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Sweet Pea Births

Chandler, Arizona

Sweet Pea Births

...celebrating every swee​t pea their birth

Blog

Q&A with SPB: Rally for Midwives

Posted on November 3, 2015 at 3:07 AM Comments comments (0)
ADHS: Stop asking our midwives to do the impossible.

They cannot offer informed, evidence-based care and follow your inconsistent rules.
 
Coercion is not consent!!



 
What: Rally in support of Arizona Midwives
 
When: Thursday, November 5, 2015
 
Where: In front of the Arizona Department of Health Services, 150 N. 18 Avenue, Phoenix, 85007
 
Why: 22 of the 74 licensed Arizona midwives have been disciplined for failing to practice according to the Arizona Rules & Regulations. It’s time to let Governor Ducey, the Arizona Department of Health Services (ADHS) and elected officials know that we want to stop the public persecution of midwives. It’s time to support them in their efforts to offer safe, evidence-based care to Arizona’s birthing families.
 
The state of Arizona has known for years that it’s archaic laws force a midwife to choose between compliance with said rules and regulations, and honoring the autonomous rights of her patient to a safe, evidence-based birth.
 
In proceedings held in November, 2014, one state employee admitted to this conflict:
 
“Tom Salow, ADHS’s acting Assistant Director of Licensing testified that ADHS has been aware of this potential conflict in its rules for years but has taken no action to rectify it, nor has it offered midwives a course of action that would satisfy both the duty to transfer care and the duty not to abandon a patient.”
Excerpt from Administrative Law Judge Decision, written by her Honor, Judge D.M. Lang http://goo.gl/7x3TVS
 
More highlights from the Administrative Law Judge Decision, written by her Honor, Judge D.M. Lang 
 
“It is hard to understand how a violation…warrants a year suspension when ADHS knows its own rules and lack of guidance have put the midwife in this position…Considering that ADHS has known about the potential problem posed by the rules for years and yet has failed to arrive a t a solution itself, it is unrealistic to expect midwives to hit on the perfect balance of safety and duty when suddenly placed in an awkward position…”
 
“…an internal inconsistency in the laws and rules, combined with ADHS’ failure to provide guidance that ensures no mother and child will be abandoned without professional care, makes it impossible for midwives to follow the rule….if ADHS cannot think of an answer to the dilemma, it hardly seems appropriate to discipline others for having the same number of answers: none."
 
My favorite line: 
“...it is not appropriate to require anyone to do the impossible.”
 
I’m going to be there on Thursday – will you join me and other birthing families to show support and raise our voices with Arizona’s midwives?
 
LIVE RALLY:
https://goo.gl/oTp1u9

VIRTUAL RALLY:
https://goo.gl/YdCxpO
 
Sweet Pea Families blog post – how compliance would have affected our birth:
http://goo.gl/iaFfES
 
AZ Midwife relates her tale of trials and tribulations with ADHS
http://goo.gl/bqg8K5
 
Ruling by Hon. Judge Lang:
http://goo.gl/7x3TVS

Disclaimer:  
Bradley Method® natural childbirth classes offered in Arizona: convenient to Chandler, Tempe, Ahwatukee, Gilbert, Mesa, Scottsdale, PaysonThe material included in this video is for informational purposes only. It is not intended nor implied to be a substitute for professional medical advice. The viewer 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 and video contain information about our classes available in Chandler, AZ and Payson, AZ and is not the official website of The Bradley Method®. The views contained in this video and on our blog do not necessarily reflect those of The Bradley Method® or the American Academy of Husband-Coached Childbirth®.


Q&A with SPB: Midwifery Care

Posted on May 5, 2015 at 7:49 PM Comments comments (0)
Happy International Day of the Midwife to the midwives of the world.

