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.
Here at the Big Push for Midwives, we highlight the fundamental importance of state licensing laws. While we all share in the excitement of the news that CPMs and the CPM credential are making headway in the U.S. Congress and in the halls of government in Washington, D.C., the excitement is more than a little tempered by the reality that unless and until CPMs are licensed in a particular state, no federal legislation will take effect in that state.
To wit, as birth centers are learning, state Medicaid plans will NOT cover freestanding birth center services unless the birth center holds a state license, and state Medicaid plans will NOT cover professional services of midwives in birth centers unless the midwives are licensed.
The same will inevitably be true with education loan repayment programs and other federal initiatives. The National Health Service Corps is simply not going to place a CPM in a maternity care shortage area of a state where CPMs are not licensed, and CPMs who are not licensed by their state cannot be eligible for Medicaid reimbursement.
Likewise, in January 2014, when the provider non-discrimination provision of the health care reform law went into effect — it is requiring all health insurance companies and managed care plans to include all categories of state-licensed health professionals in their networks — CPMs will NOT qualify for inclusion with other health professionals unless they are licensed.
Under the U.S. Constitution, only state legislatures—not the federal government—can license health care providers. The Constitution reserves this power strictly to the states. Ultimately, it is state licensure that will ensure that all women have access to CPMs, making them easier to find by legally qualifying them to practice under state agency standards, and making them more affordable by covering their services under private insurance and Medicaid.
So, now is the time for us to re-double our "in-state" efforts. Walking the halls in state legislatures is the most important thing that can be done — right now — to advance midwifery in the United States.
Here at the Big Push for Midwives Campaign nerve center, we are inspired by all of the incredible efforts performed daily by the hard-working, dedicated, unsung, and amazing PushState advocates. What each of you are doing for mothers and babies (and their babies and their babies) every day, against nearly insurmountable odds, in so many states across this great country. But it is important to note: we see you, we honor you for all that you are doing, and we are here from sea to shining sea to support you in any and every way that we can.
Shannon Earle holds her new baby Kiera Breen Earle, moments after she was born at their home. (Amanda Steen / NPR)
PushNews from The Big Push for Midwives Campaign
CONTACT: Katherine Prown, (414) 550-8025, [email protected]
FOR IMMEDIATE RELEASE: January 26, 2012
CDC Finds Continued Increase in Home Births - Report Highlights Disparities in Access for Women of Color
WASHINGTON, D.C. (January 26, 2012)—A report released by the CDC today found a 29 percent increase in home births from 2004 to 2009. The rate of home births among non-Hispanic white women underwent a dramatic increase, while the rate for women of color decreased or remained stagnant, a trend that reflects racial and ethnic disparities in other areas of maternity care throughout the U.S.
"Unfortunately, the women who could most benefit from out-of-hospital midwifery care are those who are least likely to have access to Certified Professional Midwives with the specialized training needed to provide it," said Susan Jenkins, Legal Counsel for The Big Push for Midwives Campaign. "The CDC report and other research shows that babies born to women cared for by Certified Professional Midwives are far less likely to be preterm or low birth weight, two of the primary contributing factors not only to infant mortality, but to racial and ethnic disparities in birth outcomes."
Barriers to out-of-hospital maternity care include laws in 23 states, the District of Columbia, and Puerto Rico that prohibit Certified Professional Midwives from practicing, as well as laws or policies in all but 11 of the remaining states that deny Medicaid coverage for home births managed by Certified Professional Midwives.
"As we work to address disparities by increasing the cultural proficiency of midwives practicing in out-of-hospital settings and diversifying the midwifery work force, we also need to change laws nationwide so that all women have access to out-of-hospital maternity care with Certified Professional Midwives," said Jenkins. The Big Push for Midwives Campaign represents tens of thousands of grassroots advocates in the U.S. who support expanding access to Certified Professional Midwives and out-of-hospital maternity care. The mission of The Big Push for Midwives is to educate state and national policymakers and the general public about the reduced costs and improved outcomes associated with out-of-hospital maternity care and to advocate for expanding access to the services of Certified Professional Midwives, who are specially trained to provide it.
Greetings to all dear friends, colleagues, and fellow Pushers!
The Big Push for Midwives Campaign has had an incredibly busy year! Pushing with you for Certified Professional Midwives, the Big Push is bearing down in the statehouses, on the Hill, and in the media. The Big Push campaign hosted its third PushSummit in August, gathering Pushers from all corners of the PushMap in a lovely little spot in Cary, NC to learn from each others’ successes and to develop strategies for the future.
