Statement of the Big Push for Midwives Campaign on the AMA Scope of Practice Partnership
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claim that SOPP can or should determine what is best for the patients of other healthcare professionals represents an outdated and patronizing line of thinking that cannot possibly serve the needs of today's patients—particularly childbearing women and their babies.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.
[PushNews] News from California: 'Free Our Midwives!' Rally
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:
- 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.
- 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.
- The Modesto Bee | July 8, 2013
- The Sacramento Bee (photo gallery) | July 8, 2013
- Point Reyes Light | July 3, 2013
- LAFamily.com | June 2013
[PushNews] News from Missouri: 5 Years In: Midwife-attended Home Births Double
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!!
- Missourinet | July 9, 2013
Thank you very (very) much!
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.
The Orthodoxy of Birth
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.
Birth Center Study Shows Excellent Outcomes for CPMs and CNMs, Points to Need for More Access for Low-Income Women
Members of the Big Push for Midwives Campaign applaud the publication of the American Association of Birth Centers' landmark National Birth Center Study II in the Journal of Midwifery & Women’s Health.
The national prospective study pointed to excellent outcomes in midwife-led birth centers run by both Certified Professional Midwives and Certified Nurse-Midwives. Seventy-nine birth centers participated in the study, recording data for more than 15,000 prenatal courses and births. For more information and insights, check out the blog posts and alerts from Childbirth Connection, Citizens for Midwifery, Lamaze International's Science and Sensibility and many others about the study.
While it wasn’t intended as a direct comparison of CPM and CNM outcomes in birth centers, the study nevertheless provides solid evidence that the excellent outcomes achieved in these birth centers occurred regardless of whether a CNM, a CPM, or a joint team of both provided the midwifery care. At the same time the study, which was published in a scientific peer-reviewed journal, shows that outcomes are not dependent upon any one particular midwifery certification program or any particular educational pathway to certification.
The Big Push calls on policy makers to focus on the demographics of the more than 15,000 women who participated in the study. The majority of birth center consumers were middle-class white women, confirming the unfortunate reality that women of color and low-income women are much less likely to take advantage of the out-of-hospital birth options that produce such excellent outcomes.
Increasing access to birth centers through section 2301 of the Affordable Care Act, which added birth centers and midwifery care in birth centers as mandatory Medicaid services, as well as access to home birth through federal legislation that would guarantee CPMs as providers of a mandated Medicaid service, are necessary steps to making the midwives model care in both settings accessible to all women.
The first step needs to be continued pushing for licensing for CPMs, the specialists in out-of-hospital maternity care, to legally practice in all fifty states. Unless they are licensed by their state, CPMs cannot be included in Medicaid, Tricare, and other government programs – including the new health insurance exchanges under the Affordable Care Act – that will make midwifery care accessible to all women. This new study should go far to convince state legislators to license midwives and federal policymakers to include CPMs in these payment systems and other federal health care programs.
We are keeping the focus on what really matters, after all – delivering the kind of excellent woman-centered care highlighted in this study to the women to want and need it.
Happy New Year!
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).
Pushing Back to Protect Our Birth Rights
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.
Sign-up for news from the 2013 campaign trail from every state and territory in the PushNation as we all push for birth rights.
*Please Share This Message, Birth Rights Affect Us All
- Professionals: please send to your clients.
- Moms and Dads: please share in your social circles.
- Everyone: please expand the circle of the birth activist community.
HOURS LEFT — PushAlert: Mass Needs YOU
TODAY is the day, Massachusetts!!!
The midwifery bill URGENTLY needs you!
Please call your own legislator NOW, letting him/her know that having good birth options is important to you. Please ask them to call Chairman Dempsey and ask him to release our bill—HB 4253—An Act Relative to Certified Professional Midwives—today.
We only have HOURS left to get the bill out of committee.
Every call makes a big difference.
If you have more time, please call the following Ways and Means committee members (list with numbers follows at the end of this message), asking them to release the bill ASAP so it can go to the House floor for a vote. We can still get the bill out but need your help now, more than ever.
With your help, we can do this. Thank you!
Find your own rep’s contact info here:
Ways and Means Committee members:
Please call and ask them to release the bill for a vote!