Facebook image - source: KNOW YOUR MIDWIFE

We are so blessed with so many amazing midwives in our birth community.  Here is a little more about why Sweet Pea Births advocates for midwifery care to be an available option to all birthing families:










~~~
Here is a little more about the different ways a health practioner can certify to become a midwife - excerpt from THIS article:

There are two types of midwife in the United States:
**Nurse-midwives are educated and licensed as nurses first, and then complete additional education in midwifery. They are known as Certified Nurse-Midwives (CNMs). CNMs are licensed to practice in all 50 states. They are usually licensed in individual states as Nurse Practitioners (NPs).
**Direct-entry midwives are educated or trained as midwives without having to become nurses first. They may be Certified Professional Midwives (CPMs) or Certified Midwives (CMs). The legal status and requirements for direct-entry (non-nurse) midwives vary from state. They are usually licensed in individual states as Licensed Midwives (LMs) or Registered Midwives (RMs). The Midwives Alliance of North America tracks the laws and regulations in each state for direct-entry midwives.

For a good explanation of the way a midwife is different from a doula read this excerpt from the bump:
"A midwife is…a health care provider and a doula is more of a childbirth coach. You might choose to have a midwife instead of an OB for prenatal care and to deliver your baby — midwives can deliver babies in hospitals, birthing centers or even in your home. A doula, on the other hand, doesn’t replace your healthcare practitioner but rather can add extra services, such as helping you with techniques to manage pain during labor and even providing support and help during baby’s early days." 

A midwife's main scope of practice is the health and well-being of the Mother and the Baby.  She is doing "watchful waiting" through the pregnancy and birth, ensuring that everything is proceeding and staying healthy and low-risk.  If things start to vary or complications develop, depending on the midwife and whether they are home- or hospital-based, they may encourage the family to seek co-care or transfer care to an obstetrician who is trained to manage pregnancy that is moving away from low-risk.  

In the Phoenix, Arizona area, home birth families have the choice of doing co-care with Certified Nurse Midwives in the hospital setting, and still maintaining the midwifery model of care.  This allows for families to continue with "watchful waiting" and preserve their autonomy as consumers of healthcare.

Why hire a midwife?
The first study to compare birth outcomes between midwifery and obstetrical care was published in 1998.  Here are the conclusions:

"After controlling for a wide variety of social and medical risk factors, the risk of experiencing an infant death was 19 percent lower for births attended by certified nurse midwives than for births attended by physicians. The risk of neonatal mortality (an infant death occurring in the first 28 days of life) was 33 percent lower, and the risk of delivering a low birthweight infant was 31 percent lower. Mean birthweight was 37 grams heavier for the certified nurse midwife attended than for the physician attended births. Low birthweight is a major predictor of infant mortality, subsequent disease, or developmental disabilities.

Certified nurse midwives attended a greater proportion of women who are at higher risk for poor birth outcome: African Americans, American Indians, teenagers, unmarried women, and those with less than a high school education. Physicians attended a slightly higher proportion of births with medical complications. However, birth outcomes for certified nurse midwives were better even after sociodemographic and medical risk factors were controlled for in statistical analyses."

Excerpt from http://www.cdc.gov/nchs/pressroom/98news/midwife.htm

For the study abstract, click HERE
To read the study, click HERE

Is homebirth safe?
There are several studies that have been conducted around the world that show midwifery is safe - find a reference list HERE.  The big question remained: would outcomes be comparable in the US, where we do not practice socialized medicine?

The MANA study found that:
"Among 16,924 women who planned home births at the onset of labor, 89.1% gave birth at home. The majority of intrapartum transfers were for failure to progress, and only 4.5% of the total sample required oxytocin augmentation and/or epidural analgesia. The rates of spontaneous vaginal birth, assisted vaginal birth, and cesarean were 93.6%, 1.2%, and 5.2%, respectively. Of the 1054 women who attempted a vaginal birth after cesarean, 87% were successful. Low Apgar scores (< 7) occurred in 1.5% of newborns. Postpartum maternal (1.5%) and neonatal (0.9%) transfers were infrequent. The majority (86%) of newborns were exclusively breastfeeding at 6 weeks of age. Excluding lethal anomalies, the intrapartum, early neonatal, and late neonatal mortality rates were 1.30, 0.41, and 0.35 per 1000, respectively."
~Excerpt from THIS article




Are you curious about midwifery care??
Here are some posts where we share our birth journey with midwives:

Midwives Make a House Call - Third Trimester

Preparing for our Homebirth - Third Trimester







Link List
1998 Midwifery Study
http://www.cdc.gov/nchs/pressroom/98news/midwife.htm
http://jech.bmj.com/content/52/5/310.abstract?sid=52c15f2a-a71c-45d5-a827-c403cb953fa1
http://jech.bmj.com/content/52/5/310.full.pdf+html?sid=52c15f2a-a71c-45d5-a827-c403cb953fa1

MANA Homebirth Study
http://mana.org/blog/home-birth-safety-outcomes

