Mother of All Rallies

With some exciting developments in their bill to license certified professional midwives, our sisters in Illinois are calling for a rally on January 12 and 13, 2009.

See the Illinois Families for Midwifery blog for more details.

The Other Side of the Glass: empower fathers to protect their babies (trailer)

Grab a hanky for this heart-wrenching video!

Amazing Article

A refreshingly accurate September 11, 2008, article in the Evanston Review, "Home delivery?" by Nancy Burhop, highlights the extreme home birth maternity care shortage facing home birth families in approximately half the country, with a focus on the state of Illinois.

The article features an obstetric nurse, Aime Graimer, who chose home birth for the last two of her seven children's births. Graimer wanted to have two of her prior births at home as well, but was unable to find care:

"I was interested in having the last four at home," she said, "but that wasn't an option until the last couple of years, because I couldn't find anyone to attend the births at home."

Because the main opponents to home birth in the United States, the American College of Obstetricians and Gynecologists did not agree to be interviewed for the article, the reporter draws some of her own conclusions:

It seems odd, then, that ACOG supports a woman's right to have an elective Caesarean section. That major surgery opens the womb to deliver the infant, and puts mother and baby at risk. The U.S. has the highest rate of Caesarean births in the world, over 30 percent and growing, according to the Center for Disease Control.

You can read ACOG's official but unreferenced Position Statement on Home Birth here, and an exchange between ACOG and a concerned obstetrician and member of ACOG asking the group to defend its position on Home Births here.

Illinois nurse-midwife, Jennifer Gagnon, CNM, one of only five nurse-midwives who attend births at home in Illinois, wonders about the opposition's extreme position against home birth and points out much better results in other parts of the world where home birth is common:

"In Europe home births are common. If hospital birth is safer, then why is it that in the Netherlands, where 34 percent are home births, they have a maternal death rate of 5 per 100,000, while the U.S. has 17 per 100,000, and 99 percent of our births are in the hospital?"

There are four sidebars that accompany the article. (They appear as links to "Related Stories") Of particular interest is the "Just Asking," in which author Burhop reveals that both ACOG and the American Medical Association declined requests to be interviewed for the article. Both ACOG and the AMA have vowed to lobby against laws to license Certified Professional Midwives (CPMs). Gainer lists four questions that she would have posed to the groups:

• What do you recommend for women who, for personal, monetary, cultural or religious reasons, don't want to have their baby in a hospital?


• What if a woman lives in a rural area far from a hospital? Wouldn't it be better to have a certified midwife in attendance?


• Are you looking at the consequences of all the intervention that goes on in hospital births to see if there are ways to reduce Caesareans and encourage more natural childbirth, with women in control of what happens to them?


• With obstetricians and gynecologists leaving Illinois in droves due to out-of-control liability insurance costs, wouldn't licensed midwives be a welcome addition to the field ?

ACOG's silence is deafening. As the trend to license CPMs picks up steam (with four more states gaining legal recognition in as many years), ACOG went running to its "big brother," the American Medical Association (AMA). In response to ACOG's requestion, the AMA passed the now infamous Resolution 205 vowing to lobby against CPM licensure. (Download the Word Document of AMA's Resolution here.)

Neither physicians group offers any practical solution to the maternity care crisis facing home birth families across the United States.

Labor Day Meme!

I've never done a meme before but couldn't resist, it being Labor Day and all ...

First, a hat tip to Rocks in my Drier for starting this Labor Day meme!

• How long were your labors? 

#1 --  24-36 hours 
#2 -- 4.5 hours
#3 -- Not sure how to answer b/c labor stalled in the middle. Technically, 4-5  hours, but I had about 1 hour of early labor, stalled for a couple hours, and then once it resumed a little over 2 hours until he was born.

• How did you know you were in labor? 

#1 -- it was a gradual start with menstrual-like rhythmic contractions.
#2 -- after a week of prodromal labor, contractions started fast and furious.
#3 -- strong menstrual-like rhythmic contractions that suddenly stopped after an hour. Midwife checked me, and I was at 2. Midwife thought it would be several more hours. After a nice quiet massage from DH, though, they roared back into a very fast pace.

• Where did you deliver?

All at home ...

#1 -- tried to do a water birth but water cooled off and I had to get out

#2 -- tried to do a water birth but didn't have time to fill up tub (thought it would be long again. Heh)

#3 -- finally had a water birth, but it still hurt like heck! (His hand was up by his face when he delivered, and he was 9 lbs. 3 oz.)

• Drugs?

No. I know they're really bad for the baby, and I realized that only by being at home where (1) drugs aren't available, and (2) natural labor is better supported, would I be able to do what's best for the baby and avoid all drugs and/or anesthesia.

• C-section? 

Thank Goddess, no! But I'm sure the first birth would have been if I'd been in the hospital. She was asynclitic and posterior, and I had a very long labor.

• Who delivered?

Midwives at all of them (sort of), in this order:

#1 -- Direct Entry Midwife 

#2 -- Certified Professional Midwife, but technically, DH "caught" him with midwife off to the side. This was my orgasmic birth!

#3 -- Certified Nurse-midwife (who had been apprentice trained first before going to CNM school)

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!

WE'RE NUMBER TWO!

A press release from the Big Push for Midwives Campaign ...

PushNews from The Big Push for Midwives Campaign
CONTACT: Steff Hedenkamp, (816) 506-4630, steff@thebigpushformidwives.org

FOR IMMEDIATE RELEASE: Monday, September 1, 2008

Number Two With a Bullet

Critical Women’s Health Issues Neglected as Physician Group Yet Again Sets its Sites on Midwives

WASHINGTON, D.C. (September 1, 2008)—In the newest phase of its ongoing effort to deny women the right to choose their maternity care providers and birth settings, the American College of Obstetricians and Gynecologists (ACOG) has announced that eliminating access to midwives who specialize in out-of-hospital birth is now the second most important issue on its state legislative agenda. This move puts restricting access to trained midwives ahead of such critical issues as contraceptive equity, ensuring access to emergency contraception, and the prevention and treatment of perinatal HIV/AIDS.

