Private Birth Consultation, Doula Services

AMA Resolution Would Seek to Label “Ungrateful” Patients

If you don't like the idea of being officially labeled "non-compliant" or "ungrateful" for questioning your physician, then go to http://www.ama-assn.org/ama/pub/about-ama/our-people/the-federation-medicine/state-medical-society-websites.shtml, click on the link for your state AMA and contact them. Let them know that this proposal is unacceptable. Voting is next week.

AMA Resolution Would Seek to Label "Ungrateful" Patients

http://ican-online.org/news/ican-online

AMA Resolution Would Seek to Label “Ungrateful” Patients

Redondo Beach, CA, June 11, 2009 - At the American Medical Association’s (AMA) Annual Meeting next week, delegates will vote on a resolution which proposes to develop CPT (billing) codes to identify and label “non-compliant” patients (1)

The resolution complains:

“The stress of dealing with ungrateful patients is adding to the stress of physicians leading to decreased physician satisfaction.”

“This resolution is alarming in its arrogance and its failure to recognize, or even pay lip service to, patient autonomy,” said Desirre Andrews, the newly elected president of the International Cesarean Awareness Network (ICAN).

If approved, the resolution could hold implications for women receiving maternity care. For pregnant women seeking quality care and good outcomes, “non-compliance” is often their only alternative to accepting sub-standard care. Physicians routinely order interventions like induction, episiotomy, or cesarean section unnecessarily.

Liz Dutzy, a mother from Olathe, Kansas, delivered her first two babies by cesarean and was told by her obstetrician that she needed another surgical delivery. “My doctor told me that I needed to have a cesarean delivery at 39 weeks, or my uterus would rupture and my baby would die.” She sought out another care provider and had a healthy and safe intervention-free {home} birth at 41 weeks and 3 days gestation.

A recent report by Childbirth Connection and The Milbank Memorial Fund, called “Evidence-Based Maternity Care: What It Is and What It Can Achieve ,” (2) shows that the state of maternity care in the U.S. is worrisome, driven largely by a failure of care providers to heed evidence-based care practices. For most women in the U.S., care practices that have been proven to make childbirth easier and safer are underused, and interventions that may increase risks to mothers and babies are routinely overused. The authors of the report point to the “perinatal paradox” of doing more, but accomplishing less.

The resolution proposed by the Michigan delegation of the AMA could threaten patient care and patient autonomy for several reasons:

• Billing codes that would categorize any disagreement and exercise of autonomy on the part of the patient as “non-compliance” “abuse” or “hostility” could create a pathway for insurance companies to deny coverage to patients

• Use of these labels fails to recognize patients as competent partners with physicians in their own care

• Tagging patients as “non-compliant” fails to recognize that there is not a “one size fits all” approach to care, that different opinions among physicians abound, and that patients are entitled to these very same differences of opinion

• Labeling patients as “non-compliant” may, in fact, be punitive, jeopardizing a patient’s ability to seek out other care providers

The resolution also fails to address how it would implicate patients navigating controversial issues in medical care, like vaginal birth after cesarean (VBAC). While a substantive body of medical research demonstrates that VBAC is reasonably safe, if not safer, than repeat cesareans, most physicians and hospitals refuse to support VBAC. (3) The language in the resolution suggests that patients who assert their right to opt for VBAC could be tagged as non-compliant, even though their choice would be consistent with the medical research.

“The reality is that the balance of power in the physician-patient relationship is decidedly tipped towards physicians. The least patients should have is the right to disagree with their doctors and not be labeled a ‘naughty’ patient,” said Andrews.

About Cesareans: When a cesarean is medically necessary, it can be a lifesaving technique for both mother and baby, and worth the risks involved. Potential risks to babies from cesareans include: low birth weight, prematurity, respiratory problems, and lacerations. Potential risks to women include: hemorrhage, infection, hysterectomy, surgical mistakes, re-hospitalization, dangerous placental abnormalities in future pregnancies, unexplained stillbirth in future pregnancies and increased percentage of maternal death.

Mission statement: ICAN is a nonprofit organization whose mission is to improve maternal-child health by preventing unnecessary cesareans through education, providing support for cesarean recovery and promoting vaginal birth after cesarean. ICAN has 110 chapters in North America and Europe, which hold educational and support meetings for people interested in cesarean prevention and recovery.