To keep the momentum going nationwide, The Big Push for Midwives needs your help, now more than ever.
It is with great excitement on this Labor Day 2011 that the Big Push campaign announces a new partnership that will benefit birthing families, midwives, and the Big Push campaign itself – a strategic alliance with MyBirthTeam.com, a new website developed to expand women’s birth care options and choices by matching consumers with maternity care providers who meet their needs. The goal of this partnership is to bring choices to families who don’t know that they have options … and put midwives back on the map, and back into the minds of mothers!
Similar to a dating site, MyBirthTeam connects like-minded families with care providers, helping them find the right match. This is a perfect opportunity to not only educate mainstream women about midwifery options, but also to promote your own practice while supporting The Big Push campaign’s ongoing efforts to provide media, messaging, and strategic planning services to advocates working for licensure in every state.
How does MyBirthTeam work?
Midwives, obstetricians, hospitals, birth centers, as well as other specialized providers such as doulas and lactation consultants and childbirth educators, answer a list of questions about the services they provide. Consumers answer the same list of questions about their birth care preferences. Because midwives and OBs are presented on this site in the same category and are answering the same list of questions, women will often find that a midwife may be the best option for them. By presenting medical and alternative models as equal options, MyBirthTeam has developed a new avenue of reaching and education mainstream women.
Providers pay a $4 monthly fee to be listed on the site. MyBirthTeam will donate $1 of each monthly listing fee to the Big Push for Midwives Campaign and $1 to the March of Dimes Prematurity Awareness Campaign.
The new website launches on Labor Day, highlighting the MyBirthTeam featured organization, which as it turns out is The Big Push for Midwives Campaign! The September goal is to get 250 CPMs to sign up with MyBirthTeam in this win-win opportunity, where CPMs can promote their services while so many other Pushers all work to inform the public of the benefits of midwifery care.
**SPECIAL OFFER**SPECIAL OFFER** Sign Up Today, Get One FREE Month: Join MyBirthTeam during September and get one free month. The Labor Day deal means the $4 monthly billing won’t start until October 1. Join MyBirthTeam today. Keep Pushing.
Sincerely and in gratitude,
The Steering Committee
PushNews from The Big Push for Midwives Campaign
CONTACT: Katherine Prown, (414) 550-8025, [email protected]
FOR IMMEDIATE RELEASE: August 15, 2011
Study: Two-Thirds of OB-GYN Clinical Guidelines Have No Basis in Science
Majority of ACOG Recommendations for Patient Care Found to Be Based on Opinion and Inconsistent Evidence
WASHINGTON, D.C. (August 15, 2011)—A study published this month in Obstetrics & Gynecology, the journal of the American College of Obstetricians and Gynecologists, found that barely one-third of the organization’s clinical guidelines for OB/GYN practice meet the Level A standard of "good and consistent scientific evidence." The authors of the study found instead that the majority of ACOG recommendations for patient care rank at Levels B and C, based on research that relies on "limited or inconsistent evidence" and on "expert opinion," both of which are known to be inadequate predictors of safety or efficacy.
"The fact that so few of the guidelines that govern routine OB/GYN care in this country are supported by solid scientific evidence—and worse, are far more likely to be based on anecdote and opinion—is a sobering reminder that our maternity care system is in urgent need of reform," said Katherine Prown, PhD, Campaign Manager of The Big Push for Midwives. "As the authors of the study remind us, guidelines are only as good as the evidence that supports them."
ACOG Practice Bulletin No. 22 on the management of fetal macrosomia—infants weighing roughly 8 ½ lbs or more at birth—illustrates the possible risks to mothers and babies of relying on unscientific clinical guidelines. The only Level A evidence-based recommendation on the delivery of large-sized babies the Bulletin makes is to caution providers that the methods for detection are imprecise and unreliable. Yet at the same time, the Bulletin makes a Level C opinion-based recommendation that, despite the lack of a reliable diagnosis, women with "suspected" large babies should be offered potentially unnecessary cesarean sections as a precaution, putting mothers at risk of surgical complications and babies at risk of being born too early.
