Chandler, Arizona
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Sweet Pea ​Births
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Home Birth Rights Rally
| Posted on February 11, 2014 at 9:40 AM |
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 After much thoughtful deliberation, hours of testimony, and a strong showing by the consumers and the providers of licensed midwifery care at home, the Midwifery Scope of Practice was expanded in 2013. Just when we thought home birth in Arizona was going to follow evidence-based care...a new bill was introduced this legislative session to undermine a family's right to choose home birth. Read more about it HERE Here is the most recent update from our main advocate for an expanded scope of practice, Allyson Fernstrom:
If you can join us at the State Capitol, please come out in a show of support for informed choice and dignity in birth. If not, HERE is a list of contact information, plus a quick look of phone numbers to make phone calls in opposition of SB1157: 
Disclaimer: The material included on this site is for informational purposes only. It is not intended nor implied to be a substitute for professional medical advice. The reader should always consult her or his healthcare provider to determine the appropriateness of the information for their own situation. Krystyna and Bruss Bowman and Bowman House, LLC accept no liability for the content of this site, or for the consequences of any actions taken on the basis of the information provided. This blog contains information about our classes available in Chandler, AZ and Payson, AZ and is not the official website of The Bradley Method®. The views contained on this blog do not necessarily reflect those of The Bradley Method® or the American Academy of Husband-Coached Childbirth®. |
Rally to Improve Birth - TODAY
| Posted on September 2, 2013 at 2:41 PM |
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Today is THE day...The Rally to Improve Birth is happening across the country...did it make the news in your town? I know it did in the Phoenix area, and I just saw that CNN was sending a crew down to the LA rally. Yeah for Informed Births!! Since we are out of town and I can't attend our Phoenix Rally in person, I am thrilled to be able to participate via this Virtual Rally. Here are some pictures from our personal family album from Otter's homebirth. I am sharing them with you today to show solidarity with the families who are out under the elements to Rally for Change in the maternity system. All Pictures Copyright A Bunch of Smiles Photography    Why are you Improving Birth? Please leave us a comment - it will be moderated and
posted. The material included on this site is for informational purposes only. It is not intended nor implied to be a substitute for professional medical advice. The reader should always consult her or his healthcare provider to determine the appropriateness of the information for their own situation. Krystyna and Bruss Bowman and Bowman House, LLC accept no liability for the content of this site, or for the consequences of any actions taken on the basis of the information provided. This blog contains information about our classes available in Chandler, AZ and Payson, AZ and is not the official website of The Bradley Method®. The views contained on this blog do not necessarily reflect those of The Bradley Method® or the American Academy of Husband-Coached Childbirth®. |
Time To Rally Around Our Midwives
| Posted on May 21, 2013 at 11:55 AM |
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 (Submitted as a Public Comment) Open Letter to the Midwifery Scope or Practice Committee: It feels like healthcare in the state of Arizona is going the way of the public school system. Professionals who are out of touch, some of them not working in the field anymore, or as is said quite often, "couldn't cut it in the classroom," are making rules and regulations for the folks who are in the trenches, getting their "hands dirty" every day. It is bad enough that teachers are overwhelmed with rules that have them teaching to tests instead of using their God-given talents to teach and inspire a younger generation. Please do not let that model of decision-making work against the professionals who put their hearts and souls into ensuring that mothers and babies have a safe start in life. Go back to the drawing board; honor the tradition of midwifery that existed long before the field of obstetrics. Midwives have been bringing babies into the world since time immemorial. Just because they do not use surgery as their prime mode of delivery does not make them any less professional than their obstetrical counterparts in the hospital. Birth is intrinsically low-risk and a healthy time-period for the majority of women. Mothers who are induced, given drugs that slow down labor, then given drugs to speed up labor, forced to be still due to all the wires and cords they are attached to, forced to attempt pushing in a semi-supine or supine position: THAT IS NOT BIRTH. That is a medical event that has been managed into a high-risk situation. Midwives know healthy, low-risk birth. They know that a mother who had a previous cesarean for iatrogenic reasons deserves a second look. She is not broken, and necessarily incapable of a vaginal birth just because a doctor in the hospital decided she was out of time after her medically managed event. The right to self-determination is the foundation of our country. Rules and regulations that start shackling those rights will be resisted, especially when you are talking about taking away the rights of mothers, parents-to-be and their children. You might consider writing a trial period into the new rules and regulations. I know that VBAC is already basically approved - along with that, allow breech and twins. I have a firm belief that midwives who know how to assist these births will vette their clients. As long as both parties are in mutual agreement, then they will proceed into a care agreement together. I cannot believe that professionals would risk the lives of their clients by entering into a care contract that would jeopardize the life of the mother and/or the baby they serve. Midwives know that there is a segment of the population that is best served by the care of a surgeon - they