Violence in Maternity Care

The non-profit organization Solace for Mothers: Healing After Traumatic Childbirth is asking anyone who has experienced or has witnessed violent maternity care, to write a letter to Lynn Rosenthal, the presidential advisor on violence against women, and First Lady Michelle Obama.

Solace explains:

We invite you to join us in writing to Lynn Rosenthal and Michelle Obama in an effort to bring awareness to the violence women experience at the hands of some maternity care providers. First Lady Michelle Obama has made recent remarks championing the rights of childbearing women, and may be an ally for this cause. Lynn Rosenthal is a former executive director of the National Network to End Domestic Violence.

We are calling for an official review of perinatal practices to investigate common and flagrant violations of patients? rights; mainly the right to informed consent and refusal. We are asking that enhanced and enforced mechanisms for accountability follow the investigation.

What can be considered violent maternity care? Solace states,

The World Health Organization (WHO) defines violence in this way:

“the intentional use of physical force or power, threatened or actual, against oneself, another person, or against a group or community, that either results in or has a high likelihood of resulting in injury, death, psychological harm, maldevelopment, or deprivation.”

Violence in maternity care is expressed in many different ways. There can be physical violence, such as forcing procedures which women have explicitly refused. There can be emotional violence, such as coercion, manipulation, or verbal abuse. There can be an exertion of power or force over women’s legal rights by individual health care providers and/or by hospital policies such as threatening to call child protective services if a woman does not agree to a procedure or threatening to withhold care in labor if a woman does not agree to the provider?s suggested intervention. ?Informed consent? refers to the legal right of all patients to have the risks, benefits and alternatives clearly explained prior to any procedure. All patients ? including laboring women - have the right to accept or refuse any suggested treatment. Withholding informed consent through the use of physical force, coercion or manipulation is an act of violence and is illegal.

Provider-perpetrated violence during childbirth can result in the birthing woman suffering traumatic stress, anxiety disorders such as posttraumatic stress, postpartum depression and other disabling mood disorders.

For more direction, please click here to visit the Solace for Mothers webpage about the campaign.

To read the letter sent to Lynn Rosenthal and First Lady Michell Obama from Solace for Mothers, Click Here.

Please write letters and spread the word to anyone who may have experienced or witnessed violent maternity care.

ACOG Admits Defensive Medicine & Harming Patients

You know the news is bad when the headline reads:

ACOG Releases 2009 Medical Liability Survey

Results Paint Dismal Reality for Ob-Gyns and Their Patients

While this is a group that usually likes to stick their heads in the sand when it comes to the women that they care for, I was surprised at the honesty about the OB-GYNs that they serve. ?I know ACOG has been concerned about the number of doctors who are leaving obstetrics, but this actually breaks it down and shows you the drop in doctors offering VBACs, how many are being sued, etc. ?The most startling tale? ?They admit that it harms the patients…

And why are they not doing VBACs, seeing high risk patients and providing better care? ?I think they say it best:

“Of the survey respondents who reported making changes to their obstetric practice as a result of the risk or fear of professional liability claims or litigation, 30% decreased the number of high-risk obstetric patients that they accepted. In addition, 29% reported performing more cesarean deliveries, and 25.9% stopped offering/performing vaginal births after cesarean (VBACs). An additional 13.9% decreased the number of total deliveries.”

Litigation. ?Perhaps the power cry from the women shouldn’t be “Keep your scalpels off my body!” but rather, “I’ll promise not to sue if you practice evidenced based medicine.”

Does a Laboring Woman Have Any Rights?