(1) Resolution 710 “Identifying Abusive, Hostile or Non-Compliant Patients”

(2) Evidence-Based Maternity Care: What It Is and What It Can Achieve

(3) http://www.ican-online.org/ican-in-the-news/trouble-repeat-cesareans

From HealthNewsDigest.com

Legal Issues

Oregon State University Study Reveals Conflict between Doctors, Midwives over Homebirth

By Melissa Cheyney

May 5, 2009 - 5:41:07 PM

(HealthNewsDigest.com) - CORVALLIS, Ore. – Two Oregon State University researchers have uncovered a pattern of distrust – and sometimes outright antagonism – among physicians at hospitals and midwives who are transporting their homebirth clients to the hospital because of complications.

Oregon State University assistant professor Melissa Cheyney and doctoral student Courtney Everson said their work revealed an ongoing conflict between physicians and midwives, similar to that found in other studies of the dynamics between the two groups across the country.

The pair recently examined birth records in Oregon’s Jackson County from 1998 through 2003, a period when that county saw higher-than-expected rates of prematurity and low birth weight in some populations. The researchers wanted to assess whether those rates were linked to midwife-attended homebirths.

The findings revealed that assisted homebirths did not appear to be contributing to the lower-than-average health outcomes and, in fact, that the homebirths documented all had successful outcomes. But even more importantly to Cheyney, discussions with doctors and midwives uncovered a deep mistrust between the two groups of birthing providers, with doctors expressing the firm belief that only hospital births are safe, while midwives felt marginalized, mocked and put on the defensive when in contact with physicians.

“We’ve been getting insight into their world view, and it’s been quite illuminating,” Cheyney said.

Cheyney, who is a practicing midwife in addition to being an assistant professor of medical anthropology and reproductive biology, said she was surprised that physicians, when presented with scientifically conducted research that indicates homebirths do not increase infant mortality rates, still refuse to believe that births outside of the hospital are safe.

“Medicine is a social construct, and it’s heavily politicized,” she said.

She is working with Lane County obstetrician Dr. Paul Qualtere-Burcher to draft guidelines that would help midwives and their clients decide when they need to seek medical help, based in large part on Cheyney’s research, and another that would ask physicians to recognize midwives as legitimate caregivers.

Qualtere-Burcher said creating an open channel of communication isn’t easy.

“I do get some pushback from physician friends who say that I’m too open and too supportive,” he said. “My answer, to quote (President) Obama, is that dialogue is always a good idea.”

Qualtere-Burcher said he believes that if midwives felt more comfortable contacting physicians with medical questions or concerns, there would be a greater chance that women would get medical help when they needed it.

“Treat (midwives) with respect, as colleagues, and they’ll not be afraid to call,” he said.

While Qualtere-Burcher believes it would be wonderful, but Utopian, for all midwives to agree to seek medical assistance under the guidelines they’re proposing, and for all physicians to learn to deal more collegially with midwives, he hopes that if a small group on each side agrees to the plan, it will provide more evidence that a stronger relationship between physicians and midwives will lead to better outcomes for mothers and infants.

Last year the American Medical Association passed Resolution 205, which states: “the safest setting for labor, delivery and the immediate post-partum period is in the hospital, or a birthing center within a hospital complex…” The resolution was passed in direct response to media attention on home births, the AMA stated.

What is interesting, Cheyney points out, is that 99 percent of American births occur in the hospital, but the United States has one of the highest infant mortality rates of any developed country, with 6.3 deaths per 1,000 babies born. Meanwhile, the Netherlands, where a third of deliveries occur in the home with the assistance of midwives, has a lower rate of 4.73 deaths per 1,000.

One of the biggest problems Cheyney sees is that physicians only come into contact with midwives when something has gone wrong with the homebirth, and the patient has been transported to the hospital for care. There are a number of reasons why this interaction often is tension-filled and unpleasant for both sides, she says.

First is the assumption that homebirth must be dangerous, because the patient they’re seeing has had to be transported to the hospital. Secondly, the physician is now taking on the risk of caring for a patient who is unknown to them, and who has a medical chart provided by a midwife which may not include the kind of information the physician is used to receiving.

And because the midwife is often feeling defensive and upset, Cheyney said, the contact between her and the physician can often be tense and unproductive. Meanwhile, the patient, whose intention was not to have a hospital birth, is already feeling upset at the change in birth plan, and is now watching her care provider come into conflict with the stranger who is about to deliver her baby.

“It’s an extremely tension-fraught encounter,” Cheyney said, “and something needs to be done to address it.” As homebirths increase in popularity, she added, these encounters are bound to increase and a plan needs to be in place so that doctors and midwives know what protocol to follow.

