A Must Read Alert

I wish I had written this. The Big Push for Midwives has once again done great work in educating us in what goes on behind the scenes. Thanks to PushGirl Friday for her insight at:

http://www.theunnecesarean.com/blog/2010/10/18/a-tale-of-two-moms-acog-pulls-a-fast-one.html
Please read her blog.....
A Tale of Two MOMS: ACOG Pulls a Fast One on Groundbreaking Maternity Care Legislation

As many readers here know, last summer Congresswoman Lucille Roybal-Allard introduced the MOMS (Maximizing Optimal Maternity Services) for the 21st Century Act, a groundbreaking piece of legislation that has the potential to revolutionize our maternity care system. The bill makes increasing access to evidence-based care, reducing racial and ethnic disparities in birth outcomes, and bringing down maternity care costs national priorities by promoting a number of common-sense, low-cost solutions to addressing the maternity care crisis in the US, such as:

Creating loan repayment programs to increase the numbers of family practice physicians, nurse-midwives, and certified professional midwives, all of whom provide low-cost, high-satisfaction alternatives to traditional obstetrical care
Increasing access to culturally competent care and reducing disparities by taking measures to recruit more racially and ethnically diverse students into the maternity care workforce
Launching a public awareness campaign to inform women of the benefits of increasing access to evidence-based maternity care and reducing over-reliance on often unnecessary interventions, such as labor induction, electronic fetal monitoring, episiotomy, and cesarean section
Establishing an Interagency Coordinating Committee on the Promotion of Optimal Maternity Outcomes
The MOMS Act has attracted a broad-based coalition of advocacy and professional organizations, including Amnesty International, Childbirth Connection, The Big Push for Midwives Campaign, the American College of Nurse-Midwives, the National Association of Certified Professional Midwives, the American Association of Birth Centers, and the Midwives Alliance of North America, all of whom have been working together with Representative Roybal-Allard’s office to build support for the bill both within Congress and among the general public.

Notably absent from the list of MOMS Act supporters is the American Congress of Obstetricians and Gynecologists, which is already busy lobbying Congress about its own forthcoming legislation. Not to be confused with the MOMS Act, ACOG’S proposed Making Obstetrics and Maternity Safer bill, which in the interests of clarity has been dubbed—wait for it—the MOMS Initiative, will, as ACOG President Dr. Richard Waldman stated, “lead the way” in making maternity care safer by promoting research into the causes of premature birth, obesity, and racial disparities in outcomes. Because as we all know, the problem with maternity care in the US is with the women who receive it, not with the care they receive.

Perhaps a better title for ACOG’s MOMS legislation would be the Making Obstetricians More Satisfied Initiative, because the proposal contains absolutely no provisions that encourage obstetricians to abandon current practices in favor of evidence-based care or to give up an inch of turf in their ongoing battle to protect their virtual monopoly on the maternity care market in the US—a monopoly that is responsible for creating the need for the Real MOMS Act in the first place. ACOG laid the groundwork for its sabotage of the bill in a recent letter that has been circulating in DC, assuring Congress that the organization has already put many patient safety measures into place and that their own MOMS legislation “can lead to direct measurable improvements in patient safety and quality of care, and to healthier births.” No promises that the Misleading MOMS Act actually will lead to improvements, but hey—it’s a start, right?

As for the Real MOMS Act? According to Dr. Waldman it is unacceptable because a) it promotes “the wholesale adoption of delivery models that have not yet been proven safe and effective, including doula support, group prenatal care, and home-birth,” and b) it “questions ob-gyns’ ability, compared to certified nurse-midwives, family physicians, and certified professional midwives, to deliver care that supports physiologic birth.” In other words, the Real MOMS Act told the Emperor he has no clothes, he took offense, and now he’s busy knitting himself a new Naked Suit.

Watch this blog for further developments on the Real and Fake MOMS legislative front as we head into a new Congressional session in January. In the meantime, please spread the word about Congresswoman Roybal-Allard’s brave stance in support of real maternity care reform. We need more champions like her who are willing to speak up on behalf mothers and babies and who won’t be fooled by ACOG’s bait-and-switch tactics.

