This press release from the Big Push for Midwives is in response to a news story which appeared in the Cleveland Plain Dealer last week.

Ohio Case Shows Need for Legal Reform on Liability Issues

In states where out-of-hospital midwives are unregulated, physicians put at risk to assume undue liability

(January 28, 2007) — An Ohio physician is being sued for damages on behalf of a baby born at home, and the tragic case highlights the need for legal protections for health care providers who collaborate with out-of-hospital midwives. In states where Certified Professional Midwives, who specialize in providing out-of-hospital maternity care, are licensed and regulated, laws can stipulate that physicians will not be held liable for accepting a transfer of care or for consulting with a licensed midwife.

“This case is just plain tragic on so many levels, and we sympathize with the family’s plight,” said Big Push for Midwives national campaign manager Katie Prown. “But this lawsuit fails to address the real issue here, which is that in states where out-of-hospital midwifery practice remains unregulated, physicians who provide ‘continuity of care’ in the event of a transport to the hospital are put at risk of assuming undue liability burdens.”

Prown, who co-lead the legislative campaign to license CPMs in Wisconsin – the most recent state to pass legislation to license and regulate Certified Professional Midwives (CPMs) – said that the law there clearly states that midwives are responsible for their own actions and that the physicians who work with them cannot be held liable for their acts or omissions. Physicians in Ohio lack such legal protections.

“Physicians who collaborate with CPMs in states where they remain unlicensed put the needs of mothers and babies first, and they deserve legal protection for doing so,” said Big Push campaign attorney for legal strategy, Susan M. Jenkins. A leading expert on vicarious liability, Jenkins said laws providing for the licensure and regulation of CPMs further ensure that collaborating physicians will not face disciplinary sanctions for aiding and abetting the unlicensed practice of health care.

“While I am not aware of a case where a physician has been found vicariously liable for a midwife’s actions, the risk of being sued nonetheless is still there, as the Ohio case demonstrates,” added Jenkins. “That’s why providing liability protection for the physicians who collaborate with CPMs is one of the primary goals of The Big Push for Midwives Campaign to license and regulate CPMs in every state.”

States that license and regulate CPMs offer additional liability protection for physicians by ensuring that they cannot be forced into mandatory written contracts with collaborating midwives. “Licensing CPMs works for everyone,” said Prown. “When physicians and midwives are free to collaborate together without binding contracts and under laws that provide for liability protection, mothers and babies receive better care.”

Currently, Certified Nurse-Midwives, who work predominantly in hospital settings, are licensed and regulated in all 50 states, while Certified Professional Midwives, who work in out-of-hospital settings, are licensed and regulated in just 24 states. CPMs are specifically trained to provide out-of-hospital maternity care for healthy women experiencing normal pregnancies, with a particular emphasis on risk assessment and preventative care.

Here’s a great report on the Idaho Big Push rally. Don’t miss the video portion of this local coverage.

The Big Push for Midwives Campaign will be launched today in Chicago to advocate for regulation and licensure of Certified Professional Midwives (CPMs) in all 50 states and the District of Columbia. The Big Push Campaign is also pushing back against the attempts by the American Medical Association to deny American families access to legal midwifery care.

Chicago events include a “PushDay” news conference about the national campaign launch, a book signing by author and journalist Jennifer Block for her book “Pushed,” a film screening of the Ricki Lake and Abby Epstein documentary, “The Business of Being Born,” and a viewing of The Safe Motherhood Quilt Project created by midwife pioneer Ina May Gaskin. In addition, multiple states will have PushRallies and PushParties to kickoff the Big Push Campaign. There are events planned in Alabama, Idaho, Indiana, North Carolina, Pennsylvania and South Dakota.

Currently, Certified Nurse-Midwives (CNMs), who work predominantly in hospital settings, are licensed and legal in all 50 states. Certified Professional Midwives (CPMs), who specialize in out-of-hospital delivery, are licensed and legal in fewer than half of our states.

CPMs:

• Are specifically trained to provide out-of-hospital maternity care for healthy women experiencing normal pregnancies.
• Offer a family-centered model of care, which is associated with reducing the incidence of c-section, birth injury and trauma, as well as significantly reducing the cost of maternity care.
• Play a vital role in reducing the two most preventable risk factors for infant mortality: low-birth weight and premature birth: babies born too small or too soon.
• Serve a disproportionate percentage of underserved populations, including low-income, rural, inner-city, immigrant, and uninsured families, as well as those Americans who choose out-of-hospital birth for deeply held cultural and philosophical reasons.

