home page.

On the secure donation page, add your word or phrase where it says “Please send acknowledgment of this gift to:” If contributing through Paypal on the homepage, put your word or phrase in the “Special Instructions to Seller” box.

Thank you for your support of mothers, babies and families!

The Push Team

Doctors Marti Glenn, Marsden Wagner and Sarah Buckley, along with many other respected birth professionals, join forces to help create better healthcare policies in the film Reducing Infant Mortality and Improving the Health of Babies.

OSU Study Reveals Conflict between Doctors, Midwives over Homebirth

CORVALLIS, Ore. Two Oregon State University researchers have uncovered a pattern of distrust—and sometimes outright antagonism—among physicians at hospitals and midwives who are transporting their homebirth clients to the hospital because of complications.

Oregon State University assistant professor Melissa Cheyney and doctoral student Courtney Everson said their work revealed an ongoing conflict between physicians and midwives, similar to that found in other studies of the dynamics between the two groups across the country.

The pair recently examined birth records in Oregon’s Jackson County from 1998 through 2003, a period when that county saw higher-than-expected rates of prematurity and low birth weight in some populations. The researchers wanted to assess whether those rates were linked to midwife-attended homebirths.

The findings revealed that assisted homebirths did not appear to be contributing to the lower-than-average health outcomes and, in fact, that the homebirths documented all had successful outcomes. But even more importantly to Cheyney, discussions with doctors and midwives uncovered a deep mistrust between the two groups of birthing providers, with doctors expressing the firm belief that only hospital births are safe, while midwives felt marginalized, mocked and put on the defensive when in contact with physicians.

“We’ve been getting insight into their world view, and it’s been quite illuminating,” Cheyney said.

Cheyney, who is a practicing midwife in addition to being an assistant professor of medical anthropology and reproductive biology, said she was surprised that physicians, when presented with scientifically conducted research that indicates homebirths do not increase infant mortality rates, still refuse to believe that births outside of the hospital are safe.

“Medicine is a social construct, and it’s heavily politicized,” she said.

She is working with Lane County obstetrician Dr. Paul Qualtere-Burcher to draft guidelines that would help midwives and their clients decide when they need to seek medical help, based in large part on Cheyney’s research, and another that would ask physicians to recognize midwives as legitimate caregivers.

Qualtere-Burcher said creating an open channel of communication isn’t easy.

“I do get some pushback from physician friends who say that I’m too open and too supportive,” he said. “My answer, to quote (President) Obama, is that dialogue is always a good idea.”

Qualtere-Burcher said he believes that if midwives felt more comfortable contacting physicians with medical questions or concerns, there would be a greater chance that women would get medical help when they needed it.

“Treat (midwives) with respect, as colleagues, and they’ll not be afraid to call,” he said.

While Qualtere-Burcher believes it would be wonderful, but Utopian, for all midwives to agree to seek medical assistance under the guidelines they’re proposing, and for all physicians to learn to deal more collegially with midwives, he hopes that if a small group on each side agrees to the plan, it will provide more evidence that a stronger relationship between physicians and midwives will lead to better outcomes for mothers and infants.

Last year the American Medical Association passed Resolution 205, which states: “the safest setting for labor, delivery and the immediate post-partum period is in the hospital, or a birthing center within a hospital complex” The resolution was passed in direct response to media attention on home births, the AMA stated.

What is interesting, Cheyney points out, is that 99 percent of American births occur in the hospital, but the United States has one of the highest infant mortality rates of any developed country, with 6.3 deaths per 1,000 babies born. Meanwhile, the Netherlands, where a third of deliveries occur in the home with the assistance of midwives, has a lower rate of 4.73 deaths per 1,000.

One of the biggest problems Cheyney sees is that physicians only come into contact with midwives when something has gone wrong with the homebirth, and the patient has been transported to the hospital for care. There are a number of reasons why this interaction often is tension-filled and unpleasant for both sides, she says.

First is the assumption that homebirth must be dangerous, because the patient they’re seeing has had to be transported to the hospital. Secondly, the physician is now taking on the risk of caring for a patient who is unknown to them, and who has a medical chart provided by a midwife which may not include the kind of information the physician is used to receiving.

And because the midwife is often feeling defensive and upset, Cheyney said, the contact between her and the physician can often be tense and unproductive. Meanwhile, the patient, whose intention was not to have a hospital birth, is already feeling upset at the change in birth plan, and is now watching her care provider come into conflict with the stranger who is about to deliver her baby.

“It’s an extremely tension-fraught encounter,” Cheyney said, “and something needs to be done to address it.” As homebirths increase in popularity, she added, these encounters are bound to increase and a plan needs to be in place so that doctors and midwives know what protocol to follow.

“We’re having a meeting in early May to propose a draft for a model of collaborative care that might be the first of its kind,” in the United States, Cheyney said.

Cheyney is also pushing to get hospitals and the state records division to better track homebirths. The department of vital records had no way to indicate whether a birth occurred at home until 2008, and without being able to pull data, Cheyney said it’s hard to explore the nature of home birth in Oregon.

She’s also working on education programs for midwives in rural areas, including a cultural competency piece as demographics in Oregon continue to change.

From Midwifery Today E-News 11:13. You can subscribe here.

The Midwives and Mothers in Action (M.A.M.A.) Campaign is
launched! The goal of the M.A.M.A. Campaign is to increase
women’s access to midwives and to quality, affordable
maternity care by securing federal recognition of Certified
Professional Midwives (CPM). We have hired a federal lobbyist, a
campaign manager will be hired by next week, and the M.A.M.A.
Campaign website is almost complete.

