At its November 2005 Interim Meeting, the American Medical Association (AMA) House of Delegates adopted Resolution 814 titled, “Limited Licensure Health Care Provider Training and Certification Standards.” The resolution states:

RESOLVED, That our AMA, through the Scope of Practice Partnership, immediately embark on a campaign to identify and have elected or appointed to state medical boards physicians (MDs or DOs) who are committed to asserting and exercising their full authority to regulate the practice of medicine by all persons within a state notwithstanding efforts by boards of nursing or other entities that seek to unilaterally redefine their scope of practice into areas that are true medical practice. (Directive to Take Action)

Resolution 814 emerged from the Scope of Practice Partnership (SOPP), which was formed by the leadership of the AMA and other physician trade organizations to obstruct expansion and to restrict the licensed scope of practice of other healthcare professionals. These actions by organized medicine limit access to providers who have the education, expertise and experience to offer safe, quality health care services to the public, particularly for rural, uninsured and other underserved populations.

The Big Push for Midwives Campaign objects to the misleading and divisive language used in the AMA SOPP resolution, which needlessly pits medical doctors against other healthcare professionals at a time when the American public is faced with unprecedented healthcare shortages and millions of uninsured children and adults. The healthcare professionals that have been targeted by SOPP, which include nurse practitioners, physician assistants, podiatrists, optometrists, psychologists, chiropractors, and midwives, are the solution to this crisis, not the problem. The erroneous claim that SOPP can or should determine what is best for the patients of other healthcare professionals represents an outdated and patronizing line of thinking that cannot possibly serve the needs of today's patients—particularly childbearing women and their babies. Therefore, The Big Push for Midwives opposes SOPP and its efforts to restrict the scope of practice of our allied healthcare partners and to obstruct legislative initiatives that would increase access to licensed Certified Professional Midwives.

Father Knows Best Meets Big Brother Is Watching:

"The SOPP also is overseeing the completion of the AMA Scope of Practice Data Series, a compendium of information and resources for medical associations on 10 non-physician providers, and the creation of a geographic mapping tool that will allow Federation partners the ability to map, on a state-by-state basis and by specialty, the practice location of not only allopathic and osteopathic physicians but also various non-physician providers."

"From the President" by Ronald M. Davis, MD http://elephantcircle.net/?p=429

Following this AMA directive, several state medical boards have targeted more than a dozen midwives in states where CPM licensure is not yet available, leaving hundreds of pregnant women without care.  

The Big Push for Midwives collaborated with the California Families for Access to Midwives (CFAM) to get out this latest news release in California. CFAM is a social justice organization dedicated to removing barriers that deny California citizens access to licensed midwife care.

It looks like the "Free Our Midwives!" rally on July 1 at the Capitol in Sacramento, CA, was a great success, with 375 parents, babies, and midwife supporters converging on the Capitol in support of efforts to remove from California law a repressive and outdated provision that is threatening the future of legal midwifery in California, and perpetuating racial and economic disparities in birth outcomes.

Assemblywoman Susan A. Bonilla told the crowd at the rally that "You have made an impact here today." In addition, Assemblywoman Bonilla did two important things to help remove physician supervision:

1. She removed language from the bill (AB1308) that restated and outlined a plan for implementing California’s famously ill-conceived and unobtainable requirement of physician supervision of licensed midwives.
2. She also verbally committed to amending the existing law to take physician supervision completely off the books. PLEASE THANK HER (using old fashioned pen and paper! No calls for now!) for her support.

Resulting PushHeadlines:

• The Modesto Bee  |  July 8, 2013
• The Sacramento Bee (photo gallery)  |  July 8, 2013
• Point Reyes Light  | July 3, 2013
• LAFamily.com  |  June 2013

Congratulations from the Big Push for Midwives Campaign to the Friends of Missouri Midwives (FOMM) and the Missouri Midwives Association (MMA) on the fifth anniversary of the Missouri Supreme Court decision!

The Big Push for Midwives steering committee particularly LOVES this latest FOMM news release as our own Susan Jenkins was one of the attorneys who wrote the birth activists' amicus brief back then and consulted with MMA leadership on the text of the bill.

Please enjoy the news release here, which is well-written, upbeat, and positive. Again, congratulations to Missouri!!

Resulting PushHeadlines:

• Missourinet  |  July 9, 2013

Fire up the PushMediaMachine, we are back in business! We live to Push again! Many thanks and lots of hugs and kisses to all of you incredibly wonderful Pushers and other folks who chipped in on this latest fundraising effort.

