Birth activists were all pretty happy this week reading about the new U.K. National Health Service NICE guidelines recommending birth at home with a midwife, or in a midwife-unit for first-time mothers. (And again when seeing the ripple headlines here and here and here.)
"The UK gets it right," we posted on The Big Push for Midwives Campaign Facebook page. But, positive as this development may be, it is clear it will take far more than British sanity about birth for US policymakers or the US maternity care system to likewise "get it right" or even to "get it."
As one commenter quickly noted, opponents will quickly hog-tie the new UK policy to British midwifery education, or the integration of home and hospital in that country ... the usual rhetorical smoke-and-mirror tricks used to deflect attention from the fact that US home birth midwives, CPMs, are experts in out-of-hospital care, the gold standard, educated specifically to excel as providers of home and other out-of-hospital maternity care. The casual reader, who does not yet know those facts about CPMs, will then fail to realize that the NICE recommendations hold true also for American women who, like their British sisters, are female mammals (smoke and mirrors be damned).
The good news is that The New York Times journalists saw instantly the real basis for the differences in care between the US and the UK. Read it here. Notice, in the 11th paragraph, right after the obligatory recitation of ACOG's standard rote objection to home birth ("we do not believe" home birth is safe), the article points out:
"If such a recommendation were made in the United States, doctors might worry about losing patients to midwives."
There it is, folks, in a nutshell, laid right out in the open.
The New York Times gets it, it understands that ACOG's opposition to home birth isn't really about safety, or education, or models or care, or liking CNMs better. It is all about competition, losing patients to another type of provider, about money. '
The article continues: "That concern is absent in Britain's taxpayer-funded system. There are no financial incentives in the U.K. for doctors to deliver in a particular setting (that is, hospitals) because there is no personal gain."
Shazam. It is thrilling to read that in (news) print! Yes, the percentage of home births in the US is relatively low, but for heaven's sake, it increased by 29% from 1990 to 2009, and it has continued to rise in an upward trajectory. Consumer choice is a powerful thing.
'ACOG and the hospitals can read these reports too, and they understand the implications for their bottom lines. When MacDorman, Mathews, and Declercq write, in their 2014 Data Brief on 2012 place-of-birth data exactly what those implications are: "If this increase continues, it has the potential to affect facility usage, clinician training, as well as resource allocation," the OBs and hospitals know what is being written on the wall – and we do too.
Add to that the intriguing responses regarding future birth sites provided by the representative sample of women who had given birth in a hospital in 2012-2013 and who responded to Childbirth Connection's 2013 Listening to Mothers III: New Mothers Speak Out Surveys and Reports. Asked how open she might be to a future birth at home, an amazing 11% indicated that they would definitely want to give birth at home, while another 18% said they would consider a home birth. Likewise, 25% of survey participants would definitely want to use a freestanding birth center! Another 39% said they would consider a birth center.
This is huge, friends.
At the present time, the statistics gathered and published by Childbirth Connection reveal that, in 2012, 23% of all hospitalizations were for childbirth and newborn care, and that maternity care is the "single most common" cause for hospitalization in the US.
So, if one owned a hospital, or if one medically managed all of one's patient deliveries at a hospital, how would one feel about handing off 10% or 25% of those families to midwives and birth centers? And not in some distant 20-years-from-now future, but as soon as those Mothers stop speaking out long enough to get pregnant again? Well, if present-day monopolies are any indicator, one would fight tooth and nail to maintain one's market share of the $111 billion one billed for maternity care facility charges alone in 2010.
"First they ignore you, then they laugh at you, then they fight you, then you win."
Many birth activists understand that the out-of-hospital birth movement in the US is in the next-to-last stage of this lifecycle. "They" are fighting against sanity, reality, and consumer choice. Hard. And when their junk science isn't sticking, they are trotting out the bigwigs at ACNM and ACOG shouting that CPMs need more education in more structured institutions, because those bigwigs have a very long history of taking away existing traditional educational paths and intentionally closing off and slowing down production of their competition (King Bigwig himself Abraham Flexner did it exceedingly well in 1914).
Sadly, it gets even worse when "they" sense the ship isn't sailing solely in their $111 billion direction. Bigwigs like those of Delaware ACOG come out from the bowels of the boat with last-ditch, cut-throat tactics to snatch away legislative victory from mothers and families fighting for increased access to CPMs and more out-of-hospital birth options. And when they slink back below deck, Lady Justice rightly asks why do "they" do it? Are "they" truly concerned for patient safety, or only about throwing all the midwife competitors overboard (or nearly as bad, down into the physician-oversight slave galleys)?
As the Listening to Mothers III: New Mothers Speak Out and the latest CDC Data Brief tell the story, The Big Push for Midwives Campaign (and the whole PushNation) is getting the message across. Women are hearing the true facts, and informing and educating themselves. They are beginning to make new choices.