- Stephen Kulik 617-722-2380
- Martha M. Walz 617-722-2380
- Angelo M. Scaccia 617-722-2060
- Gloria L. Fox 617-722-2060
- Thomas M. Petrolati 617-722-2255
- Robert M. Koczera 617-722-2582
- Christine E. Canavan 617-722-2575
- Timothy J. Toomey Jr 617-722-2380
- Benjamin Swan 617-722-2680
- Colleen M. Garry 617-722-2380
- Geraldine Creedon 617-722-2305
- Kevin J. Murphy 617-722-2877
- David B. Sullivan 617-722-2070
- Ruth B. Balser 617-722-2396
- John P. Fresolo 617-722-2017
- Walter F. Timilty 617-722-2230
- Thomas M. Stanley 617-722-2230
- William Smitty Pignatelli 617-722-2582
- Joyce A. Spiliotis 617-722-2430
- Carl M. Sciortino, Jr 617-722-2013
- Angelo J. Puppolo, Jr. 617-722-2090
- Michael D. Brady 617-722-2230
- James J. Dwyer 617-722-2220
- Ann-Margaret Ferrante 617-722-2210
- Timothy R. Madden 617-722-2810
- Viriato Manuel deMacedo 617-722-2100
- Daniel K. Webster 617-722-2487
- Geoffrey G. Diehl 617-722-2810
- Angelo D'Emilia 617-722-2810
- Shaunna O'Connell 617-722-2305
- Donald H. Wong 617-722-2488
617-254-6175 617-901-2777 - c
Contact for information and questions:
- Miriam Khalsa (Mass Midwives Alliance)
508-655-7885 ([email protected])
- Audra Karp (Mass Midwives Alliance)
617-522-8383 ([email protected])
- Ann Sweeney (Mass Friends of Midwives)
617-254-6175/617-901-2777 ([email protected])
- Krina Patel (The Suffolk Group)
617-303-4570 ([email protected])
Stephen Kulik 617-722-2380
Martha M. Walz 617-722-2380
PushAlert: Massachusetts Needs YOU
If you care about mothers and babies, the Commonwealth needs your help TODAY to PASS HB 4253—An Act Relative to Certified Professional Midwives. We have just a few days left to pass this important legislation that will regulate Certified Professional Midwives. Currently, there is no state oversight, which means:
- ANYONE—even an 18 year old car mechanic—can hang out a shingle and practice as a midwife and
- Hairdressers must be licensed to practice in Massachusetts but midwives do not. Should a “cut and color” be regulated and have professional practice requirements while MA midwives currently have none?
How to help?
CALL your own STATE REPRESENTATIVEYou can find contact information for your representative at the following link: http://wheredoivotema.com/bal/myelectioninfo.php
- GIVE them an update on the bill, HB 4253—An Act Relative to Certified Professional Midwives—and let them know the bill is now with the House Ways and Means committee
- ASK them to contact Chairman Dempsey's office (617-722-2990) (representing Haverill and Chair, House Ways & Means Committee) to REQUEST that HB 4253 BE RELEASED TO THE HOUSE FLOOR FOR A VOTE ASAP
- ASK them to then support the bill when it reaches the House Floor
- URGE them to tell their colleagues to support the bill on the House Floor
Want to do more?
PLEASE reach out to Massachusetts HOUSE LEADERSHIP(see listing at the end of this message), letting them know:
- This bill is important to you
- That this bill is being supported by House leaders
Also, we will be at the State House on Wednesday and Thursday afternoons this week (7/25 and 7/26). Please join us! Drop a quick email to Ann Sweeney at [email protected], and we’ll let you know where to rendezvous with us.
Text of the bill can be found on the State House website: http://www.malegislature.gov/Bills/187/House/H04253 Please help us in spreading the word and passing this legislation into law! Keep the calls coming!!! We need EVERYONE to call to get this done! Make a difference! Make it count.
Here is how you do more:
CALL more Massachusetts HOUSE LEADERSHIP
- Rep. Haddad—very supportive—617-722-2600
- Speaker DeLeo—he is aware of the bill—seems to understand need for it—617-722-2500
- Rep. Reinstein—very supportive and a co sponsor—617-722-2180
- Rep. Moran (Boston and Brookline)—supportive and a co-sponsor— 617-722-2006
- Rep. Story (Amherst)—very supportive—617-722-2012
- Rep. Donato—seems supportive—617-722-2040
- Rep. Mariano—has always supported licensure bills—617-722-2300
- Rep. Jones—aide seems supportive—617-722-2100
- Rep. Rushing—617-722-2783
- Rep. Bradley—617-722-2520
- Miriam Khalsa (Mass Midwives Alliance)
508-655-7885 ([email protected])
- Audra Karp (Mass Midwives Alliance)
617-522-8383 ([email protected])
- Ann Sweeney (Mass Friends of Midwives)
617-254-6175/617-901-2777 ([email protected])
- Krina Patel (The Suffolk Group)
617-303-4570 ([email protected])