will know who needs to be there and lovingly send them in that direction. If the state sees that the professionals are taking too many risks and that mothers and babies are having more adverse outcomes, then the rules and regulations can be re-opened and modified. I suspect that the opposite will happen, however, we will not know unless the opportunity is provided for the midwives to demonstrate that they know what they can and cannot attend as professionals. I also want to address, "one life is one too many", in terms of maternal or neonatal demise, or in lay terms, when mothers and babies die. I find that this statement highly suspect and the height of hypocrisy coming from doctors who are trained to perform abortions, and/ or who offer the option for mothers to terminate pregnancies for suspected or known deformities in their unborn children. In my opinion, you can't fight for life in one setting while being willing to extinguish it in another. At what point does life begin? That is a debate for another day, however, since "one life is too many" is a term that is thrown around in the debate when consumers ask for the midwives to be able to attend their VBAC, breech and twin births, it is something to think about and possibly explore further. I am not advocating for a pro-life position; I am simply trying to point out the hypocrisy of the "one life is too many" argument. The state of Arizona is at a crossroads. You can proceed with the draft rules as written and force healthy, reasonable women into unassisted births because they know that birth is a natural, non-medical event 98% of the time. The 2% who need extra care and attention, and possibly a hospital transfer will probably die because they choose self-determination over medically managed model of birth. The other option is to sit down with the professional midwives. Consumers are choosing midwives because they prefer the time honored tradition of midwifery care, and watchful waiting during labor and birth. Sit around the table with them; listen to them - they know how to safely do their work. Consumers want midwives to be able to assist in a greater variety of birth situations because we do not want to be subjected to the traumatic and/or patronizing care they received in the traditional doctor/hospital setting. Arizona has the potential to set the standard for a new era of honoring the tradition of midwifery. We can be the state where women and parents are free to choose care and midwives are free to offer care. Arizona can be a beacon of light to open the path for better maternal and neonatal outcomes when women of all race, class and creed can be treated as equal partners in their healthcare choices. Signed: Krystyna Bowman, Chandler, AZ Readers: For a summary of the proposed changes to the rules and regulations, check out THIS blog post. Would you like to post your own public comment to the proposed changes in the Midwifery Scope of Practice? You can do so HERE. Are you in the area? Please join us for a rally tomorrow at the NWC of 18th Ave and Adams Street from 12:00 - 2:00 pm. For more information or to contact the organizers, click HERE.   Disclaimer: The material included on this site is for informational purposes only. It is not intended nor implied to be a substitute for professional medical advice. The reader should always consult her or his healthcare provider to determine the appropriateness of the information for their own situation. Krystyna and Bruss Bowman and Bowman House, LLC accept no liability for the content of this site, or for the consequences of any actions taken on the basis of the information provided. This blog contains information about our classes available in Chandler, AZ and Payson, AZ and is not the official website of The Bradley Method®. The views contained on this blog do not necessarily reflect those of The Bradley Method® or the American Academy of Husband-Coached Childbirth®. |
Honor The Midwife
| Posted on February 12, 2013 at 9:46 AM |
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Rights for Homebirth Update: There was another Midwifery Scope of Practice Committee meeting last night at the Arizona Department of Health Services. The consumers came out en force and made it abundantly clear that the requests to have a midwife attend a homebirth of a VBAC, a breech and twin births are Human Rights and Woman's Choice issues. We know that there are risks involved. It is our right to do our own research, to explore all our options and to make the choice with the risk decisions that we can live with. Some women brought up an interesting point: if we support a woman's right to terminate life with an abortion, why don't we support her right to birth the life she chooses to carry? Here are my prepared remarks from last evening. Due to time constraints, I didn't get to present all of them. I did get most of the points across and I hope that the committee takes these points under consideration. Thank you to Will Humble and the committee for the amazing, transparent proceedings. I am so proud to claim Arizona as my home and wish that our nation’s capital would take notes. Why are we, as consumers, choosing midwives? We want the midwifery model of care – we want to be treated as individuals. We like the time we get to know our midwife and for them to get to know us. We like the approach that birth is sacred and it deserves the kind of time and care we get from our midwives. I want to repeat these important points from the presentation by Janice Bovee, CNM: Midwives acknowledge the power and strength of women, the importance of self-determination, a woman's active participation in the care of themselves, their babies and their families. Midwives offer compassionate care, they honor normalcy, they believe in watchful waiting, and they believe the birth experience has a profound effect on the mother and on humanity as a whole. Let’s remember: Who is driving this movement? Consumers want the choice. Consumers started this movement with no money in the bank and a lot of heart behind their belief that all mothers should have access to qualified, supportive, compassionate care in the home setting whether they are low risk, or if they are higher risk and want to find knowledgeable care at home. What is a key point I want the advisory board to hear?
