What’s the connection between health care reform and midwifery care?

July 8, 2009

My first article is up at The American Prospect, about Certified Professional Midwives and health care reform. I talked to some amazing advocates in reporting for the piece, including Michelle Bartlett, an Idaho midwife who helped push through licensing legislation in her state.

Michelle Bartlett is not the typical Washington high-stakes health-care player. She’s probably not on the radar of anyone in Congress or the Obama administration. Bartlett is a midwife in Idaho, but in the last few years, she’s been trying her hand at lobbying. This came after a night spent in jail for using medication during a home birth she attended in 2000. Bartlett was the second midwife to be charged for this type of practice in Idaho, and thanks to her efforts, she will be the last in her state. “I’ve done a lot of hard things in my life, and giving birth was one of them,” Bartlett says. “But giving birth to a law was really hard.”

On April 1, Gov. C.L. “Butch” Otter of Idaho signed legislation allowing certified professional midwives (CPMs) like Bartlett to administer medication during births. Unlike certified nurse midwives who are able to practice in all 50 states and generally work in hospital settings alongside obstetricians, midwives like Bartlett are referred to as “direct entry” midwives, and practice exclusively outside of hospitals, mostly in homes or birth centers. These CPMs spend three to five years training and meet the standards for certification set by the North American Registry of Midwives.

State licensing fights may be the first step for these midwives, but it’s not their last. Now they’re turning their attention to the federal health-care reform debate, and a look at the maternity-related health-care costs quickly explains why. Childbirth is among the top five causes for hospitalization, and the No. 1 cause for women. According to Childbirth Connection, Cesarean section is the most common operating-room procedure, and in 2009 the C-section rate hit an all-time high according to the Centers for Disease Control and Prevention, at 31.8 percent of all births. These rates account, in part, for the increasing cost of maternity care in the U.S. Maternal and newborn charges totaled $86 billion in 2006, 45 percent of which was paid for by Medicaid. The federal government is already footing a huge portion of the U.S.’ maternity-care bill, and these midwives think they can help reduce costs significantly, and not just for low-income women.

Check out the rest of the article here.

If you want to join the advocacy efforts mentioned in the article, check out The Big Push for Midwives and The MAMA Campaign.


Radical doula on Twitter

July 7, 2009

I joined the Twitter-mania a few months ago. I find it to be a great way to learn about breaking news and share links with other like-minded people.

You can follow me at http://twitter.com/miriamzperez

If you’re on twitter, send me a message!


Great article on the practice of shackling incarcerated women

July 6, 2009

Anna Clark has a great piece up at RH Reality Check about the practice of shackling incarcerated women. She delves into both the realities of the practice (horrific) and the amazing activist response that has arisen to organize against this practice (and has been successful!). Here is an excerpt:

The 2008 federal policy against shackling cued renewed hope among advocates for the humane treatment of incarcerated women. Beyond lawsuits and advocacy with individual departments, legislative campaigns to restrict shackling are finding unprecedented success-after years of falling on deaf ears.

New Mexico is the most recent state to bar shackling through a bill signed by Governor Bill Richardson this spring. New York and Texas currently have bills backed by legislative support that await the word of their governors before they become law. “For us, it’s not enough to change regulations (on shackling in particular prisons),” Saada Saar said. “To do this campaign through the legislature gives us a way to respond to violations of the policy. Through state statutes, mothers’ rights are better protected.”

“A lot of states do have corrections policies that restrict shackling, but (the policies) aren’t commonly known or understood,” Sussman said. “A law allows us to go to court; it makes it hard for others to say they didn’t know (that shackling is restricted).

“We have a strong case in Illinois because of the law there, for example. We need to bring cases to ensure enforcement,” Sussman added. “It’s a dual strategy.”

It’s a strategy that inspires diverse support. Broad coalitions are signing on to legislative and legal campaigns to transform the experience of giving birth in prisons, jails, and detention centers.

Among those backing the New York Anti-Shackling Bill are women’s health advocates, prison rights organizations, medical and public health groups, and “even fellowships and ministries that aren’t our frequent allies,” Sussman said.