I have been doing a lot of reading about the case of a woman who exercised her legal right to informed consent and refused a cesarean, and subsequently had her baby taken away because of it. This woman’s case hits very close to home for me. She labored in a way that was described as “combative,” “uncooperative,” “erratic,” “noncompliant,” “irrational” and “inappropriate.” I can imagine that the midwives who assisted in the delivery of my son would label the way I labored in much the same way. These terms are all very subjective, and I can imagine them being used for a patient that was vocal about refusing procedures they wanted her to comply with. The court records were vague on the next similarity, but it also seems that this woman was in an abusive environment. She even called the police from her hospital room. From everything I have read, it seems that they are using her accusations of abuse as proof that she was being irrational, and I have seen no description of what abuses occurred, as if the entire subject is too crazy a notion to spend any time on. I think if there was abuse, this is a pretty good explanation of her actions during labor. Another explanation is that she was previously treated for PTSD. A woman who has had PTSD in the past who enters a hostile environment, is in the vulnerable position that being in labor creates, is pressured and perhaps abused, will be triggered by all this and react - there is simply no way around that. When a person with PTSD is triggered, they go into panic mode which will insight the fight, flight or freeze mechanism. She obviously went to “fight”, since she could not flee or freeze at such a time. Instead of the people around her being understanding of her responses, a psych evaluation was done while she was in labor. Her past history of being treated for a mental illness was dug up, and a case was made that her and her husband (since he agreed with her), were not fit parents and the child was removed from their care.

There are several alarming factors in this case. It is legal for a woman in labor to refuse care. Every person has a legal right to informed consent and refusal. Informed consent means that the person will be given the risks, benefits and alternatives of a procedure. Informed consent includes the right to refuse care. But people always say, what if it is an emergency and the baby will die without treatment? The fetus is not legally a person, and therefore a pregnant woman has the legal right to make decisions for her own body, regardless of how those decisions affect the fetus. Furthermore, a parent of a living child has the right to choose or refuse medical treatments for their child. The only legal way that any person can be forced into medical care is if a court order is obtained that deems them incapable of making that decision. I am assuming that the psych evaluation during this woman’s labor was the first step in them trying to obtain a court order. This did not work however, because the first person to examine the woman deemed her mentally capable of refusing care. The second person to examine this woman was unable to complete his examination before her healthy baby was born.

I had no idea that it was legal to have a psych evaluation done while a woman is in labor. I am guessing that this is the only way to obtain a court order, but it seems that it should only be allowable for that purpose. It is unclear to me whether or not these evaluations had any bearing on the decision to remove her child. I find it very unsettling that a woman’s mental health can be evaluated for any purpose while in labor since women enter a different state of mind in order to accomplish the monumental task of giving birth. Is this natural alternate state of being understood by the evaluators? Do they realize that what they are seeing is not mental illness but just a woman in “labor land”? Are they able to decipher the natural affects of being in labor from true mental illness? It seems that any findings from a woman in labor would be in question, so the fact that this was even done with seemingly no understanding that they may not get accurate results is just extremely alarming.

Many people are quick to point out that the c-section refusal was not the final reason given for the removal of her child, but it was her mental illness and her and her husbands unwillingness to work with the system in having their child returned to them. As for her mental illness, she had been treated in the past for PTSD. She had completed her treatment. Many women have a history of being treated for a mental illness. If a woman has ever been to therapy, chances are there is a diagnosis of some kind in her records somewhere. Many women have been on medication at one time or another. Lots of women have been treated for postpartum mood disorders. Will these things now be held against us when we have children? Is it legal to remove a child from a home just because a woman has been treated for a mental illness in the past and they feel that she is therefore at greater risk of abusing or neglecting her child? The irony is that the very system who caused my PTSD can now remove any future children I have because of it? And this is all perfectly legal in this country? As for their unwillingness to work with the system, I can understand that. In those first weeks after being traumatized and devastated, and seeing things through this lens of overwhelming emotions, I am not too sure that they would be capable at that point of seeing the benefits of cooperating with the people who just did this to them.

So, does a laboring woman have any rights? Do the laws of informed consent and refusal apply to her? Why is it that a woman is stripped of all her legal and civil rights during the window of time that she is giving birth, yet she has personal and parental rights at any other time in her life? The laws of informed consent are on the books, but they can’t be upheld legally. If she is violated and damaged, she can not sue for compensation simply because no lawyers will take a case like that. I was just told last week by a lawyer that I had no legal right to refuse any unwanted physical contact or medical procedure during my labor since I had signed a blanket consent form upon arriving to the hospital. Apparently, according to him, a woman can scream “no” and “stop” all she wants to, but she has no legal rights do so, since once she signs that consent form she is allowing the hospital and it’s staff to do whatever they deem necessary from that point on. I disagreed with him, but he holds the beliefs and opinions of most of the lawyers and judges and health care providers in this country. In order for a woman to have any rights, it has to be able to be upheld legally in court. Otherwise, it is just a useless law written in a book somewhere and has no power or bearing on women’s lives. Therefore, I would say that no, women have no legal rights while in labor or giving birth. I think this is the singular problem with our maternity care system. If a woman has no legal rights to refusal in an emergency, then everything becomes an emergency, and she suddenly has no legal rights over anything that happens to her from vaginal exams, to IV’s, to fetal monitoring, to episiotomies and c-sections. In order to change the system, women must be granted their legal rights. Education can only go so far. We can all be highly educated victims, or we can change the system and insist that we have a right to informed consent and refusal in maternity care.