The Big Push for Midwives Campaign is the first initiative of the National Birth Policy Coalition (NBPC), which was established in 2007 and is focused on increasing access to the Midwives Model of Care in all settings, as well as supporting legislative initiatives that promote the autonomous practice of Certified Professional Midwives and Certified Nurse-Midwives. So far, the NBPC has been endorsed by nearly 40 organizations, including national and state midwifery organizations, as well as state consumer organizations.

Ricki Lake’s statement of support for the Big Push campaign states: ““When I decided to give birth to my second child at home under the care of a professional midwife, I faced a lot of criticism and skepticism from family and friends. Most of the people around me had a perception of childbirth as a risky medical procedure and thought that I was taking a chance by giving birth in my home, instead of at the local hospital. But after extensive research and a previous hospital birth with my first child, I knew that homebirth with a trained midwife was not only safe, but potentially safer than giving birth in a hospital. I knew that I was giving my child a gift by allowing him to come into the world gently, in our bathtub, with his mother in control of the birth. I knew that I was receiving the best prenatal care available and that it was costing me a few thousand dollars, instead of the thousands and thousand of dollars involved in most hospital births. This was not just a privilege that I could enjoy as a celebrity — this was excellent, cost- efficient healthcare that all women should have access to. …

“…The Big Push for Midwives Campaign comes at a time when we realize we much increase access to U.S. maternity care, decrease maternity care costs, and improve our nation’s birth outcomes. The campaign will facilitate this by achieving licensure for ALL midwives in ALL states, D.C. and Puerto Rico. The campaign will highlight the importance of family healthcare choices, and will defend the ability of CPMs to provide legal and safe prenatal, birth and postpartum care to families in every state…

“… I sincerely hope that U.S. state lawmakers do not deny parents a basic human right by restricting how their children can come into the world. I also hope that policy makers recognize midwifery as a serious, social-service profession that deserves licensing, public support and admiration.”

Ohio Families for Safe Birth is proud to be a supporting member of the Big Push and member of the National Birth Policy Coalition.

This past Saturday, midwives, apprentice midwives, and consumer activists gathered in Columbus for a workshop with Ida Darragh, chair of the North American Registry of Midwives (NARM). Ida’s experience working with groups in other states that have recently passed midwifery licensure laws, as well as those who are attempting to get licensure laws passed but have not yet reached that goal, was a valuable resource to those in Ohio who hope to see direct-entry midwifery established as a legally recognized option for birthing families.

Ida shared stories about successful and not-so-successful strategies and tactics for educating and lobbying legislators. She explained the steps we would need to take to create an organized and effective grassroots effort to get a midwifery bill passed in Ohio. She guided us through role-playing practice at answering difficult questions and emphasized the importance of preparation, practice, eye contact, and body language in leaving legislators with the message we want them to hear. And she encouraged us to leave with an action plan for working together to send a unified message to our representatives: Ohio families want safe, legal, professional midwives.

The group of workshop participants included not only midwives and mothers who have given birth at home but also a nursing student who hopes to have a home birth in the future, a mother who birthed in the hospital but believes the home birth option should be available, and a home birth dad. Ida explained that this kind of diversity of voices would be extremely helpful in showing a broad base of public support for a midwifery licensure bill. Legislators have no reason to pass a law that will only benefit or protect a small “special interest group.” That is why our first task is to identify potential supporters beyond the obvious pool of home birth families. The names and contact information of friends, family, and neighbors who agree that women who want to birth at home should be able to choose a licensed, professional midwife to attend them and are willing to write or visit with a legislator to communicate their support for our bill need to be compiled in a database so that we can coordinate our efforts and show legislators that this issue is important to their constituents all across the state.

Ida also emphasized the importance of supporting and encouraging the core group of activists who will need to bear the lion’s share of work in getting a bill passed. To be successful, she explained, we will need to have someone at the Capitol every day that the legislators are in session, ready to seize any opportunity to inform, educate, and win support for our bill. This is a task that requires dedication, time, energy, and money and has a high potential for burnout. Appreciation and recognition of the sacrifice made by the primary players in the lobbying effort will mean a lot to them, especially if — as is frequently the case — it takes more than one season’s effort to get a bill passed.

2008 will be a year of preparation for the legislative effort, as we hope to introduce our bill in the 2009 legislative session. The key players: the Ohio Midwives Alliance (Ohio midwives’ professional organization), Ohio Friends of Midwives (a consumer group established in 1996 but largely inactive in recent years) and Ohio Families for Safe Birth (established last year and envisioned as a coalition group which could combine the efforts of all parties interested in midwifery legislation and other initiative supportive of the midwives’ model of care). The leadership of these groups needs to determine who will take responsibility for the various necessary organizational tasks as we work together for our common cause.