This campaign is a partnership of the National Association of
Certified Professional Midwives (NACPM), Midwives Alliance of
North America (MANA), North American Registry of Midwives (NARM),
Midwifery Education Accreditation Council (MEAC), Citizens for
Midwifery (CfM), and International Center for Traditional
Childbearing (ICTC). This historic partnership is now at work to
get federal recognition of Certified Professional Midwives so
that women and families will have increased access to quality,
affordable maternity care in the settings of their choice. We
look forward to working with everyone who supports this work and
in concert with other national initiatives to achieve our common
goals.

Our federal lobbyist, a specialist in health policy, will move
our agenda in Washington, D.C. Billy Wynne is a former Senate
staffer, an expert in Medicaid and health care reform, with a
diverse portfolio of connections. He is excited to be promoting
the values and important services provided by Certified
Professional Midwives and is implementing a strategy with the
M.A.M.A. campaign steering committee, based on our priorities,
for achieving success in this Congress.

A campaign manager will be hired by next week to work with the
network of volunteers already lining up to support the M.A.M.A.
Campaign. A campaign website is nearing completion; watch for
the website launch announcement at the end of this week!

Your support will be essential to the success of the campaign.
Watch for weekly updates and action alerts about how you can
become involved!

We look forward to working with you in this effort!

The M.A.M.A. Campaign Steering Committe

…that maternity care needs an overhaul. Fill out the form via this link. See below for a great explanation and some ideas about what to write.

From Susan Hodges, Citizens for Midwifery:
Dear Friends,

Katherine Prown sent a message to the members of The Big Push for
Midwives Campaign with a request to forward it to state lists and
midwives, as well as friends and family, so I am forwarding it here. We
can each take advantage of every opportunity that becomes available to
make sure our message gets to the Federal Government: Recognize
Certified Professional Midwives so all women, including those on
Medicaid, can have access. Care from Certified Professional Midwives
improves outcomes and saves everyone money!

Sincerely,

Susan Hodges “gatekeeper”

——————–
Subject: Let’s set a record! NEW action alert!

As many of you may know, the White House issued a call this week asking
citizens from across the country to send emails about what they would
like to see in health care reform. Not long afterwards, the server
accepting the emails crashed.

Why? Because it got flooded with emails about the President’s birth
certificate!

Now the press is reporting about it, just as they did when grassroots
organizers for the legalization of marijuana set the record for the most
number of emails sent during the transition—a mere 6000. We can top that!

It turns out there is another, lesser-known online form for submitting
comments about health care reform. Let’s use it!

If we top 6000 emails—and I know we can—we will set a new record and
get the White House’s attention on how strong support for
out-of-hospital maternity care and Certified Professional Midwives is.

So please go to the following link and *fill out the form with a short,
simple message about why you want all women, including those on
Medicaid, to have access to out-of-hospital maternity care and Certified
Professional Midwives who are specially trained to provide it.*

http://www.facebook.com/l/;http://www.healthreform.gov/communityreports/comments.html

Pick one or two points to include in your own words: And *always use the
title, Certified Professional Midwives, spelled out.*

* Certified Professional Midwives are specially trained as experts in
out-of-hospital maternity care and deliver babies in private homes and
in freestanding birth centers.

* Research consistently shows that low-risk women planning to deliver
their babies at home under the care of Certified Professional Midwives
experience outcomes equal to low-risk women who deliver in the hospital,
but with far fewer costly and preventable interventions, including a
five-fold decrease in cesarean section.

* Babies delivered under the care of Certified Professional Midwives
have significantly reduced rates of prematurity and low-birth weight,
two of the leading contributing factors to racial and ethnic disparities
in birth outcomes and to the costs associated with long-term care.

* David Anderson, Professor of Economics at Center College with a
specialization in the costs of out-of-hospital maternity care,
calculates that increasing use of Certified Professional Midwives and of
out-of-hospital maternity care by less than 10% would result in savings
of $9.1 billion annually, while actually improving outcomes.

* The state of Washington reports a savings of $3.1 million dollars over
a period of two years to the state Medicaid system when women
experiencing healthy, low-risk pregnancies give birth with licensed
midwives instead of in the hospital.

* The recent Milbank Report conservatively estimates savings of $2.5
billion dollars a year if the cesarean surgery rate is brought down to
15% in the U.S.

* Certified Professional Midwives are the only providers specially
trained in out-of-hospital birth in the event that hospitals become
unsafe for healthy pregnant women during a disaster.

Thank you to everyone who is reaching out—it only takes a few minutes
but it is so very helpful. We are making amazing progress in DC and now
is not the time to let up! So please forward this to family and friends
who can help,
and thank you for doing your part to get Certified Professional Midwives
and out-of-hospital maternity care included in health care reform.

ATTENTION MIDWIVES! Yes, we are shouting at you! Please send this action
alert with a personal appeal to your networks of clients—it only takes
a few minutes, and people are especially motivated to act when they get
a personal request from their midwife.

STATE GROUPS! Please be sure to post this alert to your state lists!

Katherine Prown, PhD | Campaign Manager |

http://www.facebook.com/l/;TheBigPushForMidwives.org

|

http://www.facebook.com/l/;414.550.8025

| JOIN US on Facebook! | SIGN UP
for PushAlerts

Envisioning a safer, less-costly model of maternity care in the United
States.
——————–

According to the Cochrane site, “The Cochrane Library is a collection of databases that contain high-quality, independent evidence to inform healthcare decision-making. Cochrane reviews represent the highest level of evidence on which to base clinical treatment decisions. ”
This review concludes “that all women should be offered midwife-led models of care.”

Wonder what the AMA and ACOG say about this review?