Drunken Breastfeeding

There is a lot to this story that I do not know or pretend to know, so my comments are more just me thinking out loud. The basics are that a woman calls the police because her boyfriend is beating her up, she has a record. When the police arrive, the boyfriend is not there. The mother has obvious wounds on her face and is nursing her baby.

She is arrested for drunken breastfeeding. The officers did NOT do a blood alcohol test at the scene or ever. The Chief of Police said that his officers deal with a lot of alcohol related problems and therefore, know drunks when they see them.

I am so baffled. This stand of knowing drunks when you see them would certainly not fly had this mother been driving. Could her behavior not have been caused by anything other than alcohol? Perhaps the sleep deprivation of being a new parent? The stress from having just been beaten? Again, in any other case other causes of a medical origin would have at least been ruled out.

One thing from the article that really startled me was the fact that they couldn’t believe that the mother was breastfeeding while they questioned her. She was in her home to the best of my knowledge, so why would breastfeeding a needy newborn not be normal? Breastfeeding is not a crime.

You’re going to read words, I never thought I would write, I agree with Dr. Amy on this one.

All this said, I think that if you choose to drink to the point of being intoxicated while you are breastfeeding, you need to have someone with you to care for the baby. But was this woman at this point or otherwise having issues? I’m interested in how this unfolds. Please share your thoughts.

Can Doctor’s Stop Negative Online Reviews?

The article Docs Seek Gag Orders To Stop Patient’s Reviews has been circulating around the internet.? The article states that some doctors are so uncomfortable with being rated online on sites such as RateMDs.com or Angies List that they are actually asking their patients to sign wavers prohibiting them from giving any online ratings or reviews of that doctor.? I read this article with great interest since I am involved with the project The Birth Survey which will soon display ratings of doctors and midwives who assist with births.

It seems that some doctors are quite upset over being rated online.? One doctor received this comment from one of his patients: ?Very unhelpful, arrogant, did not listen and cut me off, seemed much too happy to have power (and abuse it!) over suffering people.”? Dr. Segal, who has started a business to help doctors fight these online reviews states: “such postings say nothing about what should really matter to patients ? a doctor?s medical skills ? and privacy laws and medical ethics prevent doctors from fighting back.”? I think this statement is very telling.? It seems many doctors feel that the only thing that should matter to a patient is the doctor’s medical skills.? These sites are showing doctors that something else does matter to patients: bedside manner.? Patients today don’t place unquestioned trust in their doctors like they did in generations past.? They want to be involved in their health care decisions, and feel respected and cared about.? I think that most patients would desire a balance between medical skills and a good bedside manner, as well as feel like they have decision making power over their own health care.? I think what is happening with these websites is that patients are using their consumer power and really showing doctors what is important to them and how they need to be treated.? Medical skills are not the only thing that matters to patients anymore.

Segal’s company is providing wavers for doctors to ask patients to sign.? These wavers will ensure that a patient can not fill out an online review, or post about a doctor online in any other way.? The article states: “Doctors are notified when a negative rating appears on a Web site, and, if the author?s name is known, physicians can use the signed waivers to get the sites to remove offending opinion.”? Of course, these wavers only have power if the name of the person who wrote the review is named, which is not the case on many of these sites.? The article states: “RateMd?s postings are anonymous, and the site?s operators say they do not know their users? identities. The operators also won?t remove negative comments.”? Hopefully if this happens on any site that hosts ratings of doctors with anonymous sources, they will follow the example of RateMD.com: “John Swapceinski, co-founder of RateMDs.com, said that in recent months, six doctors have asked him to remove negative online comments based on patients? signed waivers. He has refused.”

