New York State passes Midwifery Modernization Act

Read more about it here.

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New York City's midwives in jeopardy

With the closing today of St. Vincent's Hospital, New York City's home birth midwives have found their livelihoods cut from under them. Their pregnant clients, some only weeks or days away from giving birth, suddenly are without care providers. New York State law mandates that home birth midwives have signed practice agreements with either a physician or an institution. St. Vincent's Hospital provided this agreement to most, if not all, of New York City's licensed home birth providers. With the hospital's closing, more than half of the city's home birth providers have been unable to find a new institution or physician willing to sign the agreement and are thus unable to legally practice midwifery.

To learn more about the situation, read these articles and blog posts:

• St. Vincent's Hospital Shutdown Leaves Expectant Moms Without Home-Birth Option
• With the Closing of a Hospital, Women’s Childbirth Options Diminish
• St. Vincent's Hospital Closes its Doors After 160 Years
• Radical Doula: Access to Homebirth in NYC Put at Risk by Closing of St. Vincent's Hospital
• RH Reality Check: Solidarity Now! The Eleventh Hour for NYC Midwives
• Marvelous Kiddo: Help Save Home Birth Midwifery
• Choices in Childbirth blog has updates on the NYS situation and tells you how to get involved

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Midwifery in Illinois

I lived in Illinois for three years after completing my PhD coursework at the University of Iowa. Direct-entry midwifery in both Iowa and Illinios was (and still is) illegal. Citizens' groups in both states are currently trying to pass legislation to license Certified Professional Midwives (CPMs). A lot of people have told me that Illinois will probably be the toughest state for legalizing and licensing direct-entry midwifery, since it is the home state of the American Medical Association. I went down to the Illinois state capitol when Zari was a baby to lobby and testify in favor of licensing CPMs. There was a large group of Amish people present on that particular day to support the proposed midwifery bill. At that particular meeting, the home birth supporters got portrayed as religious nut-jobs. None of us were particularly happy about that, the Amish included.

Certified nurse-midwives can attend home births in both states, but Illinois is particularly difficult for home birth CNMs. They have to have a signed collaborative agreement with an OB in order to practice. As you might imagine, this proves incredibly difficult to obtain. One home birth CNM I know approached something like 100 physicians before she found one willing to take her on. And the supervising OB can dictate what the CNM can and cannot do.

Iowa is more friendly to home birth CNMs than Illinois. In Iowa, nurse-midwives are considered independent health care practitioners and do not need any kind of physician supervision or collaborative agreement to attend births. Still, in both states, there are very few home birth CNMs. Only 5 of Illinois' 102 counties have legal home birth attendants. The situation isn't much different in Iowa. This means that most women wanting home births in Iowa or Illinois will have to hire "underground" midwives.

For two fascinating, in-depth looks at contemporary direct-entry midwifery in Illinois, I suggest you read these two articles that just came out this week:

• An Illegitimate Birth: Kim and Steven McCarty put their baby in the hands of an unlicensed midwife by Tiffany McClain in the Chicago Reader
• Home delivery: Thirty years later, Illinois midwives fight for birth rights by Amanda Robert in the Illinois Times

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The Amish defend midwife Diane Goslin

The Christian Science Monitor recently published a story, Laboring To Save Home Birth, about a midwife who serves the Pennsylvania Amish and the political battles over her right to practice.

What surprised me the most was how many births the midwife attends each year: 200 to 300. Most home birth midwives limit their practice to around 40 or 50 births per year. This is in part due to the relative scarcity of midwives, which means they spend a lot of their time traveling to and from their clients' houses. I wonder how she manages such a large load. I have read the the Amish generally do a lot less prenatal care, which would definitely cut down on the midwife's time demands. Her practice is 65% Amish.

A few paragraphs from the article:

Midwife Diane Goslin’s farmhouse office bustles with activity this summer morning. Horse drawn buggies line the driveway, while pregnant women line the waiting room inside – their hair tucked into bonnets, their dark dresses covered by black aprons.

A mother expecting her 11th child arrives with her daughter, who is expecting her first. Women do mending as toddlers scoot around their ankles. Childhood friends reunite, chattering in Pennsylvania Dutch. Sisters shriek with laughter at the unexpected sight of their expectant aunt.