Meanwhile, everyone can be identifying potential supporters in their social networks. And for those who are able, this election year is a great time to establish a relationship with your representatives. Can you volunteer an hour or two to help with your house representative or senator’s re-election campaign? If your current legislator’s term is expiring, find out who is running to replace them. The Ohio State Legislature web page is the place to start to find your legislators’ names and contact information and whether they are up for re-election this fall. Take a minute to find out who your senator and house representative are if you don’t know already, see what bills they’ve sponsored in the past, and try to find a point of contact. When our midwifery bill comes up for a vote it will be our goal to have every legislator hear from as many as possible of his or her own constituents asking for their vote. So we need you and anyone else who is willing to help, and if you can start building bridges with your representatives now so that they remember you next year, so much the better!

If you missed the workshop and want more detailed information about the covered topics, you should definitely check out The North American Registry of Midwives Planninf for Legislation Handbook. Ida had spiral-bound copies available for $10 at the workshop,many of which went home with OMA and OFSB members, but the handbook is also available as a PDF file from NARM’s website.

The Concord Monitor reports on the passage of a bill requiring health insurance companies to cover home birth. New Hampshire licenses direct-entry midwives and also requires Medicaid to cover midwifery services. Two years ago, they passed a bill requiring health insurance companies to cover birth center births.

“Carol Leonard, a midwife and longtime advocate for her group’s cause at the State House, said that since the Legislature began requiring insurance payment for birthing center births, the number of babies delivered at such centers increased by 600 percent.”

Look for an increase in New Hampshire home births now that families don’t have to compare the full price tag on a midwife’s at-home care to an insurance deductible at the hospital or birth center.

Click here to download registration information in Microsoft Word format.

Protect the Right to Birth at Home!

Learn How to be an Effective Advocate!

A one day public legislative workshop sponsored by Ohio Families for Safe Birth, Ohio Friends of Midwives and Ohio Midwives Alliance

Saturday, January 19, 2008

Clinton Heights Lutheran Church

15 Clinton Heights Ave, Columbus, OH 43202

Ida Darragh, chair of the North American Regsitry of Midwives, will facilitate this day-long workshop. It is for midwives, consumers and other activists who are interested in working for legislation to end prosecution of direct entry midwives and protect the rights of families to birth at home with direct entry midwives. Ida will present an overview of the legislative process and lobbying strategies, as well as answer questions and address why this is the best route to end the prosecutions.

Lobbying “how to” topics include writing fact sheets, conducting interviews, speaking with legislators briefly and effectively, giving public testimony and answering tough questions spontaneously.

The workshop is designed to engage people who are new to engaging in politics around midwifery issues. You won’t come out an expert, but you’ll understand a lot more than before you came and you’ll leave far more confident about how you can be part of the solution!

If you are a midwife or apprentice, Ida will be offering professional development workshops (Preceptor-Apprentice Relationships, Midwifery Ethics and How to Become a CPM) the day before. CEU’s will be awarded for all workshops attended.

If you are traveling quite a distance and find that hospitality for Friday night would make is possible to attend the workshop, please indicate that with your registration.

Homebirth in Ohio is Under Seige!

Let’s join our efforts to protect families who choose to birth at home and the midwives who are committed to serving them!

MEAC accredited Continuing Education Units (CEUs) awarded for all sessions!

Babes in arms are welcome.

Childcare will be available on Saturday for older children.

Friday, January 18th - Professional Development ($5.00 per session)

1:00 p.m. - 3:00 p.m. Preceptor-Apprentice Relationships (2 CEUs)

3:00 p.m. – 5:00 p.m. Midwifery Ethics (2 CEUs)

5:00 p.m. – 6:30 p.m. Supper on your own

6:30 p.m. – 8:30 p.m. How to Become a CPM (2 CEUs)

Saturday, January 19th - Legislative Workshop

9:00 a.m. – 5:00 p.m. Preparing for Midwifery Legislation (7 CEUs)

There is no set fee for the Saturday workshop. We will ask for a small free will donation to give to the church for the use of their space. We will have child care available and ask that you help provide a stipend for child care providers if you use their services.
Registration should be received by January 15, 2008.

Questions? Contact Stephanie Beck Borden at 513-546-1015 or safebirthohio@gmail.com

Free-standing birth centers are sometimes described as “the best of both worlds” — combining the advantages of both home and hospital birth. This blogger disagrees. The comment section discussion raises many interesting points. Bottom line: different women have different needs; safe and legal options should be available wherever they choose to give birth.