There has been a lot going on these past few weeks in the birth world that I have been watching, but not had the chance to blog about. Here are a few of the highlights and things you can do to be involved with promoting access to midwifery nationwide.
North Carolina:
A midwife in North Carolina (my home state!) was arrested in February. Via Birth and Bloom and North Carolina Friends of Midwives:
On February 19, a Certified Professional Midwife who would be licensed and regulated in neighboring states was arrested for performing the duties for which she is trained. Charged with practicing midwifery without a license, her practice is in jeopardy. Should it close, dozens of pregnant women will face a crisis of care. “Our focus is on the mothers,” says a fellow Certified Professional Midwife. “This is an unfortunate day for mothers in North Carolina.” It is also an unfortunate day for the taxpayers of North Carolina, as they face the potential for a huge bill as the case winds its way through the criminal courts.
At the root of this case is the struggle to further legalize and license Certified Professional Midwives across the country. I’ve written about this struggle before, and how the opposition to the practice of CPMs (who are trained, although not as nurses, to practice primarily home birth) is mostly a fight about who gets to provide birth care. While those in opposition tout all sorts of research about why they think home birth is unsafe, what’s really at stake is the desire for doctors and the American Medical Association to keep tight their monopoly on birth care.
Twenty six states have successfully fought the medical lobby to legalize the practice of CPMs, a hugely important step toward expanding access to a wide variety of birth care both in and out of the hospital. North Carolina is not one of them, which is why this midwife was subjected to arrest and possibly prosecution.
For more information about the situation in North Carolina and how to get involved, go here. There is also a petition you can sign here.
CPM legislation introduced in Congress:
Congresswoman Chellie Pingree, a Democrat from Maine has introduced legislation into the House of Representatives that would allow women in Medicaid access to coverage for CPM birth care. The bill, Access to Certified Professional Midwives Act of 2011, and has two other co-sponsors.
While the battle to get this kind of legislation through Congress will be a serious one (that’s going to take years of advocacy) it’s a really important first step. I’m also glad to see that the focus of the legislation is access to midwifery care for low-income women. I have a feeling this would also impact the ability of CPMs to practice even in states where it isn’t specifically allowed, but I need to corroborate that. If you know more, leave details in comments!
Radical Doula 
Re: the Access of CPMs Act of 2011 and impact on the ability of CPMs to practice even in states where it isn’t specifically allowed-
Federal guarantee of payment to CPMs could help from an advocacy perspective to convince legislators in states like North Carolina to legalize and license CPMs to take advantage of cost-savings to state Medicaid budgets.(you could also talk about the rights of all women regardless of income to give birth with the provider and in the location of their choice, but that tends to be a political nonstarter in a lot of places)
But it will have no impact on CPMs ability to practice legally. This is because regulation of health professionals happens at the state, as opposed to the federal level. “Federal recognition” or Medicaid payment of CPMs will never prevent them from being arrested in states where laws remain on the books prohibiting them from practicing.
Also I think Chellie Pingree is from Maine? In any case, this bill will most certainly need the support of Republicans to get anywhere in our current congress. And this bill makes a lot of sense for Republicans to support! It emphasizes consumer driven care by letting families, rather than the government or BigMedicine, decide on the best care provider for them.
Thanks Rebecca! That makes sense. It would be interesting to see the response from house republican leaders to this legislation since they have made restricting abortion such a huge priority. Supporting something like this might make the label “pro-life” make some sense.
I know on the state level CPMs have gotten bi partisan support but I assume the AMA would be all over this if it started to move.