Read the rest here and more from Anna Clark here.


Latino’s born to midwives will no longer be denied passports

June 29, 2009

An update to this story from almost a year ago. It was reported by the NY Times that Latinos born near the border to midwives were having their citizenship challenged.

Well some good news for us on this front from the ACLU:

Pending court approval, DOS will train its staff on how to fairly weigh all the evidence provided in passport applications and how to avoid improperly subjecting people whose births were assisted by midwives in Texas and along the U.S.-Mexico border to heightened scrutiny in reviewing their passport applications.

All denials will be automatically reviewed by a three-member panel comprised of experienced DOS staff members, and if that panel also denies an application, DOS must communicate the specific reasons for the denial to the applicant. The applicant can then challenge the denial and ask DOS to reconsider its decision.

Additionally, anyone birthed by a midwife who has filed an application for a passport between April 2003 and September 15, 2008 and, with a few exceptions, whose application was not expressly “denied,” can re-apply for free. DOS will be setting up mobile units across the border on specific dates to assist those reapplying.

Via Latina Lista


Home birth in Australia may soon be illegal

June 26, 2009

New legislation in Australia that requires all midwives to be insured may make home birth illegal and inaccessible.

From News.Com.Au:

Under the draft Health Practitioner Regulation National Law, released last week, a midwife cannot be registered unless she has insurance.

But with insurance companies and the Government so far refusing to include homebirths in the indemnity scheme, midwives will face being de-registered if they attend a homebirth.

Via Citizens for Midwifery.

This is really terrible and this insurance squeeze often effectively makes midwifery illegal/inaccessible in the US too.


Great segment on doulas in the mainstream media

June 23, 2009

This is unusual, but refreshing! A great segment on the benefits of doulas on the Today show.

The only feedback, as usual, was the lack of racial diversity in the segment. But they only talked to one doula and one family.

Thanks to Tanya for the link!

(Note: I removed the embedded video because it was not functioning, but go here to watch the video.)


Have you miscarried? A research opportunity

June 23, 2009

From Lisa Rosenzweig, a doctoral candidate in Clinical Psychology:

Research Opportunity for Women who have Miscarried

Everyone has a unique experience with miscarriage and unfortunately, little is known about women’s experiences of support and how this may affect responses to miscarriage, and so I invite you to participate in my dissertation research study examining women’s experiences following a miscarriage. Although there is no direct benefit to you, survey results may help healthcare providers better understand and meet the needs of women following miscarriage. This online survey takes approximately 15-20 minutes and is open to women who have miscarried a wanted pregnancy in the previous 6 months who are 18 years of age or older, living in the United States, and involved in a relationship with a significant other. Participants are eligible for a raffle for a $50 American Express gift certificate. For more information, please don’t hesitate to contact me.

Lisa Rosenzweig
Teachers College
lsr2106@columbia.edu

Link to the survey here!


Immigrant woman’s baby taken away because she couldn’t communicate with hospital staff

June 17, 2009

Thanks to Indra Lusero for posting this on facebook, from RaceWire:

In Pascagoula, Mississippi, in November 2008, Cirila Baltazar Cruz gave birth to a baby girl. Soon after, her daughter was taken away from her because she could not communicate with the hospital attendants.

Far away from her native Oaxaca, Mexico, she did not understand the Puerto Rican interpreter assigned to her. Cirila speaks Chatino, an indigenous Mexican language spoken by about 50,000 people. A social worker called in by hospital authorities deemed the new mother negligent and unfit to raise the baby, stating as reasons that she was an “illegal immigrant” and that she did not speak English.

Baltazar Cruz is up for deportation, while her daughter is reported to be with an affluent Ocean Springs couple.

The way immigrant women are abused in this country is incredible and so saddening. Not being able to communicate with the hospital staff is the HOSPITAL’s issue, not the mother’s.


Guestblog from Muneera Fontaine: About the ICTC Full Circle Doula Training

June 11, 2009

Muneera generously offered to write a guestblog about her experiences with the ICTC doula training.