I wonder why a doctor would even present wavers to a site that rates anonymously?? Perhaps they feel if they make every one of their patients sign a waver, then of course one of those patients broke that agreement?? However, it seems to me that the doctor would need to take this up with the patient, not with the site hosting the comment.? The site did not sign anything forbidding them from hosting ratings of doctors, the patient signed something forbidding them from giving that rating.? Therefore the agreement is with the doctor and the patient, and the website does not have to honor that agreement.? I think as long as the site is anonymous, then there is nothing a doctor can legally do to prevent this from occurring.? The article states: “Segal, of Medical Justice, said the waivers are aimed more at giving doctors ammunition against Web sites than against patients. Still, the company?s suggested wording warns that breaching the agreement could result in legal action against patients.”? It seems to me that the only function of the wavers would be to scare a patient into silence, making them feel as though they may get sued if they rate their doctor on one of these sites.? It is odd that Segal states this will give doctors ammunition against the sites, when they have no legal agreements with the sites.

I am sure it is distressing for a good doctor to stumble upon a bad review made about them, however, your typical consumer is savvy enough to be able to discern that one bad review does not mean much.? Many bad reviews on the other hand could be really telling.? If a doctor is getting so many bad reviews online that they would consider asking their patients to sign a waver, perhaps they should think about changing the way they practice.? If a doctor asked me to sign a waver like this, I would run, not walk, out of their office.? I would never want to see a doctor who would attempt to stifle my freedom of speech.? I would be afraid that signing this waver would leave me open to bad treatment, and I would be left with little recourse if I signed my rights away.

In the birth world, we now have The Birth Survey which will soon be putting their national results online (currently only NYC’s resluts are up).? The Birth Survey differs from these other sites in that it focuses solely on doctors or midwives who assist with childbirth, and it asks comprehensive questions about the entire birthing experience, from prenatal to postpartum.? This is not a flippant rating given on a whim, but a thought out recounting of an actual experience.? The survey is anonymous and takes about 20 to 30 minutes to complete.? If you have given birth in the last three years and have not taken The Birth Survey yet, please do.? Hopefully doctors and other care providers will begin to learn from the feedback given on sites like these and adapt their practice style in a way that will serve their patient’s needs.

Attention Virginia Birth Activists!

Please take action now to stop two bills introduced into the House of the Virginia General Assembly to limit the practice of Certified Professional Midwives. These bills have been introduced by Delegate Matthew Lohr - Harrisonburg.? Calls to the constituent hotline and members of the Health, Welfare and Insurance sub-committee opposing these bills are urgently needed!? For the latest Action Alerts, join our yahoogroup today!

http://groups.yahoo.com/group/VAMUM/

HB 2163, is a bill to amend ? 54.1-2957.9 (the CPM statute).

What is wrong with it:

• The proposed legislation would add an amendment requiring midwives to give informed disclosure to their clients about the risks associated with home deliveries and with some specific pregnancy conditions. This legislation is redundant to the existing statute that already requires that licensed midwives in Virginia hold the designation of Certified Professional Midwife (CPM) and practice according to the standards of the National Association of Certified Professional Midwives.

• CPMs are required by their certification to give a written informed disclosure regarding their experience, training, and the risks and benefits of home birth to every client at the beginning of care.

• The NARM Job Analysis (cited in the VA statute) specifies the principles of informed consent and the conditions that may require additional education and informed decision making. The conditions cited in HB 2163 are included in this list.

• The NACPM standards of practice (also cited in the VA statute) refer to informed consent and requirements for education and information of CPM clients.

• The Virginia Licensed Midwife regulations already require that informed consent be obtained before any invasive procedure is performed.

HB 2167 is a bill to require the Board of Medicine and the Department of Medical Assistance Services to review regulations and policies to ensure that no reimbursement is made to certified professional midwives providing services in high-risk situations, including high-risk home deliveries.