Midwives want the best outcome for the mothers and babies that they serve. They know the extent of their training in normalcy. Midwives want safe, non-emergent outcomes for the mothers and babies they serve. If midwives working in the home setting are going to say yes to any of the options being considered by the Arizona Department of Health Services, they will not do so if their training is just adequate. Knowing how much they care about the population they serve, my guess is that the ones who say yes to those mothers are abundantly knowledgeable, or will take the steps to be so, before they agree to the care contract for VBAC, breech, and/or twin mothers. If a midwife knows that her clients needs do not match her skill set, then she can decline care to the mother. She will decline care to the mother because above all, midwives care deeply about both the mothers and the babies – they want a Healthy Mom, Healthy Baby outcome not just sometime...Every Time. They can and they do everything to ensure that outcome as they get to know their clients over the term of the pregnancy. Even when it is the decision to recommend something that no client wants to hear before their baby’s Birth Day: the better choice for you and your baby is to transfer care. Safety at home versus safety in the hospital: I have had the privilege and honor of attending ICAN meetings for the last two years. I have heard story after story of women who felt abused by the traditional obstetrical and hospital model. They do not want to repeat the trauma that they experienced at the hospital. They are choosing homebirths because they have done their research, and they are finding care providers that will provide abundantly qualified care at home. When they choose a VBAC care provider who works in the hospital paradigm, a common theme is “stay at home as long as possible”. How is this providing qualified care? The scary word is “uterine rupture”. If a woman is at home, alone without any assistance from a trained provider, how is this providing any care at all? As a state, we have an incredible opportunity to provide the mothers who are laboring and/or birthing at home unassisted to receive qualified, caring, supportive, compassionate care. The homebirth setting can be that place with clear goals to standardize training as we move forward, and that place can be the hospital with a greater shift to the midwifery model of care. Midwives honor us as women. Let’s honor them as care providers.
What do you think? Is the right to choose your birthplace despite your risk category a Human Rights or Women's Rights issue? Please leave us a comment - it will be moderated and posted. *I think* that the amount of traffic you so generously generate has led to a lot of spam posting. In an effort to keep the spam to a minimum, I am taking the time to moderate comments now. Link list Rights For Homebirth http://www.rightsforhomebirth.com/ Janice Bovee, CNM Presentation See the recording at the 42:05 mark Video recording of the MSPAC meeting: http://www.livestream.com/azdhs/video?clipId=pla_ecdd7764-047a-4dd5-b749-1ab1a9f64bd2&utm_source=lslibrary&utm_medium=ui-thumb  Disclaimer: The material included on this site is for informational purposes only. It is not intended nor implied to be a substitute for professional medical advice. The reader should always consult her or his healthcare provider to determine the appropriateness of the information for their own situation. Krystyna and Bruss Bowman and Bowman House, LLC accept no liability for the content of this site, or for the consequences of any actions taken on the basis of the information provided. This blog contains information about our classes available in Chandler, AZ and Payson, AZ and is not the official website of The Bradley Method®. The views contained on this blog do not necessarily reflect those of The Bradley Method® or the American Academy of Husband-Coached Childbirth®. |
Open Letter to The Arizona Department of Health Services
| Posted on January 15, 2013 at 4:45 PM |
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 The State of Arizona held another Open Meeting with the Midwifery Scope of Practice Advisory Committee last evening. You can view the proceedings by clicking on this link:HERE is a link to the meeting - ADHS is taping them for public record. First of all, I want to thank Will Humble, Director of Health Services, for
facilitating the Midwifery Scope of Practice Meetings. I have never been prouder of our state than
in the last two meetings I attended. Director Humble is truly committed
to a transparent process. I can only imagine how wonderful government
could be if all agencies and government operated out in the open and in full
view of the public that they are supposed to serve.
Secondly, I want to say that I appreciate the perspective of the hospital-based
practitioners on the board and in the audience. I know that you feel
passionately about the safety of the mothers and the babies. Some
homebirth transfers that happen are critical, and I understand why you feel
that homebirth is not safe. You only get to see, and you only get
involved, when a labor and delivery has passed out of the realm of what a
midwife’s training has prepared her for in the home setting.