“We’re having a meeting in early May to propose a draft for a model of collaborative care that might be the first of its kind,” in the United States, Cheyney said.

Cheyney is also pushing to get hospitals and the state records division to better track homebirths. The department of vital records had no way to indicate whether a birth occurred at home until 2008, and without being able to pull data, Cheyney said it’s hard to explore the nature of home birth in Oregon.

She’s also working on education programs for midwives in rural areas, including a cultural competency piece as demographics in Oregon continue to change.

The research was funded by Oregon State University's Department of Anthropology Summer Writing Fellowship, the Center for the Study of Women and Society, and the Stanton Women’s Health Fellowship.

About the OSU College of Liberal Arts: The College of Liberal Arts includes the fine and performing arts, humanities and social sciences, making it one of the largest and most diverse colleges at OSU. The college's research and instructional faculty members contribute to the education of all university students and provide national and international leadership, creativity and scholarship in their academic disciplines.

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Evidence Increases for Risks in Cesarean Surgery as National Rate Continues to Rise

PRESS CONTACT: Kara Dress, 202-367-2434, marketing@lamaze.org
ALL OTHER INQUIRIES: 800-368-4404; info@lamaze.org

WASHINGTON (March 18, 2009)? As research continues to mount for the risks of cesarean surgery, the Centers for Disease Control released new, staggering statistics today reporting that 31.8% of women endure birth by cesarean in the United States (2007). This announcement comes after the release of significant findings from the New England Journal of Medicine reinforcing that birth by cesarean surgery before 39 weeks of pregnancy causes increased complications in newborns.

Despite the latest advances in medical technology, health care providers cannot determine a baby?s due date with 100% accuracy. Therefore, cesarean surgeries scheduled before a woman?s estimated due date could result in a baby born as early as 36 weeks to a few days before the baby is actually due. During the last few weeks of pregnancy, a baby?s lungs mature and a protective layer of fat forms, both of which are vital developments for a healthy baby. In addition, babies need time for their lung cells to shift from being fluid producing to fluid absorbing cells. Without time during labor to prepare the baby to breathe, lungs cells may not be ready. Thus, babies born by cesarean surgery, even when they are full-term, need to go to an intensive care unit more frequently than babies who were born vaginally to get help breathing.

Research published in the New England Journal of Medicine (NEJM) supports earlier findings that cesarean surgery performed prior to 39 weeks of pregnancy increases poor outcomes in babies. Of the babies in the NEJM study born before 39 weeks, more than 26% had complications, including the need to be on a ventilator, respiratory distress syndrome, low blood sugar and severe infection (sepsis).
Overuse of cesarean surgery complicates the otherwise natural process of birth, says Lamaze Institute Chair Debra Bingham, LCCE, MS, RN, DrPH, ?Allowing the natural process to occur not only reduces risks for mothers in this and future pregnancies, but also reduces health risks for her baby.

Spontaneous labor is almost always the best indication for a baby's physical readiness for life outside of the womb. As one of the key steps to a healthy birth, Lamaze International recommends that women let labor begin on its own. Allowing labor to begin naturally increases the likelihood that a baby is healthy and ready for birth. When a birth outcome is good, mother and baby can bond and start breastfeeding immediately after birth both of which provide the best start for a baby's growth and development.

Lamaze International President Pam Spry, PhD, CNM, FACNM, LCCE says, Maternity care in the United States is at a crossroads. The most commonly used practices don?t align with the best evidence for a healthy birth. The Milbank Report's Evidence-Based Maternity Care: What It Is and What It Can Achieve reveals that several routine maternity care practices, including cesarean surgery, contradict best evidence and are overused in the United States.

Cesarean surgery, a major abdominal surgery, also carries risks for women, such as blood loss, clotting, infection and severe pain, and poses future risks, such as infertility and complications during future pregnancies such as stillbirth and placenta problems like percreta and accreta, which can lead to excessive bleeding, bladder injury, hysterectomy and maternal death. The research is clear, however, that when medically necessary, cesarean surgery can be a lifesaving procedure for both mother and baby, and worth the risks involved.

Two of the most important decisions a woman can make are where she gives birth and who she chooses as her care provider. Lamaze International has developed tools to help women with these decisions, including the questions to ask and other reference material. Visit www.lamaze.org  learn more about the Lamaze during pregnancy, birth and beyond. 