As one who has seen pregnancy from both sides of this "debate" my wish is that ACOG and academic medicine would stop maligning evidenced based midwifery as in doing so they only malign themselves. There is a role for collaboration between the models but it is time for ACOG to realize that more medical intervention may not be the solution to the rising intervention rates. Nurturing care, individual attention and prevention do work and have been the way of the midwife for centuries. Dr F

Midwife Celebration at Golden Bridge

Just a heartfelt thank you to the wonderful people at Golden Bridge and to Debbie, Carrie Anne, Ricki, Peggy, the choir and all the wonderful speakers whose names I can't even begin to remember. It was a joy to see so many smiling faces in that most friendly of places. A special thank you to Congresswoman Roybal-Allard for her advocacy. You all said so eloquently what we all know to be true. It is a marvelous feeling to be associated with you and I am proud to also carry the banner for normalcy and choice. I know now as much as ever that midwifery is the best choice for those low risk women who desire it. I came directly from the airport and the sadness of burying my beloved uncle in Minnesota to the warmth and nurturing of all of you. What a healing talent you all have. Thank you, thank you, thank you!!

Love, Dr. F

Midwifery Week Blog

http://www.rhrealitycheck.org/blog/2010/10/04/state-midwifery-pushing-legalization
This is Rebecca Spence's blog this week. Please check it out.

Today is the Midwife Gathering at Golden Bridge Yoga at 1:30PM in LA. I will be traveling back from Minneapolis this morning and hope to arrive in time to pay tribute to my midwife colleagues. Continuing to promote access to midwifery and birth choices is an honor and joy and every little thing helps. Please support the Big Push with letter writing and spreading the word client by client. Dr F

Time Magazine Cover

Just a quick thought on the recent time cover story about the significance of external factors during intrauterine life that may play a much more significant role in our health and wellbeing than previously thought. Traditional teaching about how we end up has always been nurture v. nature, heredity v. environment. Well, it appears that there is growing data to support the idea that exposure to many things in utero may play just as big a role in determining our physical and mental health later in life. This comes as an interesting "discovery" to those of us brought up in the medical/scientific world but is well known to my colleagues trained in the more natural world of midwifery and common sense. The midwifery model emplores women to be in a healthy state of mind and body before and during pregnancy and has known the benefit of this knowledge for centuries. It is nice to see the science catch up with the empirically obvious and kudos to Time for a nonpartisan story that is beneficial to all. Dr. F

Internet TV interview

Here is a link to my interview on the Dr. Cassie Show on local KADY TV here in Ventura, CA. Dr. Cassie does great work with children and for the community and it was an honor to be a guest on her show. Check out what's happening with her at The Children's Therapy Network. Having good prenatal care and a nurturing birth will get babies off to a good start. Dr. F

http://www.ustream.tv/recorded/9737013

First Waterbirth

Well, I am happy to announce I had the privilege of assisting on my first home birth in water. After 27 years of the lithotomy position it was really enlightening to experience another way. I was honored to be present for the birth of Eva and want to thank her parents for their trust. I also want to thank Karni and all my midwife and birthing advocate colleagues for their support during this transition. It seems the demand for information and alternatives to hospital birthing is growing. I am getting quite a few inquiries from women looking into all options. It feels really good to give them an open and honest discussion about choices. I have been contacted by women with previous c/sections, twins, breeches and medical issues. All seeking just an honest discussion about risks and benefits of their individual situation. It is with great respect that I thank those of you who send potential clients my way. While out of hospital birthing is not for everyone, the choice of how and where to give birth belongs to the woman and her family. All good things, Dr. F

C-section rates higher at for-profit hospitals

From todays San Francisco Chronicle. This link below was sent to me by Brian Gilmore of Rumi Baby.
Looking only at low risk birth, women were 17% more likely to have a c/section at a for profit hospital than at a non-profit one. Each of us can draw our own conclusions but knowing what we know about what motivates many hospitals and physicians these days it is not surprising. In 2008, our practice in Camarillo at The Woman's Place had a 6% primary c/section rate compared to a greater than 20% primary rate at our local hospital overall in low risk women. I believe the difference is using the midwifery model vs. the obstetrical model for labor management.
This information has to rely on reporting of birth rates and methods by each institution. This may raise some question about honesty in reporting. I suspect the data comes from birth records so there is likely to be some credibility here. Just another reason pregnant women need to be educated and informed of choices, benefits and risks so keep spreading the word to your clients, family and friends.

Thanks, Dr F

http://www.sfgate.com/cgi-bin/article.cgi?f=/c/a/2010/09/12/MNSS1FA3LH.DTL&feed=rss.news