What is wrong with it:

• This legislation is discriminatory to low-income women. Any woman who qualifies for Medicaid is designated “high-risk” based on her socio-economic status. Midwifery care, by way of its hallmarks of increased education, support, and respect, has been proven to benefit women who are at risk for pregnancy complications. Evidenced-Based Care does not support restricting access to home birth to women based on perceived risk. This is a bill intended to discourage VBAC, thereby mandating surgical deliveries to women with prior c-sections in some Virginia communities.

Submitted by Birth Activist Pam Pilch

A Lawsuit is Filed Over Abuse During Birth

Catherine Skol, a former police officer, gave birth to her fifth child nine months ago.? She was treated in an abusive manner by the doctor on call and has filed a civil suit against him.? You can read about her story and the lawsuit she has filed here, here, and here.

Catherine Skol was the victim of abuse and harsh mistreatment.? Unfortunately others have also endured this type of treatment when giving birth.? Her case is particularly horrific, and I am sure she is suffering from the effects of this trauma in her life.? I personally am thrilled that she has brought a lawsuit in order to try to bring this doctor to justice.

The fact that Catherine Skol secured a lawyer and was able to actually sue her abusive doctor is perplexing.? I have heard many stories of trauma over the last few years, and there are many other women who have had similar experiences.? I have only ever heard of one other woman being able to bring a legal case over this type of treatment at a birth, and there were unique extenuating circumstances that made retaining a lawyer and getting a settlement possible for her.? I have never heard of any other woman being able to get a lawyer to even talk with them about a birth experience where they were abused or mistreated.? As an example, I myself called several lawyers about my birth experience and was unable to even get past the receptionist.? This is quite common, no matter the severity of the experience, if there are no physical damages it is pretty much unheard of that you will be able to retain a lawyer to file a suit.

I speculate that there are three reasons that Catherine Skol was able to retain a lawyer and file a civil suit.? First and foremost, she is a former police officer.? If there is one job where people (particularly men) will take what you say seriously, it is probably this one.? People would feel that surely a police officer wouldn?t be lying, or blowing things out of proportion, or not have been tough enough to handle the situation.? They would reason that surely a police officer deserves to be listened to.? Second, she was a seasoned mother and this was her fifth baby.? I?m sure it was thought that of course she knew what to expect, and how things should go, and was able to decipher that things were not going as they should because she had been through this experience four times already.? Third, she was denied pain medication.? There is a difference between not wanting pain medications or other standard treatments and being mistreated for your choices, and wanting pain medication or other standard treatments and not being allowed to have them.? I think either situation can induce trauma for a woman, but a lawyer would be much more sympathetic to a woman who wanted the standard pain medications and was denied it.? Both acts can be a form of mistreatment or abuse, but being denied what is considered to be standard medical care in that situation garners much more sympathy from most people.

No matter how Catherine Skol was able to retain a lawyer, I feel that this is an important case that could possibly set a precedence for other women who are abused while giving birth.? If Catherine Skol wins her case, women who have had similar experiences would then have a leg to stand on legally.? There would be a case they could show a potential lawyer in order to persuade him to take their case.? I am glad that she has gone public with this case so that providers and institutions as well as other women who have been mistreated are made aware of it.

I have read of some people expressing concern over why this woman would sue.? Many are very concerned about lawsuits being brought up in any form concerning maternity care.? Some say that lawsuits have caused the current atmosphere in the maternity ward, and how can more lawsuits possibly help the situation?? What will Catherine Skol, or women like her gain from a lawsuit?

There are a few things that can be gained from lawsuits of this type.? First, there are monetary damages.? Being traumatized is quite expensive.? Severe trauma may take years of various types of treatment to overcome.? Many people are not adequately covered by health insurance when it comes to mental health treatment.? Most people are either not covered or their coverage is limited in some way.? This means there will be extensive out of pocket expenses for months or years, which can add up to thousands of dollars.? Second, when a person is mistreated, in order to protect others from the same type of mistreatment, that person will desire to take some type of action.? They will also be looking for some type of closure for themselves.? In the hospital system that fears litigation, there is no room for debriefing sessions with staff members or providers who participated in the event, and there can never be an apology or an admittance of making a mistake.? Some women will never have the opportunity to see their providers again, and others will see them once at six weeks postpartum, but will generally not be given the time they need to even begin to process the experience with their providers.? This situation is bad for both the women and the providers.? If this scenario was possible, the woman could possibly gain some kind of healing knowing she has made her grievances known and that she has been heard, and a provider could possibly gain some understanding and compassion, and use the situation as a learning experience.? If there were adequate health care coverage in this country, and not such fear of litigation that provisions were made to allow a patient?s grievances to be heard and acknowledged, then there would be no reason to sue.? Since women who have been mistreated during their birth experiences do not have that, then they must sue to be heard by the provider, and to gain monetary damages.