"It’s no wonder that the cesarean rate is going through the roof and women are seeking alternatives to hospital-based OB/GYN care in unprecedented numbers," said Susan M. Jenkins, Legal Counsel of The Big Push for Midwives. "ACOG’s very own recommendations give its members permission to follow opinion-based practice guidelines that have far more to do with avoiding litigation than with adhering to scientific, evidence-based principles about what’s best for mothers and babies."
The Big Push for Midwives Campaign represents tens of thousands of grassroots advocates in the United States who support expanding access to Certified Professional Midwives and out-of-hospital maternity care. The mission of The Big Push for Midwives is to educate state and national policymakers and the general public about the reduced costs and improved outcomes associated with out-of-hospital maternity care and to advocate for expanding access to the services of Certified Professional Midwives, who are specially trained to provide it.
Media inquiries: Katherine Prown (414) 550-8025, [email protected]
(FULL STUDY is available in PDF format on this page)
- Are you working toward licensure for Certified Professional Midwives in your state? Are you planning to?
- Are you concerned about the future of VBAC and HBAC (vaginal birth after cesarean and home birth after cesarean)?
- Have you been frustrated by lack of consensus and infighting within your local birth community?
- Have legislative road blocks, back-door dealings, and insider politics at the state capitol prevented your bill from advancing?
If the answer to any of these questions is YES, then please join us at the PushSummit, on August 6 in Cary, NC, to learn from veteran birth activists who’ve been there in the trenches and will share their insight, wisdom, experience, and not-so-dirty tricks!
Discounted student rates are available.
The Summit’s PushUniversity is a unique opportunity for people who want to become agents of change to learn from the birth community’s experts on everything from effective organizing tactics, to grassroots mobilization, to utilizing the media—as well as the many resources available via The Big Push for Midwives—to promote positive messages about midwifery and out-of-hospital birth and to build effective legislative campaigns that expand access to the full range of birth options for families nationwide. Groups in every state that are working to improve birth can benefit from sending a representative to the Summit, not only to learn but to share. All of us have valuable information to share, and every time we leave our virtual worlds to spend face-time together, it makes our community stronger. Hope to see you there, and please share this link widely! http://bit.ly/PushSummit2011
The Summit will take place alongside the MANA Region 3 conference, which has secured a special rate of $115 per room. Rooms can be booked at http://ncmidwife.org/MANARegion3Conf/?page_id=17
Please check your calendars and make plans to attend!
The Big Push for Midwives Campaign is pushing hard to ensure that Certified Professional Midwives are legally authorized to practice in all 50 states, D.C., Puerto Rico, and Guam.
And we're proud to push hard, since our opponents, ACOG and OBGYN PAC, are working so fiercely together, raising and spending money big hand over closed fist on ads, telemarketing calls, and direct contributions to legislators' campaign chests, all to protect the specific interests of its member OB/GYNs.
In 2010, ACOG's PAC raised nearly $900K and spent more than $680K of it (a 10-fold increase over what they raised for their honeypot just 8 years ago), and it's interesting to consider ACOG boasts that its PAC can raise as much as $30,000 in a single month and that hundreds of OBs from across the country donate to the PAC at the President's Club level of $5,000 each.
No wonder then that they achieved a 60% increase in the number of physicians elected to Congress in 2010, and no surprise that these OB-legislators have hit Capitol Hill pre-programmed with the messages put forth by recently-stepped-down ACOG President Richard N. Waldman, MD, whose focus for the 112th Congress was on "keeping our specialty safe from those would transform it," in other words, from those who advocate for access to midwives and out-of-hospital maternity care.
Heck, if you can't beat the high-quality, low-cost competition that Certified Professional Midwives bring to the maternity-care marketplace, just make your focus the absolute elimination of these nationally certified providers of out-of-hospital maternity care. (For those of you watching gobsmacked from home, you may not realize that working behind the scene, ACOG's lobbyists have already systematically stripped CPMs out of various Health Care bills – with nary an objection from the other maternity-care groups around the table that ACOG has already pushed down into submission.)
Give Hope to Mothers and Families
Please make a recurring monthly donation of $10 dollars to the Big Push for Midwives Campaign for the U.S. States and Territories that are pushing together for a nation of CPM birth options.
Goliath is well-financed, and the Big Push for Midwives Campaign needs your support this month and every month so that we may continue to provide vital "labor" support (in the form of legal counsel, media and general advocacy support, education and outreach) to the courageous mothers and families who sacrifice so much in order to push the CPM birth options movement ahead.
PLEASE DONATE TODAY.