Homebirth Studies Reference Page
http://mana.org/research/section-a-best-available-studies-grouped-by-design-level-of-evidence

Bradley Method® natural childbirth classes offered in Arizona: convenient to Chandler, Tempe, Ahwatukee, Gilbert, Mesa, Scottsdale, PaysonDisclaimer: 
The material included in this blog and video is for informational purposes only. It is not intended nor implied to be a substitute for professional medical advice. The viewer 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 and video contain information about our classes available in Chandler, AZ and Payson, AZ and is not the official website of The Bradley Method®. The views contained in this video and on our blog do not necessarily reflect those of The Bradley Method® or the American Academy of Husband-Coached Childbirth®.
 


Two Paths to One Truth

Posted on June 4, 2013 at 7:28 AM Comments comments (0)
The final open meeting of the Midwifery Scope of Practice committee was held yesterday, June 3, 2013.  The whole time I have been attending or watching the livestream recordings, there has been a nagging thought that was tugging on my brain.

The Director of Health Services wrote THIS blog post that really helped me clarify the thought that had been rolling around in my head, and I couldn’t quite pin it down until I read his post:

Excerpt:
“In the draft rules, there are a handful of tests that women need to take if she wants to have Licensed Midwifery services.  These tests (HIV, Hepatitis B, blood glucose, and blood Rh factor) are the only way for the midwife to establish that the birth will be low risk and safe for the health of the newborn and mom.  The mom-to-be can still refuse the tests, but that means she wouldn’t be able to have a Licensed Midwife present during the home-birth because it wouldn’t be possible to determine if the birth is low-risk and suitable for a home delivery.”
       ~Will Humble, Arizona Department of Health Services Director

Here is an excerpt from the comment I left him:

"The ADHS is approaching birth as something that needs to be established as “low-risk” in order to proceed at home. Those of us who have had a homebirth, and the care providers who support us, have a belief that pregnancy and birth are low-risk from the outset.

The medical model wants birth to be proven safe; the midwifery model believes birth is safe until it is proven otherwise. We will continue to go around and around about what is best for mothers and babies until some sort of resolution is found between those two disconnected approaches to pregnancy and birth."

The good news is: thanks to the public outcry against the mandatory testing, that part of the rules and regulations is being left alone for the most part to stand as it was.  Some minor updates are being made to take account new information about infectious disease since the rules were last updated in 1999.  For the most part, consumers and midwives were happy with the verbal agreement reached by the committee about how testing is going to be written in the updated rules.

Sadly, the issue of the "Us Versus Them" mentality that exists between the medical model and the midwifery model has not been resolved.  Here are two interactions that happened at the June 3, 2013 Midwifery Scope of Practice Meeting that clearly illustrate the disconnected paradigms in two approaches to one fact of life: Birth Happens.

1.) The medical community does not understand the scope of midwifery training.
Transcript of video (http://www.livestream.com/azdhs) starting at time stamp 13:18
Maria Manriquez, MD, FACOG, President of ACOG Arizona: “In your explanation, that’s then inferring that you continue care of the neonate.  Does that imply that you are not providing the infant with a pediatrician or a doctor of it’s own at the appropriate time?  Correct me; I am assuming you are not implying that you then become the provider for the newborn?  You are practicing out of scope of practice! You’re not pediatricians or lay pediatricians!” 

Wendi Cleckner, CPM, points out that on page 24 of the May 24, 2013 version of the rules, the parameters of a midwife’s care for the newborn are clearly stated.  (There are 16 different clinical observations a midwife must make about the newborn, and if necessary, protocols for referrals that she will follow that are in the best interest of the baby, before she can say her role in that infant’s care is complete.)

Janice Bovee, CNM, MSN, “Midwifery, including Certified Professional Midwives and Certified Nurse Midwives, in our programs, and in our training; we include mother’s pregnancy, intrapartum care, birth, postpartum care and care of the newborn.  We are trained in that.  That is part of the midwifery model.”

Thank you, Janice for defining the scope of practice for midwives for Dr. Manriquez and anyone else who is unclear about exactly what midwives are trained to do.  A midwife is trained to practice in the home setting, so she must assume some of the care that a pediatrician would perform in the hospital setting because childcare is not in the obstetrical job description.  Whether she works in the home, a birth center or a hospital, a midwife is willing, capable, and knowledgeable in the care of both the mother and the neonate as part of her scope of practice every day of the week.

(Side note: can you see how midwives start to lower the cost of healthcare in this simple illustration?  One person caring ably for two people, instead of two people caring for two people.)

2.) The medical community does not understand the rigors of midwifery training.  The fact that practitioners of midwifery care are not learning to do surgery does not mean that their training is inconsequential. 