The other reason it is important to file a lawsuit over abusive treatment is to try to change the type of maternity care that women routinely receive.? If it is possible for a care provider to be sued over this type of treatment, then care providers will begin to take notice when women complain over it.? It gives women power to be given the opportunity to voice their grievances, and since this is the working system in the country to do so, it is high time that women were able to use this system in this regard.? Not being able to even get a lawyer to consult with on a case like this leaves women damaged and powerless.? Powerless to get compensation for her own suffering, and powerless to prevent it from happening to anyone else.

Thank you Catherine Skol for having the courage to take advantage of your unique position and filing a precedent setting civil suit.? I hope you pave the way for women after you to also have the power to file a lawsuit, and I know that your even filing one has made a difference to this doctor and other care providers who have undoubtedly read about the case.

Northwestern Women’s Law Center Writes Article About Birthing Women’s Legal Rights

Sarah L. Ainsworth is senior legal and legislative counsel at Northwest Women’s Law Center. She is the author of a recent article in a Washington paper. The article is entitled “High rate of C-section births is health concern for women”.

Some notable quotes from the article:

Both the law and respect for women’s humanity require that every pregnant woman be fully informed of the risks of all forms of labor and delivery in a language she can understand; that she be supported in her decisions about how to bring her children into the world, whether it be in a hospital, a birthing center or at home; and that she not be penalized for those decisions either medically or legally.

A pregnant woman must either submit to a subsequent C-section, whether she thinks it is a wise medical decision or not, or deliver her baby outside the hospital. For those women who do not want a home birth, or who cannot have one because of lack of health insurance coverage or lack of available midwives within a safe distance of home, this is coercion, not consent.

Policies and practices that force pregnant women to submit to unnecessary surgery cannot be justified. We would never countenance that practice for any other patient. Pointing to potential risk to the baby does not justify ignoring the mother’s decisions about her medical care.

Such reasoning inappropriately views a pregnant woman’s decision about her and her baby’s needs as suspect, and it ignores her legal rights as a patient. All pregnant women, whether they view birth as a natural event only rarely needing medical intervention, or whether they willingly accept medical assistance with the birth process, have the legal right to informed consent and to direct the experience of bringing their children into the world.

Cesarean’s are just one of many procedures that many birthing women are not allowed to give informed consent to. This is the first article or statement I have ever seen by someone in the legal field that says that this is legally wrong to do to women. I personally have contacted several lawyers and not one would talk to me, or allow me to pay them for an hour of their time while I presented my case to them. I am thrilled to see some acknowledgment by a legal organization that ignoring a pregnant woman’s rights is illegal and cannot be justified.

A Victory for Missouri Midwives and Moms

My deep congratulations to the women and families of Missouri! I was raised in Missouri and I feel a close connection to the struggle of midwives in that state, where it is a felony to practice midwifery. My youngest sister was delivered at home almost 23 years ago by one of the most competent, talented midwives in the state, despite the illegal status of midwives. However, after many years of fighting, a midwives licensure bill just passed the Missouri Senate in its final hours. Unfortunately, there was not sufficient time for the bill to make it to the House, so they still have a fight ahead. But finally, there is hope. Do you ever wonder if we birth activists are making a difference? Be assured, we are. Read on for the media release in its entirety. . .

FOR IMMEDIATE RELEASE: Friday, May 16, 2008

Midwives Licensure Bill Passes Missouri Senate

Grassroots momentum sweeps Capitol as legislation 25 years in the making now heads back to the Missouri House in the final hours of the last day of session

(JEFFERSON CITY, MO)–HB2081, which included would provide for the licensure and regulation of Certified Professional Midwives (CPMs), passed the Missouri Senate today by a strong majority. CPMs are allowed in 40 states, 24 of which license and regulate them. Missouri law classified CPMs as felons.