I have a couple of points I want to make based on the proceedings of January
14, 2013. The first one is directed at Dr. Manriquez. The second
one is directed at the hospital-based providers that want the public to believe
that the hospital is the safest place to give birth for all mothers, regardless
of their own risk level.
Point 1.) People having homebirth are informed about the risks and benefits.
Dr. Manriquez made a couple of statements that to my mind betray her bias.
Her first statement was about the ability of the homebirth mother to
assess the information that is available to her so that she can make an
informed consent decision. She pointed out the education level of the two
consumers sitting on the panel, and her own educational level. Later, she
brought up the high percentage of women who were self-pay on a document that
was being passed around with homebirth statistics across North America.
I have news for the panel: A woman’s level of education does not necessarily
impact her ability to read. It does not affect her ability to listen.
It does not affect her ability to feel. Although I do not have a master’s
degree, or a jurisdoctorate, or a medical degree, I am capable of researching
on the Internet. I can find the sites that impartially collect
information. I can attend meetings with my peers to hear their anecdotal
information. I can consult with doctors and licensed midwives when I am
pregnant. I can listen to their information and process it to make the
best decision for our particular situation. My formal level of education
has no bearing on my ability to educate myself on a topic that impacts the well-being
of my unborn child. My first priority as
a mother is to choose what I feel is best based on all the information I have
evaluated.
It is a fact – a large majority of homebirth families are self-pay. There
are several reasons. Here are five that I am aware of:
Point 2.) The safety of homebirth versus the safety of hospital birth is
debatable.
Every midwife licensed through the state of Arizona is
required to prepare and submit quarterly reports. By the states own
admission, the Department of Health has failed to do anything with those statistics
until this Midwifery Scope of Practice Advisory Committee was formed.
Presenting statistics with over 2000 empty fields is irresponsible.
With so much at stake, it is absolutely imperative that every “text
field” is read and recorded electronically in such a manner that can be used to
report the true picture of homebirth.
What the state and the medical community are patently
unaware of is all the homebirths that go smoothly and beautifully at home with Healthy
Mother, Healthy Baby outcomes. I echo the sentiment that the state is not
ready to have this discussion until a clear picture is received. You must
complete the homebirth statistics without empty fields. The state must
pull the records from the family doctors, naturopaths, and the certified
nurse-midwives that are allowed to attend VBAC, multiple and breech births at
home, as well as the unassisted births at home. We in the community know
that these things happen safely at home because we are the ones witnessing them
and holding these women up through their birth journey. It is time for a wider
audience to become aware of the real picture of birth in the home setting.
Going forward, we have to consider the consumer. The
piece that was missing from the discussion last evening was the piece about a consumer
having the right to choose her care provider. We all seem to be making
the blanket assumption that if the State of Arizona expands a midwife’s scope
of practice, then all midwives across the state will be taking VBAC, multiples
and breech deliveries.
I believe a truer statement
is that those who feel qualified to attend those births will make themselves
available to do so. I also believe that mothers will choose providers
that have the skill set to support them at home. We have to try to give
the midwives credit for making the best practice choices for their abilities,
and the mothers and babies they serve; and consumers credit for making the
safest choice for the babies that they carry.
If we remove egos and simply look at care providers as providing a skill set
for birth, the paradigm can start to shift. A licensed midwife is trained
to serve low-risk women in a home setting. A certified-nurse midwife is a
great option for a woman who regardless of her risk category, and who wants to
birth under the midwifery model of care in a hospital setting.
Obstetricians are trained surgeons, whose level of training and expertise
is exactly what a mother in a higher risk category needs.
However, in a country where we live and die by our freedom to choose, there has
to be an effort made to provide choices for all women to access care in spite
of their risk category. As Director Humble so eloquently stated last
evening, this is an opportunity to rise to the occasion and make a real effort
for the women in the State of Arizona to effect Real Change.
I propose that Arizona becomes the first state to provide true informed consent
and a collaborative model of care that other states can use as their midwifery
model. We could be the first state that has a way for midwives to confirm
on record that they have provided the risks and benefits of a homebirth and
offers the option to speak to an obstetrician. We could be the first
state that has mothers under obstetrical care consult with licensed midwives
before consenting to a hospital birth.
I implore the Midwifery Scope of Practice Advisory Committee do the hard work
to establish a collaborative model of care. Let us remember that this is
a consumer-driven movement – women want the freedom to choose. Consumers
are demanding access to homebirth midwives regardless of their risk status.