Because you reached down and gave what you could, the Big Push for Midwives campaign's "50+ Shades of Green for CPMs" fundraiser was a pretty solid success.

Although we did not quite reach our goal of $5,000 (and anyone who wants to tip us over the top is still happily encouraged to do so), we got SOOOO close that our media relaunch is a definite GO.

We are thrilled to report that we will now be able to sign up again with our media software vendor, pay our loyal social-media-maven intern his back wages, and be back to our old PushNewsRelease and PushAlert tricks again real soon.

Don't forget to visit the Newsroom and get signed up for PushAlerts!

If you have any favorite reporters, bloggers, media outlets who you want to make sure are on our lists, please pass their contact info on to [email protected].

The Big Push for Midwives campaign belongs to you.

• It isn't the website alone (although we do have a lovely website).
• It isn't the Facebook page alone (though we're delighted to have so many fans!)
• And it certainly isn't just the steering committee.

We are here to help you in the PushStates out and to keep the Big Push for Midwives campaign going, but we are not a top-down organization, rather, we are the essence of grassroots. The Big Push campaign has always been the work of a coalition of the PushState groups, and our focus has always been to create a mutual-help project for all the consumers and midwives pushing in the statehouses and sharing ideas, strategies, successes, and setbacks to create efficiencies and interconnectivity.

For this coalition to be be sustainable, we realize that it will be necessary for periodic fundraisers. Please think of these as chipping in to keep your coalition going. A natural question is what other sources of funding might be available to us?

Our applications for grants have not been successful for the most part. Grant-makers don't seem to get it that, without licensing CPMs, nothing else really matters much—Medicaid, education, federal "recognition," schmoozing with midwives from the rest of the world, really none of it.

So long as nearly half of the women in the US lack access to Certified Professional Midwives (CPMs) just because they live in the wrong state, License First has to be the policy priority. We won't stop sharing this message.

So, again, THANKS SO MUCH to all of you and to everyone else who helped us turn 50+ shades of green into some much-needed green dollars.

Have you ever stopped to think about how one group's version of what is true and what isn't becomes the dominant voice? All through history, one group or another has decided that it had the insider information not only about God but about life, the world, how things were supposed to work. If you weren't part of the in-group, if you doubted their worldview, their claims to orthodoxy, you were a heretic and life could get pretty unpleasant if the orthodox view had the support of the government. So, pagans against early Christians, Christians against pagans, Christianity against Islam, Islam against Christianity, Catholics against Protestants -- and that's just Europe and colonial America. Almost every religion was oppressed somewhere at some time and, if it became dominant, has done some oppressing itself.

A state-forced orthodox worldview can lead a lot of people to embrace a belief which, empirically, turns out to be false. But those "heretics" who saw the flaws in the worldview, those who are the ones who said "you know, by my scientific calculations, the earth is probably round,"  and, in addition, "it revolves around the sun." They got into a lot of trouble when the state- or religion-enforced world view saw a flat earth that was the center of the universe.

When finding ways to make sure that Consumers can access the provider of their choice so that they can have a safe birth in the location of their choice, you inevitably run into the dominant worldview of the American Medical Association (AMA). To wit, in 1914, a man named Abraham Flexner told the AMA to get in one room, agree on what teaching was right, and then lobby the State and Federal governments to enforce this with their power. He didn't use the word "orthodoxy," but it just means "right teaching." All of the AMA's justification for dominance comes from the idea that they are "orthodox," and the best plan is to have the state force their ideas on us "heretics."

We now mock some of the pre-enlightenment ideas of the Church, such as the "flat earth" theory, but we aren't really any better. We still let orthodoxy dictate healthcare decisions instead of the evidence. For example, physicians knew for 20 years that they should not x-ray pregnant women, but it was "standard of care" i.e. "orthodoxy." So they kept on doing it until forced to stop.

Our challenge is very simple but very difficult: No matter what we say or can prove, "they" are going to state an unwavering belief in a flat earth. "There be monsters over there!" "You are going to sail off the end of the world!" Our task is to get us the freedom to risk sailing that way anyway on the chance that we might discover a new world instead.

Fortunately, we've already done the math. The world is, indeed, round.

Special thanks to Keith Williston of Missouri for inspiring this PushBlog post. At the heart of Keith's work in the PushStates, in Missouri and beyond, is his family-owned freestanding birth center, A Mother's Love Birth Center. Keith and his wife Rachel Williston, CNM, CPM, encourage more people to become involved in the work of the PushStates.