“Today’s vote was a victory for democracy, and we applaud the Missouri Senate for standing firm in the face of intense pressure from well-financed special interests out to protect their turf,” said Laurel Smith, President of the Friends of Missouri Midwives. “The Senate chose instead to listen to the thousands of people from across the state who have been steadfastly and patiently demanding access to legal midwifery care for many years.”

In addition to being trained as specialists in out-of-hospital birth, CPMs are experts in risk assessment who work in collaboration with physicians when mothers or babies develop conditions that require a consultation or
transfer of care. CPMs are also trained to ensure that all babies born outside of the hospital undergo state-mandated newborn screenings and are provided with legal and secure birth certificates.

“This bill ensures that midwives who have met the national standard and state regulations are legally available to provide care for families who desire out-of-hospital births. It also provides transparency and accountability through the state agencies that oversee midwife licensure and birth records.” said Debbie Smithey, President of the Missouri Midwives Association.

Missouri is a priority of The Big Push for Midwives Campaign , a nationally coordinated campaign to advocate for regulation and licensure of Certified Professional Midwives (CPMs) in all 50 states, the District of Columbia and Puerto Rico, and to push back against the attempts of the American Medical Association Scope of Practice Partnership to deny American families access
to legal midwifery care.

Media inquiries should be directed to Mary Ueland at (417) 543-4258, better_birth@yahoo.com.

The Big Push for Midwives

In better late than never news:

PushNews from The Big Push for Midwives Campaign
CONTACT: Steff Hedenkamp, (816) 506-4630, RedQuill@kc.rr.com
FOR IMMEDIATE RELEASE: Friday, January 18, 2008
MEDIA ALERT
National “Big Push for Midwives” Campaign to Launch
20 states already signed up for nationally coordinated advocacy campaign for regulation and licensure of Certified Professional Midwives (CPMs)
WHAT:

The Big Push for Midwives Campaign will launch next week in Chicago on “PushDay” to advocate for regulation and licensure of Certified Professional Midwives (CPMs) in all 50 states and the District of Columbia. The Big Push Campaign is also pushing back against the attempts by the American Medical Association to deny American families access to legal midwifery care.

Following the PushDay news conference about the national campaign launch, there will be several activities, including a book signing by author and journalist Jennifer Block for her book “Pushed,” a film screening of the Ricki Lake and Abby Epstein documentary, “The Business of Being Born,” and a viewing of The Safe Motherhood Quilt Project created by midwife pioneer Ina May Gaskin.
WHY:

Currently, Certified Nurse-Midwives (CNMs), who work predominantly in hospital settings, are licensed and legal in all 50 states. Certified Professional Midwives (CPMs), who specialize in out-of-hospital delivery, are licensed and legal in fewer than half of our states. CPMs:
Are specifically trained to provide out-of-hospital maternity care for healthy women experiencing normal pregnancies.

Offer a family-centered model of care, which is associated with reducing the incidence of c-section, birth injury and trauma, as well as significantly reducing the cost of maternity care.

Play a vital role in reducing the two most preventable risk factors for infant mortality: low-birth weight and premature birth: babies born too small or too soon.

Serve a disproportionate percentage of underserved populations, including low-income, rural, inner-city, immigrant, and uninsured families, as well as those Americans who choose out-of-hospital birth for deeply held cultural and philosophical reasons.
WHO:

The Big Push for Midwives Campaign is the first initiative of the National Birth Policy Coalition (NBPC), which was established in 2007 and is focused on increasing access to the Midwives Model of Care in all settings, as well as supporting legislative initiatives that promote the autonomous practice of Certified Professional Midwives and Certified Nurse-Midwives. So far, the NBPC has been endorsed by more than 20 organizations, including national and state midwifery organizations, as well as state consumer organizations.
CONTACT:

Media inquiries about the news conference, book signing, film event, or participating states PushEvents should be directed to Steff Hedenkamp (816) 506-4630, RedQuill@kc.rr.com. http://www.thebigpushformidwives.org/