About Muneera: Muneera Fontaine is a wife, busy mother of two, doctoral student at ICDL Grad School, Infant Special Educator, and Full Circle Provisional Doula. She should be writing a research paper instead of this blog post but saving our babies can’t wait…and the research can. When not juggling all the different hats she wears, she can be found at Doulas of Color or curled up with a good book and some herbal tea!

I offered to do a guest blog for Radical Doula on my doula training with the International Center for Traditional Childbearing (ICTC). For the record I do not work for ICTC and I have no personal gain by writing this blog. I just felt compelled to let others know about this amazing training that I was able to take that really changed my life. I am going to try and keep it short and simple because I could go on and on about most any topic related to birth. :)

I initially wanted to become a doula because of my own personal experience with having my first son by Un-necesearian ( a whole other blog post!) and then my daughter eight years later by a midwife in a birthing center. The difference in support and control that I felt were unmeasurable. It was then that I realized that I wanted every woman to be able to claim that as their own. I felt that every woman deserved to feel the empowerment of visualizing and achieving the birth where she was an active participant. In particular as women of color, I felt that we are already so dis-empowered on a regular basis that we come to expect it. My personal observation was that we are less informed because we are often not given the same amount of information as others. You cannot have power without choice and you cannot have choice without information. And ICTC definitely sends you home with lots and lots of information!

There are five main topics that I think are distinct to the ICTC doula philosophy which was developed from a traditional midwifery model of care. That means they strive to be community based, and work to “empower families to improve birth outcomes, breastfeeding rates, and reduce premature birth” (Shafia Monroe, African American Infant Mortality), especially in communities of African-American women and other women of color. We have the worst infant mortality statistics here in the United States and the goal is to change that from within our own communities.

Read the rest after the jump!

Read the rest of this entry »


Thoughts from comments: On doula certification

May 31, 2009

Often times people will find old posts I’ve written and add their thoughts to the comments. Many times it’s really great stuff and it makes me sad that it gets buried on old posts. So I’d like to highlight this comment from a soon to be radical doula Mel on my post about DONA and doula certification:

this blog (in totality) is air to me. thank you. i just found the blog a few days ago, and getting to this post is right on time…as i’m preparing for DONA workshops and certification starting tomorrow. i’m not a doula, yet. i’m a partnered queer woman of color (qwoc) and worry about finding a doula and midwife that get us. my partner and i are planning our first baby, and in figuring out my own birth plan…a natural-at-home-in-the-water-orgasmic-birth…i thought, “dang, if i knew about this ten years ago i would’ve gone to midwifery school!” i talked to a co-worker about my feelings and she said, “why not become a doula.” my research began and i made my decision. i do not intend to quit my job (teaching) to become a full-time doula. i recognize that quitting my job would force me to charge high fees for support, which would make it so that white upper-class women make up the bulk of clients. i want to be really clear…i’m neither anti-white, nor anti-wealth. however, the reality is that options are already abound in these communities. many american born/cultivated Q/WOC don’t even know what doulas are, or have no idea of the benefits of having a doula assist birth (in addition to having no idea how dangerous it is giving birth in a hospital!)…i want to work with qwoc, because historically we have fewer resources, less access and higher statistics. so you can pretty much guess that reading about how DONA ignores issues of race, class, gender, etc…comes as a bummer. HOWEVER…i wonder if abstaining from being DONA certified is the best response to this issue. wouldn’t it be beneficial to become certified…become a trainer…and give affordable or free workshops in our communities to empower doulas of the future? or do the same and provide workshops outside of our communities that force folks to look at and grapple with these issues? perhaps it’s my inexperience in the birthing community coming to the surface in my response…but in having dealt with other types of “fucking with the system”…i see that this may be an instance where you need to be in the system, if only for a minute, to fuck up the system. who knows, in 3 sundays i may have a different view ;-)

You can read more from Mel here.

Now that I am looking into beginning my volunteer doula work again, this question of whether I made the right choice in not getting certified comes up again and again. I hear many different view points, including the thought this commenter shares. Isn’t it better to get as much training as possible, and then use that to create our own new system?

I’m going to try and do this every once in a while, to bring attention back to older threads with great comments.