Dearest birth activists, amazing Pushers, and Salty Dogs, we are all seaworthy!
Don't give up the fight now and don't reach uncomfortable compromises.
Do not even be discouraged, all hands on deck!
We are in the fighting stage to turn this battleship around, and the data point toward the absolute bearing of our winning.
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!"
Maryland's Action Alert
Dear Loyal Supporters,
The year 2012 has been full of excitement! It was exciting when we decided to submit a bill to license Certified Professional Midwives. It was thrilling to find a dedicated sponsor. It was truly wonderful and encouraging to get serious consideration by the HGO Committee. It is no surprise that the reason these things happened and continue to happen is because of the support that MFSB supporters give to this campaign!
The HGO Committee received hundreds of hand written letters last year asking them to consider our CPM licensure bill. It is your letters that pushed the committee to consider our bill and to assign a DHMH workgroup to review the possibilities and issues.
It is time to work your magic again!
Please grab pen and paper, solicit the help of your children, and start writing letters to your representatives. Your letters should be be personal. Perhaps recount why you choose to birth at home, how you decided that home was the safest place for you and your baby, and how challenging it was to find a midwife to support you.
A few buzz words/phrases that would be helpful to include:
Have your children decorate the letters or envelopes. Include a family picture. Remind your representatives that they are in their positions to represent you! Tell them that you want CPMs to be licensed and regulated in the state of Maryland so that you have access to their services.
- Having a baby at home is your legal right. Having a midwife helps ensure safety.
- 26 US states already license CPMs to attend homebirth.
- CPMs establish personal relationships with the families that they serve. CPMs engage in an informed/shared consent practice that enables families to make educated choices about the practices that affect their families.
- Access to midwives in Maryland is seriously limited. Homebirth is on the rise. Families need access to midwives at home in order to ensure safety.
- It is a basic human right to choose the place of birth and the attendants. Let Maryland women have this right.
Don't know who your representatives are? Find your elected officials by address by going to the Maryland State Archives, WHO ARE YOUR ELECTED OFFICIALS page: http://mdelect.net/
Please also continue to ask your family, neighbors, and co-workers to sign the License Midwives Petition. It is vital that we continue our momentum and collect more signatures. The link to the petition can be accessed at www.MFSB.me. Are you unsure if you signed the new petition? No worries, it will not submit your signature more than once. Go ahead, sign it. Make sure that your voice is heard.
Your MFSB Leadership Team
Jeremy Galvan, Robin O’Brien, Kathy Talbott, and Andrea Goldstein
Maryland Families for Safe Birth is a nonprofit, 501(c)(4), consumer-driven, social welfare organization. Our mission is to ensure the health and well being of Maryland families by expanding access to the evidence-based maternity care provided by Certified Professional Midwives.In order to meet our mission the organization will:
We appreciate your support. Click here to volunteer your time and talents. Click here to donate via PayPal.
- Introduce legislation to license Certified Professional Midwives (CPMs) and regulate the practice of midwifery
- Monitor and deter legislation that would be detrimental to families and care providers who choose out-of-hospital birth
- Support organizations who offer, through education and other means, information, support, and advocacy regarding the midwifery model of care
Action Items! Letter Writing Campaign
Access your Maryland State Representative Contact Information Here. Hand written letters, telephone calls, and in person visits carry the most weight. If your schedule only permits time to email, please know that emails are important as well. Best Yet -- Do All 4!
Petition Drive! We need signatures on the petition. Every Maryland signature that is collected generates an email that is sent directly to the House and Senate representatives. This is big, especially right now. We want them to see the community support for midwives. Please commit to collecting 10 or more signatures each week.Petition link is available at the MFSB website. www.MFSB.me
Hearing Day Rally! Remember last year's big rally? We will be doing it again! Details to be announced as soon as the dates are set. Please plan to attend.
Freedom for Birth Movie Fundraiser/Potluck and Outreach Event Click Here January 12, 2013, 5 pm Takoma Park, MD Please contact Ryan for details.
Birthing Circle of Frederick January 28, 7-9 pm, Frederick, MD Contact Bridget or Lindsey for more information
Potential Spring Events
Coordinators and Volunteers Needed!
Request information here.
March 11: 11am-4pm, Columbia, MD, Baby Expo
April: 12pm-5pm, Baltimore, MD, Greenworks EcoFest
May: 10am-5pm, Boonsboro, MD, Green Festival
Please share information on local events and happenings where MFSB might be welcomed as a vendor or speaker. Invite us to your book club, birth circle meeting, ICAN event, knitting circle, PTA meeting, to share our common goal of increasing access to midwives in Maryland.
Click here to let us know of events in your area (in Maryland).