In closing, I ask you all consider the babies. I believe that every provider
wants what is best for the babies. Consumers are asking that licensed
midwives be available to legally serve a population that is choosing unassisted
births at home. In which way, shape or forms can it possibly be safe for untrained
consumers to intentionally birth outside of any care model? I think we can all
agree that it is a situation to which a solution must be found.
There is no way to quantify the empowerment, the rite of passage, the growth in
a woman that happens when she is allowed to labor away from the smell, the
noise, the pinging and the intrusion of a hospital. It is our duty to
rise to the occasion and allow them legal access to the care they want and the
choice they deserve.
Sincerely,
Krystyna Robles-Bowman
LINK LIST Video of January 14, 2013 meeting http://www.youtube.com/watch?v=QacwYdrvp5g&feature=youtu.be
Disclaimer:
The material included on this site is for informational purposes only.
It is not intended nor implied to be a substitute for professional medical
advice. The reader should always consult her or his healthcare provider to
determine the appropriateness of the information for their own situation. Krystyna and Bruss Bowman and Bowman House,
LLC accept no liability for the content of this site, or for the consequences
of any actions taken on the basis of the information provided. This blog contains
information about our classes available in Chandler, AZ and Payson, AZ and is
not the official website of The Bradley Method®. The views contained on this blog do not necessarily reflect those of The Bradley Method® or
the American Academy of Husband-Coached Childbirth®. |
Midwifery Scope of Practice, Arizona
| Posted on December 18, 2012 at 2:04 PM |
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 I was thrilled to be part of a process in our state by which
we as citizens can participate in the legislative process yesterday. The Arizona Department of Health Services has
started an Open Meeting process with the Midwifery Scope of Practice Advisory Committee. The stated goal of this committee is to
review and update the rules and regulations that govern Lay Midwives and
Certified Professional Midwives that practice in the state of Arizona. As a consumer, am hopeful that they will be modernized
to reflect current evidence-based practices. Historically, there has been animosity and prejudice between midwives and obstetricians. When it comes to homebirth advocates, the stance is that birth is safer at home; the other side argues that
birth is safer in a hospital. Both sides
are correct. In healthy, low-risk
pregnancies, a birth at home is perfectly safe.
There are circumstances in which a birth at a hospital is the best
choice. And then there is a chasm, a
gray area, in which births can go either way. However, the forgotten component here is: what does the
consumer want? Even if her risks are
higher in one place or the other, where does the birthing mother feel the
safest? Where does she want to choose to
give birth to her child(ren)? The truth is that in the “land of the free”, women of
Arizona are shackled in their birth choices.
The only option for a mother who has a breech baby, who is carrying
multiples, and who has a history of previous cesarean is birth in a hospital
setting. (At least now, in many cases, access to Certified Nurse Midwives is growing, so that a woman can still have midwifery care in a hospital setting. Even so, they are a considered a threat by some OB's). In some places, women with
previous cesareans are not even allowed a trial of labor. They are forced to have repeat cesareans,
despite evidence that best practice should be to allow women to labor for a
vaginal birth. Is every birth outcome going to be perfect? No. That is unrealistic. However, each woman should have the option to approach the care provider of her choice to have the conversation about the possibility of having her birth wishes honored and come to fruition. If a woman is willing to assume the risk of any of these births at home, and if she can find a homebirth midwife who is willing to travel that path with her, then they, as two consenting adults, should have the right to enter into that contract together without fear of repercussion from the state in which they live. What I suspect is missing from the discussion is the understanding that no mother and no care provider would knowingly and willingly endanger the life of a child. A mother knows her mind. A care provider knows their abilities. If the two do not mesh, then a different choice will be made, a choice that ensures the safety of the child. Here is my speech from yesterday during the “Call to Public”
portion of the meeting. As a mother who
carried a breech baby, I felt that I could speak to that aspect of the law:
I hope that you will do some reading, visit the Rights for
Homebirth webpage and Facebook page. Get
involved. You have a voice. The Arizona Department of Health is
listening.
Disclaimer: The material included on this site is for informational purposes only. It is not intended nor implied to be a substitute for professional medical advice. The reader should always consult her or his healthcare provider to determine the appropriateness of the information for their own situation. Krystyna and Bruss Bowman and Bowman House, LLC accept no liability for the content of this site, or for the consequences of any actions taken on the basis of the information provided. This blog contains information about our classes available in Chandler, AZ and Payson, AZ and is not the official website of The Bradley Method®. The views contained on this blog do not necessarily reflect those of The Bradley Method® or the American Academy of Husband-Coached Childbirth®. |