Florida Celebrates National and State Midwives Week this October

Florida Friends of Midwives is proud to join the American College of Nurse Midwives, the Midwives Association of Florida, and communities statewide in celebrating National Midwifery Week and Florida Licensed Midwives Week during the first week in October.

Midwifery Week is a chance for midwives and the women they serve to reflect on their experiences and midwifery's contributions to women's health care, including attending births and providing well-woman care. Throughout Florida, regional groups of Florida Friends of Midwives are celebrating with awareness events, social gatherings and local Mayor's proclamations.

One such proclamation will be read at the Sarasota City Commission meeting October 3rd. “Midwives make a strong contribution to the health and well-being of mothers and babies through proper care and treatment in all phases of childbirth," says Sarasota Mayor Suzanne Atwell. “I look forward to welcoming all those involved in this important effort.”

Midwives have a long and valued history in Florida. The state first passed legislation to license direct-entry midwives in 1931, and the first Certified Nurse Midwife was licensed in Florida in 1970. Florida’s midwives have continued to tirelessly serve the families of Florida and to ensure the continued availability of safe, evidence-based birthing options for Florida’s families.

Florida Friends of Midwives celebrates midwives in Florida and throughout the world during this special week. For more information about midwifery in Florida, please visit flmidwifery.org.

ABOUT FLORIDA FRIENDS OF MIDWIVES (FFOM): Florida Friends of Midwives (FFOM) is a nonprofit grassroots organization dedicated to promoting the Midwives Model of Care and supporting the practice of midwifery in Florida. Florida Friends of Midwives was formed to support midwives who offer safe, cost-effective, evidence based care to Florida's Families. FFOM members are consumers and birth advocates committed to organizing the community to support midwives and to assure the continued availability of midwifery care in the State of Florida. For more information, please visit flmidwifery.org.

Legislative Update - Capital Testimony

The following is a testimony that was presented jointly by Midwives Association of Florida and Florida Association of Birth Centers last week to the Health Care Appropriations Subcommittee. FFOM endorses this testimony and encourages your support of these allied organizations.

Good Afternoon Chairman Hudson and Members,

In this tough budget year I am glad to have the opportunity to share with you a good investment. Birth Centers are an investment that has a high PE (price per earnings) ratio. - A licensed midwife and a birth center is the perfect combination for a healthy birth outcome. The State of Florida in its wisdom has recognized the need to utilize prenatal funds more efficiently and to increase the limited availability of care providers. Families view midwifery services in a birth center as a quality, cost-effective alternative to traditional physician hospital births.

The Florida Health Finder lists over 20 free standing birth centers that are located th

roughout the state. As you are aware prenatal providers in some counties are scare.

Presently a birth center is reimbursed by Medicaid an average of $2,000 per birth. A hospital birth would cost more than double the cost. At this time Medicaid pays for 10 prenatal visits. Birth Centers promote optimum care – they encourage the pregnant woman to start prenatal care at 10 weeks and goes to 42 weeks of pregnancy. That is a total of 16 visits.

Did you know that Birth center service also offer additional free services to their clients and at no cost to the taxpayer?

• Initial and ongoing diet evaluation and nutrition guidance. We know how important it is for the pregnant mother to be healthy during her pregnancy.
• They offer exercise for pregnancy, birth and postpartum -a birth center offers. This could lower the incidence of post-partum depression.
• Child Birth Classes – not only do they educate the pregnant mother what to expect during her pregnancy. Provide awareness to parents to put their baby to sleep on their back to reduce SIDS.
• Parenting and infant care classes
• Baby Safety Education.
• Breastfeeding support – research shows breastfeeding reduces infant illness; babies are healthier, which saves the Medicaid dollars in visits to the physician.
• Breastfeeding also has long-term health benefits:
• Reduced incidence of diabetes, heart disease, childhood obesity……

And last but not least – importance of family planning and baby spacing.

All of this for $2,000.

Most birth centers use a formula of 1/3 Medicaid, 1/3 self paid and 1/3 private health insurance. Some birth centers have 50% or more Medicaid patients. A proposed 20% reduction of an average of $400.00 per patient would cripple the fiscal health of a birth center. Many would be forced not to see Medicaid patients in order to keep their door open.