“ACOG claims to be an advocate of women’s health and choice, but when it comes to the right to choose to deliver your baby in the privacy of your own home with a Certified Professional Midwife (CPM) who is specifically trained to provide the safest care possible, ACOG’s paternalistic colors bleed through,” said Susan M. Jenkins, Legal Counsel for the Big Push for Midwives Campaign. “It is astonishing that an organization that purports to be a champion of women’s healthcare would put a petty turf battle that affects less than one percent of the nation’s childbearing women ahead of pressing issues that have an impact on nearly every woman in this country. If this is not dereliction of duty, I can’t imagine what is.”

In recent years, ACOG has led a well-financed campaign to fight legislative reforms that would license and regulate CPMs and has now teamed up with the American Medical Association (AMA) to promote legislation that would prevent families from choosing to give birth at home. Despite these joint efforts, the groups have not been successful in defeating the groundswell of grassroots activism in support of full access to a comprehensive range of maternity care options that meet the needs of all families.

“Wisconsin is a good example of what ACOG and the AMA are up against,” said Jane Crawford Peterson, CPM, Advocacy Trainer for The Big Push. “Our bipartisan grassroots coalition of everyday people from across the state managed to defeat the most powerful and well-financed special interest groups in Wisconsin, all on an expenses-only budget of $3000 during a legislative session in which $47 million was spent on lobbying. When you try to deny women the fundamental and very personal right to choose where and how to give birth, they will get organized and they will let their elected officials know that restrictions on those rights cannot stand.”

Noting these successes, ACOG has recently launched its own grassroots organizing effort, calling on member physicians to recruit their patients to participate in its “Who Will Deliver My Baby?” medical liability reform campaign.

“ACOG itself admits that we’re facing a critical shortage of maternity care providers,” said Steff Hedenkamp, Communications Coordinator for the Big Push. “They certainly realize that medical liability reform is nothing more than a band aid and that increasing access to midwives and birth settings is critical to fixing our maternity care system and ensuring that rural, low-income and uninsured women don’t fall through the cracks. Midwives represent an essential growth segment of the U.S. pool of maternity care providers, but instead of putting the healthcare needs of women first, ACOG would rather devote its considerable lobbying budget to a last-ditch attempt to protect its own bottom line. This is not a happy Labor Day for our nation’s mothers and babies.”

The Big Push for Midwives (http://www.TheBigPushforMidwives.org) is a nationally coordinated campaign organized 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 and the American College of Obstetricians and Gynecologists to deny American families access to safe and legal midwifery care. The campaign plays a critical role in building a new model of U.S. maternity care delivery at the local and regional levels, at the heart of which is the Midwives Model of Care, based on the fact that pregnancy and birth are normal life processes. Media inquiries: Steff Hedenkamp (816) 506-4630, steff@thebigpushformidwives.org.

# # #

The Big Push for Midwives Campaign is fiscally sponsored by Sustainable Markets Foundation, a not-for-profit organization recognized as tax-exempt under Internal Revenue Code section 501(c)(3). The mission of the Big Push for Midwives is to build winning, state-level advocacy campaigns towards successful regulation and licensure of Certified Professional Midwives (CPMs) in all 50 states, the District of Columbia, and Puerto Rico.

Visit the Big Push for Midwives Campaign on the Web at www.TheBigPushforMidwives.org.

Sustainable Markets Foundation | 80 Broad Street, Suite 1600 | New York, NY 10004-2248

The Big Push for Midwives Campaign | 2300 M Street, N.W., Suite 800 | Washington, D.C. 20037-1434

American women ripped off in childbirth

Why is it that in Great Britian, women receive one on one care if they have an epidural due to its dangers, but in the U.S. women are monitored remotely by an RN overseeing a few to several women at once?

There's an interesting piece, a diary excerpt, written by a newly qualified British midwife at the Daily Mail Online, which states (in Shift 8):

"Women with an epidural require one-to-one support from a midwife, because they are more at risk of their blood pressure falling, fainting or of having a reaction to the drugs.

The baby can also react to the drugs so its heart needs to be continuously monitored. "

But American women aren't told that their baby's reflexes will be dulled, and all the risks they put themselves and their babies in when they accept that epidural. (See Medical Risks of Epidural.)

So, if you're a practitioner or nurse who is familiar with hospital birth who thinks home birth is like what you witness, please stop projecting the dangers you see in hospital onto home birth! It's not the same. No epidural, no pitocin, no artificial rupture of membranes, all those things, and more, avoided at home means a lot more safety at home.

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!

Belly Dance and Birth

My first birth was very long, in part because the baby's position was less than perfect, being both posterior and asynclitic. (See this excellent website for more info on optimal fetal positioning.)

Eventually it resolved after the midwife helped me to walk the stairs and swing my hips. Now, lookign back, I wonder if I would have avoided it altogether by being familiar belly dance. I have since studied belly dance, and according to others present, I used a lot of belly dance type moves in my subsequent births.

There are belly dance videos and classes available for pregnant moms. Just be careful to avoid sharp, sudden popping moves. Otherwise, this can be a wonderful prenatal exercise that helps you learn to control your pelvic muscles and might assist you in an active labor, to help ease your birth.

Check out this beautiful video of pregnant belly dancing!

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."
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~

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.
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~

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.
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~

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.)