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!

HUGE Court Win in Goslin Pennsylvania Case!

Diane Goslin, CPM, who was charged by the state of Pennsylvania Medical Board with practicing medicine/nurse-midwifery without a license, has scored a huge victory for home birth midwives, winning an appeal to the Commonwealth Court of Pennsylvania. You can download a pdf of the Court's ruling here

There are numerous new stories related to this case I'll list some them here that detail the win, with headlines and initial paragraphs.

The Philadelphia Enquirer
Birthing women win legal decision
By Angela Couloumbis
Inquirer Harrisburg Bureau

HARRISBURG - In a case that touched on whether women have the right to give birth where and with whom they want, a Commonwealth Court panel of judges ruled yesterday that a Lancaster County midwife could resume her work delivering babies for the Amish.

Diane Goslin, 50, had been under a cease-and-desist order from the Pennsylvania State Board of Medicine, which had charged her with practicing medicine and midwifery without a license.

But the Commonwealth Court panel, in a 5-2 decision, nixed that order yesterday.

"I am very excited," Goslin, from New Providence, said shortly after she learned of the decision. "This is such an encouraging day of victory for women and families."
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Harrisburg News
Midwife for Amish wins appeal
by DAVID WENNER, Of The Patriot-News
Friday May 23, 2008, 3:41 PM

A Pennsylvania court has reversed state-imposed fines and penalties against a Lancaster-area midwife who has delivered thousands of babies for the Amish.

A panel of Commonwealth Court judges ruled the state medical board was wrong to fine and order Diane Goslin to stop delivering babies.

But rather than state that Goslin is free to deliver babies, the written decision concludes Goslin hadn't been given adequate opportunity to defend herself against charges of practicing midwifery without a license.

Goslin, 50, said today her interpretation of the ruling is that it allows her to resume deliveries. The state board of medicine couldn't immediately be reached for comment.
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York Daily Record
Pa. court allows unlicensed midwife to resume practice
MARTHA RAFFAELE
The Associated Press

HARRISBURG, Pa. - An unlicensed midwife who assists Amish and Mennonite families with home births won a legal challenge Friday to a state decision that stopped her from practicing.

The Commonwealth Court's 5-2 ruling also overturned an $11,000 civil fine that the State Board of Medicine imposed on midwife Diane Goslin. The board can appeal to the state Supreme Court.

Commonwealth Court said the board erroneously concluded that by practicing midwifery, Goslin was also illegally practicing medicine and surgery without a license.

The board also denied Goslin due process by charging her under a 1985 state law that established licensing requirements for nurse-midwives, but disciplining her under a 1929 law that requires other types of midwives to hold state-issued certificates, the court found.
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For more information about what's happening in Pennsylvania, visit, SaveHomeBirth.com

Jennifer Block on childbirth

What does the former health editor of Ms. Magazine say about childbirth in America, after researching and writing the book, Pushed: The Painful Truth About Childbirth and Modern Maternity Care.

You can see a succinct explanation/introduction as to why Ms. Block wrote her book and what she discovered in her extensive research, in this video.



For more information, visit Jennifer Block's excellent blog, PushedBirth.com

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.)

Rock, meet hard place

What would you do, if you were on the cusp of winning a 30 year battle to make home birth midwives (CPMs) legal, and in the 11th hour an unanticipated fork in the road was presented to you? One path leads to legalization that's desperately needed, but the twist is many moms could be left to the cold, steel rooms of the surgical suite. The other fork means almost certainly giving up licensure for many years to come.

It's not an easy place to be in. Illinois advocates find themselves wedged tightly between a giant boulder, and one of the hardest places of all. And a lot of moms are hopping mad about it. So mad, that some individuals have threatened to withdraw support of the bill that would licensed CPMs.

The issue is regarding whether or not an Illinois CPMs would be allowed to attend moms who have had a cesarean birth, in their first attempt at vaginal birth (primary VBAC, or first time vaginal birth after cesarean). The twist is that it's extremely difficult, at best, to achieve a safe VBAC attempt in most Illinois hospitals, and in many parts of the state, officially disallowed by hospital protocols.

So we have a group of moms who expect other women (most of them moms themselves) to risk jail or losing ALL their personal assets, to preserve the ability to access vbacs. And another group of women who desperately want to serve vbac moms but don't necessarily want to risk jail and all of their personal assets in order to do so. (And yes, a lot of midwives have served time.)

Where's the balance?

Please post a comment if you have an answer to this quandary. Or just to spout off. (Please note: I understand that this is an emotionally charged issue, but personal attacks will be removed.)