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About Lamaze International
Since its founding in 1960, Lamaze International has worked to promote, support and protect birth through education and advocacy through the dedicated efforts of professional childbirth educators, providers and parents. An international organization with regional, state and area networks, its members and volunteer leaders include childbirth educators, nurses, midwives, doulas, lactation consultants, physicians, students and consumers. For more information about Lamaze International, visit www.lamaze.org.

ICAN Online

From www.drjaygordon.com  Listed under T for Thrush in the alphabetical index, for further reference.

Grapefruit Seed Extract is a broad-spectrum antimicrobial compound synthesized from the seeds and pulp of grapefruit. It is an extremely potent and effective broad-spectrum bactericide, fungicide, antiviral and antiparasitic compound. Tests have shown that GSE is dramatically more effective than Colloidal Silver, Iodine, Tea Tree Oil and Clorox bleach against five common microorganisms. In studies performed by Dr. John Mainarich of Bio-Research Laboratories in Redmond, WA, samples of each of the common antimicrobials or sanitizing agents were evaluated for effectiveness against Candida albicans, Staphylococcus aureus, Salmonella typhi, Streptococcus faecium and E. coli. The other antimicrobials tested were considerably less effective than the GSE.

GSE is extremely effective in the treatment of thrush. I also find it to be the easiest place to start. If used diligently, it typically will clear up thrush within a couple of days

.
Treatment of thrush with GSE

Make a mixture of 10 drops of Citricidal Grapefruit Seed Extract to one ounce of water. The use of distilled water to make your solution is very important.  The chemicals placed in your local tap water to kill bacteria can reduce the effectiveness of the active ingredients in GSE.    

IF thrush is not markedly improved by the second day, increase the mixture to 15, or even 20 drops of GSE per one ounce of distilled water.   If after reaching up to at least 20, and a full day of hourly treatment with it, you see no improvement, I would consider using Diflucan.  If you are prescribed Diflucan, continue to treat topically with GSE during the course of treatment. 
 
Use this solution with an absorbent swab on mom's nipples and baby's mouth once every hour during all waking hours. Swab baby's mouth prior to nursing and mom's nipples after nursing.  Applying it to baby's mouth prior to nursing will help them to  avoid the possibility of baby associating the bitter taste with nursing.  
If diaper area is affected, put the same strength solution into a spray bottle or swab as above at every diaper change.
  
If the infection is particularly rampant or you are having difficulty getting rid of it, mom may need to take acidophilus or GSE capsules to get rid of it systemically. 
 
GSE solution can also be used in laundry or as a surface cleaner to kill yeast hiding and waiting to multiply again.
 
It may be necessary for Mom to eliminate sugar from her diet until the yeast infection is gone.

If treatment with GSE seems to leave your nipple area dry, I suggest applying a light coating of Vitamin E oil in the following manner: First apply the GSE solution, allow that to dry or use a hairdryer to dry it completely, then apply a light coating of Vitamin E oil.  I would suggest doing this 3 to 4 times a day until the dryness is gone.  It should only take a couple of days to show significant improvement.  The Vitamin E oil should absorb into the skin thoroughly prior to the nursing following the application.  I'm a big fan of Lansinoh, but do not use it when dealing with thrush, because it provides a moisture barrier that is counterproductive to getting rid of thrush. 

Since learning of the powerful antimicrobial that Grapefruit Seed Extract is, I have always kept a bottle in my home for many uses.

For more information on GSE:

Nutriteam: Grapefruit Seed Extract 

For prevention of thrush while taking antibiotics:

There are times over the course of nursing when a nursing mother needs to take antibiotics.  While taking antibiotics, good bacteria are destroyed  along with the bad. The absence of the good bacteria, which usually keep yeast in reasonable balance within the body, is what can leave a nursing dyad with thrush.   There are several options that may help to avoid this imbalance:

Take acidophilus/bifidus capsules with doses being as far away from the dose of antibiotics as is possible.  There is dairy free acidophilus available for those needing dairy free products.  Check labels for ones requiring refrigeration.

Take Florastor, which can be taken with the antibiotic dose. Eat yogurt with active live cultures.  Make sure you get unsweetened yogurt as you don't want to feed the yeast with sugar. All of these probiotics help to reintroduce to the gut the good bacteria that will help to regain control of the yeast overgrowth in the system. 

If the infant or child is the one taking the antibiotics, they usually fare better at avoiding thrush while taking antibiotics because breastmilk has a bifidus factor.  It promotes the growth of Lactobacillus, a harmless bacterium, within the gut.  Growth of this bacteria helps to eliminate the overgrowth of yeast.  A toddler or child can also take acidophilus.  The powder itself has a pleasant creamy taste and most are happy to lick it off your finger, take it with spoon or you can mix it into a food. 