The second exchange, that occurs at time stamp 26:23 of the meeting:
Maria Manriquez, MD, FACOG, President of ACOG Arizona: “Is there any room for demonstrating actual; I know that you’re at least, that’s what Wendi has communicated, that you have to demonstrate physical competency?  So, all of the physician providers have to demonstrate competency.  So what physical competency is demonstrated by licensed midwives?  So there’s an exam, there’s NARM certification, but it doesn’t spell out specifically what and who signs off on that particular practitioner.”

Wendi Cleckner, CPM: “That’s what we’re adopting as the CPM process, is NARM.  The national organization does all of that and there is a clinical aspect; that you are in front of a qualified examiner who takes you through scenarios, you have to work on models, you have to demonstrate your clinical skills in front of them, and then they pass or fail you.”

Maria Manriquez: “We break it down even more specific.  So you can be knowledge, medical knowledge approved but not clinical, and vice versa.  So, is there an opportunity to have that information?”

Wendi Cleckner: “It’s on the website of NARM.”

Maria Manriquez: “So on the website, I could go and look you up and see that you had passed both the medical knowledge portion and the (unintelligible)?”

Wendi Cleckner: “If I did not pass all the sections, I would not be a CPM.  You would not be certified, you would not get your license, if you didn’t pass all the sections.”

Mary Langlois, CPM: “You also have to pass an apprenticeship.  So, you have a preceptor who is designated to oversee your competency.  So you’re taught by the preceptor, and the preceptor also does skills check offs and oversees you and helps you manage the deliveries.  So not only do you have to complete the clinical side, and then you would have to complete all your documentation, you take it to NARM, you take the practical examination, you pass that, then you take the written.”

I especially love Mary’s comment because it reminds us that the midwifery model is personal not just to the woman receiving care, but also to the woman who is providing the care.  Another women who saw her passion, helped her hone her skills, and took the time to teach her.  She was not taught in an amphitheater setting, and not in a residency program designed to weed out the weak links, but in the intimate, person-to-person knowledge transfer, one or two students at a time.

Without too much extrapolation, I think it is easy to see that the medical model of training looked at the eons-old midwifery model of knowledge transfer and sterilized it to suit the needs of the medical community.  If we are honest with ourselves, we need to ask ourselves what the conflict is really about. 

Is it really about the safety of the mothers and the babies, or is it the continual push of one system against another?  One system still trying to prove it’s soaring above the other one that is merely trying to stay grounded and true to its roots.

As Bradley™ teachers, Bruss and I recognize that there is real value brought to the table by both knowledge sets.  We help couples find a path to stay healthy and low-risk so that they a variety of birth options available to them.  If they want midwifery care at home or at a birth center, great!  If they want midwifery care in the hospital – fantastic!  If they feel comfortable with the obstetrical approach, we know there are care providers that support natural birth.  They have choices. 

Although very seldom, occasionally there are developments that move a couple’s pregnancy or birth out of the healthy and low-risk category wherever they are seeking care.  We want those couples to have specialized obstetrical care so that they, too, can have a Healthy Mom, Healthy Baby outcomes like their low-risk counterparts.

Director Humble and his team are in the unique position of being able to set the tone and the groundwork for collaborative care to really take root in the United States.  It is our hope and prayer that a peaceful, respectful and collaborative model of care will be pioneered in the state of Arizona. 

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.
 
Bradley Method® natural childbirth classes offered in Arizona: Chandler, Tempe, Ahwatukee, Gilbert, Mesa, Scottsdale, PaysonDisclaimer: 
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 Comments comments (0)
Bradley Method® natural childbirth classes offered in Arizona: Chandler, Tempe, Ahwatukee, Gilbert, Mesa, Scottsdale, Payson
(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.

Bradley Method® natural childbirth classes offered in Arizona: Chandler, Tempe, Ahwatukee, Gilbert, Mesa, Scottsdale, Payson


Bradley Method® natural childbirth classes offered in Arizona: Chandler, Tempe, Ahwatukee, Gilbert, Mesa, Scottsdale, PaysonDisclaimer:  
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 Comments comments (0)
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?      
  • Consumers want choice.  Licensed midwives have a choice.  Both have the right to choose.       
  • Consumers want access to compassionate care at home that honors their ability to give birth.

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.

  • Midwifery Scope of Practice Advisory Committee Meeting, February 11, 2013 - View the entire meeting HERE

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

Bradley Method® natural childbirth classes offered in Arizona: Chandler, Tempe, Ahwatukee, Gilbert, Mesa, Scottsdale, PaysonDisclaimer: 
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®.