More on ACOG's campaign against midwives

First, let me explain where the "number two" came in, b/c I'm not sure how clearly that press release explained it...

The American College of Obstetricians and Gynecologists (ACOG) is a private trade union representing America's OB's.  ACOG, along with state doctors' groups around the country, have been spending millions of dollars to fight licensure of home birth midwives, and they've been losing! ACOG just announced their 2008 legislative agenda, and on the state level it's no surprise that Midwives and Home Birth are listed as their second priority. (If you ask me, on a state level, we are their first priority, b/c we often hear from friendly legislators that we are usually the first thing their hired guns bring up when they see them.)

Here's what ACOG says about Midwives and Home Birth:

"Lay" Midwives and Home Birth

We [ACOG] are seeing an increase in home birth and lay midwife bills across the country. Different tiltes for midwives and different levels of training foster public confusion and legislators often cannot distinguish between different types of midwives. Least - qualified midwives are gaining licensure as more and more states adopt the certified professional midwife (CPM) credential for licensure and not the certified midwife (CM) credential which ACOG recognizes.

TRANSLATION OF ACOG'S STATEMENT 

"We are the OBs trade union, and we are hopping mad that women want to give birth without paying into our multi-billion dollar industry, So we're going outspend those consumers who are trying to get their midwives licensed and throw all our political clout around, hoping some of our lies stick."

THE TRUTH OF THE MATTER

Some women are going to give birth at home, regardless of the smear campaign and lies of ACOG, but in half of the U.S., women choosing home birth face a real problem: lack of licensure for the most common home birth provider, certified professional midwives (CPMs). Despite good, scientific evidence that CPMs provide excellent, safe home birth care, ACOG is more concerned with protecting their turf than helping all women access good safe childbirth care.

But what about this "CM" ACOG mentions in their statement? First, CMa are hospital trained, and only about 50 CMs exist in the entire country (compared with more than 1,300 CPMs who are actually educated and trained specifically for out-of-hospital birth). 

Or what about nurse-midwives (CNMs)? Nurse-midwives are not trained for home birth either (in fact, it used to be forbidden even to discuss home birth in CNM educational programs until very very recently). For the most part, CNMs just don't do home birth! (with very few individual exceptions) Only about 1% of CNM attended births take place at home, down from from approx 2% in 1990 at a time when total births are on the rise for CNMs. The trend is fewer home births for CNMs, not more.

So what's a home birth mama to do. in half of our country? Hire an underground midwife, who is then less able to access collaborative care if it becomes necessary? Hire an underground midwife whose qualifications are hard to verify? Go it alone? Hire a midwife from another state and hope and pray she makes it on time? THOSE ARE ALL UNACCEPTABLE! That's why it's paramount that all 50 states license CPMs, and the sooner the better!

North Carolina Midwifery Study Commission in the news!

In North Carolina, the legislature has commissioned a study group to look at the issues surrounding home birth and the certified professional midwife. An Indyweek.com article says, in part,

"The study committee was the way birth reformists sought to get around a seeming impasse: For the better part of a decade, the leadership in the state House and Senate has agreed to pass legislation legalizing direct-entry midwives if and only if the North Carolina Medical Society would sign off.

'That is a perfectly understandable position, but it's just not going to work,' Fawcett said. 'They are not going to agree, and never have.'"

Russ Fawcett is right. It doesn't matter what evidence you have, or how many individual doctors support licensing certified professional midwives. The doctors' groups are intent on grabbing every penny of their $33 BILLLION dollar obstetrics industry, and organized medicine is fighting back hard.

The doctors don't play a clean game, though, and instead insist on misrepresenting the facts in order to scare legislators into voting for them. Until licensed professions are no longer allowed to make large campaign contributions, to state officials and lawmakers, they will keep their deathgrip on healthcare.

The reason that these midwifery groups are able to gain any traction is that -- in a true grassroots movement that's growing across the country -- home birth mothers and fathers are refusing to buckle in, and are storming state capitols en masse, to demand their right to a safe home birth with a midwife.

You can read an unreferenced account of the "history" of midwifery in North Carolina, written from a nurse-midwifery perspective. It's interesting to note that in the early 20th century, North Carolina midwives suddenly had to receive "instruction" from doctors and nurses, but there's no mention that midwives at that were getting bad results (odds are they weren't; every study in the late 19th and early 20th centuries show midwives had superior outcomes to doctors of that same time). and I shudder to think what they "taught" the midwives -- probably to force the mother to lie down on her back (which actually impedes the birth process and increases the risk of fetal distress). I bet the midwives could have taught them a thing or two!

So close! Show me the truth, show me state!

MISSOURI is one of the "hot" states in the effort to license midwives. Last year, the Missouri CPM licensure bill, introduced by Senator John Loudon (R-Ballwin), was effectively filibustered by Missouri Senator Graham (D - Columbia), which incluced reading pages of the phone book, discussing his and his colleagues' new blackberries, and countless hours of wasting Missourians taxpayer dollars.

Seemingly out of frustration, Louden attached a clause onto an insurance bill that allows anyone to practice if they are certified to provide tocological services, by a group that's accredited by the National Commission on Certified Agencies (in other words, CPMs, CNMs or CMs).

The doctors, with all their overblown education, didn't catch it. The law passed, and it was a huge victory, which is now being battled out in the Missouri courts.

This year, a licensure bill passed the Missouri Senate after some political maneuvering, but the medical lobbyists stopped it from getting out of the House.

The stories from those "on the ground" in Missouri are spooky. This is hardball politics, to say the least.

Midwife licensure news from Maine

Some very interesting developments have occurred this year. In all my trips to the state capitol, I've not posted, but soon the legislative session will end, and I should be able to catch up. Until then, here are a few interesting things that have occurred.

MAINE
The Main Department of Professional Regulation issued an official Legislative Report (<--link to a pdf download) that states, "Information presented to the Department of Professional and Financial Regulation suggests that the 22 CPMs practicing in Maine are knowledgeable, compassionate and sincerely dedicated to the welfare of women and children. The competence of these CPMs is suggested through good birth outcomes and the absence of examples in which serious medical problems have resulted form the care they provide ..." [Report of the Commission of Professional and Financial Regulation to the Joint Standing Committee on Business, Research and Economic Development, Sunrise Review Regarding the Practice of Licensed Midwifery, February 15, 2008, pg. 16.]

In the end, the governor signed a bill that allows UNLICENSED CPMs to carry certain, life-saving medications (like pitocin and oxygen). They felt that CPMs already do an excellent job. One correction to the news story I linked to is that the drugs would not be used for induction. Midwives never induce, which is one of many reasons home birth is healthier and safer for the majority of women.

The doctors groups went apeshit. (Note: this is an editorial, but it includes the same old doctor's talking points.)