As if we as birth workers and childbearing women didn't know this.. at least the media is finally realizing.. maybe it isn't too late to turn the tide

PRESS CONTACT: Kara Dress, 202-367-2434, marketing@lamaze.org
ALL OTHER INQUIRIES: 800-368-4404; info@lamaze.org

WASHINGTON (January 7, 2009) Despite best evidence, health care providers continue to perform routine procedures during labor and birth that often are unnecessary and can have harmful results for mothers and babies. The Centers for Disease Control's (CDC) most recent release of birth statistics reveals that the rate of cesarean surgery, for example, is on the rise to 31.1% of all births, 50% greater than data from 1996. This information comes on the heels of The Milbank Report's Evidence-Based Maternity Care, which confirms that beneficial, evidence-based maternity care practices are underused in the U.S. health care system.
Research indicates that routinely used procedures, such as continuous electronic fetal monitoring, labor induction for low-risk women and cesarean surgery, have not improved health outcomes for women and, in fact, can cause harm. In contrast, care practices that support a healthy labor and birth are unavailable to or underused with the majority of women in the United States.

Beneficial care practices outlined by Evidence-Based Maternity Care, a report produced by a collaboration of Childbirth Connection, the Reforming States Group and the Milbank Memorial Fund, could have a positive impact on the quality of maternity care if widely implemented throughout the United States. Suggested practices include to:

Let labor begin on its own.

Walk, move around, and change positions throughout labor.

Bring a loved one, friend, or doula to support you

Avoid interventions that are not medically necessary

Choose the most comfortable position to give birth and follow your body's urges to push

Keep your baby with you; it's best for you, your baby and breastfeeding.
Lamaze is alarmed by the current rate of cesarean surgery, and furthermore, by the overall poor adherence to the beneficial practices outlined above in much of the maternity care systems in the United States,says Lamaze International President Pam Spry, PhD, CNM, FACNM, LCCE, "We are continuing to work to provide women and care providers with evidence-based information to improve the quality of care.
Lamaze International has developed six care practice papers that are supported by research studies and represent 'gold-standard' maternity care. When adopted, these care practices have a profound effect--instilling confidence in the mother, and facilitating a natural process that results in an active, healthy baby. Each one of the Lamaze care practices is cited in the Evidence-Based Maternity Care report as being underused in the U.S. maternity care system".

Debra Bingham, MS, RN, DrPH(c), Chair of the Lamaze International Institute for Normal Birth says, "As with any drug, we need to be sure that women and their babies receive the right dose of medical interventions. In the United States we are giving too high a dose of cesarean sections and other medical interventions which are causing harm to women and their babies. Yet there are many countries where life saving medical interventions are under dosed which can also cause harm. Every woman and her baby needs and deserves the right dose of medical interventions during childbirth".

 
The research is clear, when medically necessary, interventions, such as cesarean surgery, can be lifesaving procedures for both mother and baby, and worth the risks involved. However, in recent years, the rate of cesarean surgeries cause more risks than benefits for mothers and babies. Cesarean surgery is a major abdominal surgery, and carries both short-term risks, such as blood loss, clotting, infection and severe pain, and poses future risks, such as infertility and complications during future pregnancies such as percreta and accreta, which can lead to excessive bleeding, bladder injury, a hysterectomy, and maternal death. Cesarean surgery also increases harm to babies including women giving birth prior to full brain development, breathing problems, surgical injury and difficulties with breastfeeding.
For more information on the Six Care Practices that Support Normal Birth, finding a health care provider and how to give birth with confidence, visit www.lamaze.org.

About Lamaze International
Since its founding in 1960, Lamaze International has worked to promote, support and protect normal birth through education and advocacy through the dedicated efforts of professional childbirth educators, providers and parents. An international organization with regional, state and area networks, its members and volunteer leaders include childbirth educators, nurses, midwives, doulas, lactation consultants, physicians, students and consumers. For more information about Lamaze International and the Lamaze Institute for Normal Birth, visit www.lamaze.org.

Here are some gems that have come through my inbox recently; Good postpartum care is essential. Remember the adage.. "an ounce of prevention is worth a pound of cure"

 I will come back and add more tips and techniques as time allows, so be sure to check back in the future!

Physicians commonly have women return for a checkup at six weeks
postpartum to assess the healing of the perineum and to make
recommendations for contraception, as appropriate. But most women are
told little or nothing about how to care for the perineum in the
interim, or how to watch for warning signals of infection like
swelling or inflammation. Pain is an important signal of problems
too, but it may go unnoticed if a woman is taking painkillers during
the first few days, the most critical time for healing.