PushGirl Friday gets down to where rubber meets road, sharing her hard-won expertise from the campaign trail to increase pro-midwife and pro-birth options in the U.S. The work continues, and together, we are pushing forward for birth options! Sign-up for PushAlerts!

"Good news out of Maryland—and what an excellent action alert! (Please see Maryland's Alert below.) Jeremy and other folks working in MD and other states, my only caution would be that when you ask folks to personalize their communications to legislators (which is so critical), do NOT encourage them to write about why they decided to have a home birth.

"What we’ve found to be much more effective is to ask them instead to pick one or two of your suggested talking points and put them into their own words (and you all have a great list for a state with a Democratic majority—it’s so critical to tailor your talking points to the majority party in each chamber).

"When people include the reasons why they decided to have a home birth they veer way off message, go on way too long, and get into all sorts of thorny issues that tend to be very off-putting to people outside the home birth community, who often feel put on the defensive about their own birth choices and who often see home birth parents as misinformed, irresponsible, and smug people who put the birth “experience” above the safety of their own babies. Then you leave the door wide open for keeping the discussion framed around bad mothers and dead babies instead of on the one point opponent groups can’t refute—it doesn’t matter why people are having their babies at home, the fact is they are, and the numbers are steadily increasing each year. So here’s what we need to do to make it safe—license home birth midwives as Certified Professional Midwives (CPMs).

"We’ve consistently found that the only reasons for talking about why people have home births that gain us any traction are religious, cultural, or financial reasons. It’s hard to argue with those, and most people won’t, even if they still think home birth is a bad idea. But just a reminder to everyone gearing up for the new legislative season is that it’s always most effective for us to keep the focus on the reasons why home birth is a reality for a whole range of reasons other than personal choice.

"One of the realities we often neglect to mention but that is very effective to point out has to do with issues around birth certificate security. A good reason to have a licensed provider attend every birth is, for Democratic legislators, to make sure that no baby born in the U.S., regardless of the immigration status of their parents, can have their citizenship challenged or revoked because their birth certificate was signed by an unlicensed midwife (which has been a big problem in Texas, for example). And for Republican legislators, so that birth certificates handled by unlicensed, illegal providers who may or may not be on the up-and-up don’t fall into the wrong hands—terrorists, illegal immigrants, or black-market adoption peddlers. Actually, this point works well with Democratic legislators, too, but the threat posed to the citizenship of the children of undocumented immigrants is pretty much unique to them for obvious reasons having to do with the partisan fault-lines around the immigration debate.

"I know these points seem preposterous to us, but it’s amazing how effective they are with legislators who are already biased to consider midwifery and home birth to be somewhat shady practices, so why not turn that negative bias into one we can use to bolster our argument about why the safest route for multiple reasons is to license and regulate home birth midwives as CPMs. So I do like to remind folks every once in a while about the birth certificate issue since it’s one we tend to overlook. "Happy New Year everyone!"

~PushGirl Friday

Dear Childbirth Professionals, Moms, Dads, and Birth Options Activists:

On behalf of The Big Push for Midwives, a most sincere THANK YOU for all you do to increase pro-midwife and pro-birth options in the U.S. You inspire us.

Before 2012 gets away, please take a breath to think of all you've done this year to push for victories in the ongoing movement to protect our birth rights. Stay encouraged. Note all you have invested in our shared cause! The work continues: together, we're pushing for birth options!

The Big Push for Midwives Campaign is fiscally sponsored by Sustainable Markets Foundation, a 501(c)3 nonprofit organization. Support the work of the amazing folks in the PushStates. 

Please donate.

Credit: Elinor Carucci/Redux, for The New York Times

"[Ina May] Gaskin says that because midwife-assisted home birth is illegal in many states, many women are de facto coerced into surgery or other interventions they don’t need. For Gaskin, choice in birth remains a realm of reproductive freedom that mainstream feminism, until recently, has foolishly ignored; women should seek not just the freedom to decide whether or not to have a baby but also how to have it. Here, Gaskin assists Jane Montanaro during labor, March 27."

• See the entire New York Times slide show here.
• Read the related New York Times article "Mommy Wars: The Prequel" here.
• Learn about the state of reproductive freedom birth options across the U.S. here.
• Join the movement today and help support efforts in your state here.
• Appreciate the amazing Ina May Gaskin even more here.