Outside, on the porch – in a waiting room of his own – a lone, straw-hatted man rocks, amused, pretending not to overhear the women.

The Amish here in Lancaster County may go to the hospital if they break an arm or need surgery, but when it’s time to give birth they stay home. Usually, they deliver their babies with the aid of a midwife, and the women in this waiting room half-joke that if Ms. Goslin goes out of business, they are through with childbearing.

Read the rest of the story...

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MO midwifery legislation

Midwifery legislation is currently in the works in several states, including Missouri. Here's an update from the most recent efforts in Missouri: Push for midwives strengthening.

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Jan 24 is "Pushday"

The Big Push for Midwives
Launches on Jan. 24 "Pushday"

The Big Push for Midwives is a nationally coordinated campaign to advocate for regulation and licensure of Certified Professional Midwives (CPMs) in all 50 states and the District of Columbia, 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.

State-by-State Status of Legislation to License
Certified Professional Midwives (CPMs)

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Ron Paul on Licensure

Presidential Candidate Ron Pal discusses health care licensing.

The first part of the video is hard to make out because of the background noise, but the last half is a discussion of midwifery licensing. Some of his main points:

• licensing is a monopoly; it keeps other people from competing.
• licensing is better than prohibition, but the ideal is that people make up their own minds.
• I'm not in favor of government prohibiting people from making private choices. I might have a medical opinion, but politically people should make their own choices.

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Go to Jail

This is what happens to midwives in many states and provinces, including the state where I currently live. For more information on the legality of direct-entry midwives, visit MANA.

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Calling all Illinois Home Birth Supporters

News just in regarding the CPM legislation that passed the Senate 51-7 last month in Illinois:

The bill (which would license Certified Professional Midwives in Illinois) is currently in the House Registration and Regulation committee and seems in danger of being killed. If any of my readers are from Illinois, please get your pens out ASAP! If you don't live in IL, but have friends or family who do, please ask them to participate. Instructions below:

Dear Homebirth and Midwifery Supporters:

We have gotten the news that the House Registration and Regulation committee
intends to kill our bill unless we take additional action. We are considering another amendment, but in the mean time, we need EVERYONE to write a letter to the individuals on the Reg and Reg committee, even if their own Rep is not on that committee. We must produce a packet of letter for each committee member, just bursting with letters from you - the midwives, doctors, doulas, childbirth educators and families who are effected by the homebirth crisis.

This should be a very simple letter to produce. You can recycle a previously sent letter and just change the date and add a few lines as listed below, or you can start fresh. If starting fresh, please pick up pen and paper, and then read the rest of this email. You'll be done before you know it! These letters should be addressed to “Dear Committee Member:” In the following sentence or two, identify yourself as a homebirth consumer or supporter.

Next, unless your Rep IS a committee member, indicate that you are not one of their constituents, but that it is your understanding that they represent the interests of all the people, the whole state, when working in committee.

Express your deep desire to see that your own state Representative is allowed to vote on this matter. Ask the Committee members to PLEASE allow Senate Bill 385, the Midwifery Licensure Act, Senator Haine's bill, to get to the floor so that your Rep can weigh in. If your Rep is a committee member, remind them there are many families in addition to you, many of whom are not their constituents, but are depending upon them to help make homebirth birth safer for them. Give some sort of plea to help the families who choose homebirth have a chance to have a safer experience, or access to all safe maternity care options, or something similar.

Sign off and send via email to jiandra@aol.com
If you have a fax machine, please fax to 630.369.2456. Please do not use a cover sheet. If you have no fax, please drop a signed copy in the mail to Coalition for Illinois Midwifery, 901 E. Krage Drive, Addison, IL 60101 PLEASE DON'T DELAY! DO THIS TODAY OR TOMORROW AT LATEST.

We will take all these letters and distribute them in a packet to the Reg and Reg committee members early next week. WE STILL HAVE A CHANCE TO GET OUT OF THIS BILL OUT OF COMMITTEE WITH YOUR HELP!!! PLEASE HELP US, please write and help us show the State Medical Society just how strong we are!

Thank you,
Rachel Dolan Wickersham, CD, LCCE
President, Coalition for Illinois Midwifery

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