I suggest that women use ice packs for 24 hours to reduce swelling,
and then switch to sitz baths several times daily using hot water
with selected herbs. Nothing speeds healing faster than heat, and
soaking is far superior to topical application as it more deeply
stimulates circulation. Fresh ginger is a good addition to the
solution; it helps relieve the itching that often occurs as stitches
dissolve and the skin heals.

Here is how I recommend women take a sitz bath: Grate a 3- to 4-inch
piece of ginger root into a large pot of water; simmer twenty
minutes; strain and divide into two portions. Save one for later in
the day, and dilute the first with water in a sitz bath. After
soaking for twenty minutes, thoroughly dry the perineum and expose to
air or sunlight for another 10 minutes before putting on a fresh pad
(or use a hair dryer to speed the process). If the perineum feels at
all sticky, use aloe vera gel to dry and soothe the tissues. Avoid
vitamin E or other oil-based ointments until the skin is healed over,
as these tend to keep edges from closing.

The wall-like ridge characteristic of episiotomy can be softened and
relaxed with thumb or finger pressure, using a little oil (just make
sure to wash your hands before handling the baby or breastfeeding).
When scarring is extensive, evening primrose oil (found in health
food stores) may significantly help to reduce it.

If adequately repaired and cared for, the perineum should be fully
healed at six weeks no matter how extensive the damage. I recently
saw a woman who was experiencing pain and bleeding with intercourse
seven months after perineal repair! She had been back to see her
doctor, who offered little assistance. (Unfortunately, he was also a
relative, so she hesitated to seek a second opinion.) As I suspected,
she had been sewn up too tightly with the "husband's knot." Even
gentle pressure to the area caused bleeding, as the skin tore ever so
slightly apart. Both she and her partner were frustrated and
miserable, and eventually, she had to have reconstructive surgery.
But other women who have seen me for this problem report spontaneous
resolution with application of evening primrose oil to the perineum,
massaged in thoroughly twice a day.

 Elizabeth Davis
Excerpted from "Sex after the Baby Comes," Midwifery Today, Issue 62

Raw honey is a great remedy for first-degree [perineal] tears.
Honey's thick consistency forms a barrier defending the wound from
outside infections. The moistness allows skin cells to grow without
creating a scar, even if a scab has already formed. Meanwhile, the
sugars extract dirt and moisture from the wound, which helps prevent
bacteria from growing, while the acidity of honey also slows or
prevents the growth of many bacteria. An enzyme that bees add to
honey reacts with the wound's fluids and breaks down into hydrogen
peroxide, a disinfectant. Honey also acts as an anti-inflammatory and
pain killer and prevents bandages from sticking to wounds. Laboratory
studies have shown that honey has significant antibacterial
qualities. Significant clinical observations have demonstrated the
effectiveness of honey as a wound healing agent. Glucose converted
into hyaluronic acid at the wound surface forms an extracellular
matrix that encourages wound healing. Honey is also considered
antimicrobial.

 Demetria Clark
Excerpted from "Herbs for Postpartum Perineum Care: Part I," The
Birthkit, Issue 46

Greetings!
In honor of today's Inauguration theme, "A New Birth of Freedom," we at The Big Push for Midwives are asking all of you to take a few minutes to send an email with the subject heading "A New Birth of Freedom" to our new president today. Click on the URL below and send a very simple but powerful message to the Obama administration:
"Please be sure to include Certified Professional Midwives (CPMs), who specialize in providing out-of-hospital maternity care, in federal healthcare reform."
http://change.gov/page/s/healthcare
Our goal is to submit 5,000 emails by midnight today. That number will put us ahead of every other grassroots movement that has submitted comments to the Obama administration and will ensure that our issue – expanding access to out-of-hospital births attended by CPMs – gets the attention it deserves.
Please send a quick email notification to the The Big Push for Midwives Facebook wall after you post your comment so we can keep a running tally.
Keep in mind that we are at a crossroads. Healthcare reform is now inevitable and will be based on the reimbursement categories and rates for Medicaid and federal employees. Private insurers are widely expected to follow suit. So if CPMs are not included as recognized providers in federal healthcare reform, there is a very real possibility that home birth families will not be able to receive insurance reimbursement, regardless of whether they have private or public healthcare insurance.
Please act now.
Thank you very, very much.
Big Push for Midwives