We are aware of the budget climate and I hope this information will be valuable you continue to craft the budget. Let us know a good investment when we see one!

Thank you for listening and your dedication to our state and our soon to be born citizens.

TIPS: How to Contact Elected Officials

As we find ourselves in the Spring 2011 Legislative Session, it is a critically important time to contact our elected officials and make our voices for midwives heard. The following will give you some ideas on how to best get your message across to legislators during this busy time.

GETTING STARTED

Identify your legislators and learn about their background, affiliations and voting record. These websites will help get you started, and our FFOM Legislative Committee can help you find more information.

• State House of Representatives: http://www.myfloridahouse.gov
• Florida State Senate: http://www.flsenate.gov

Schedule a meeting with your legislators. Most legislators spend the majority of time in their home districts, as the legislative session is quite short. Take advantage of the opportunity to meet with your representative or senator between sessions to foster a relationship and introduce the concerns of FFOM to him/her.

When meeting with your elected officials, bear in mind that a brief visit is all that is necessary as follow-up phone calls and letter will enhance the impact of your meeting. During your meeting, keep the following in mind:

1. Introduce yourself – as a constituent. Thank the legislator for taking the time to meet with you. Identify yourself as a member of FFOM and share a little about our mission and the people we serve (keep it brief).
2. State your purpose. If appropriate, be clear about what legislation you are supporting or opposing. Mention it by bill number and topic. Focus on one topic per meeting. Let the legislator know your position and why you are asking her/him to vote for that position.
3. Let the legislator and her/his staff members know that you FFOM have information and expertise. Let them know we can be a resource to them on midwifery related issues.
4. Give them a chance to talk about their perspective on your issue.
5. Ask for their vote and try to get a commitment at the meeting.
6. Let them know you plan to stay in touch.

Remember: KEEP IT BRIEF. At most, you can expect 30 minutes of their time. During session or other busy seasons, a 10 minute conversation will be the average. Follow up with a thank you letter right away.

LETTER WRITING TIPS

Writing letters, particularly after an in-person visit, help to keep midwifery issues and related legislation on the table with your representatives. The more often they hear and see information from FFOM about our concerns, the more important the issue will seem. Here are some hints to make your letters well received:

1. Use the correct address and salutation (i.e., Dear Senator name, or Dear Representative name, or Dear Governor name). While the legislature is in session, send letters to Senate or House offices. Between sessions, use the local office in your area.

2. Describe the bill by popular name and by House or Senate file number, or clearly describe the issue.

3. Be brief and clear. Write about one issue per letter, and state the issue and how you want your elected official to vote in your first sentence. Letters should be no longer than one page, however longer letters may be appreciated if you have some new information on the subject.

4. Be specific. If possible, give an example of how the issue affects your district.

5. Be timely. Make sure your legislator will have sufficient time to consider your request.

6. Know your facts. Inaccurate or misleading information will hurt your credibility.

7. Be polite in your requests for support or opposition. Never express anger, make demands, or threaten defeat at the next election. You will want to have future contact with the legislator.

8. Use your own words and stationary rather than form letters or postcards. In addition, write legibly or type – your letter could be discarded if it is not easy to read.

9. Be constructive. Explain an alternative or better solution to the problem and offer to be a resource on the issue.

10. Send a note of appreciation when your elected official supports your issue. When he or she does not support your issue, explain why you think a different decision should have been made. It might make a difference the next time.

PHONE CALLING TIPS

Phone calls can be used to follow-up on letters and meetings, but are often best used for immediate action requests, just prior to votes or new legislative activity. Multiple calls from multiple constituents just prior to a vote can help impress upon the legislator how important this issue is to the people s/he represents. Below are some guidelines for phone calls:

1. State your name, address and indicate that you are a constituent.

2. Give the name and House or Senate File number of the legislation, or clearly explain the issue.

3. State whether you oppose or support the legislation and how you want your legislator to vote. Include a statement on how the issue affects you personally.

4. You will usually be speaking with a secretary or aide who is checking pro or con and the call will last a very short time. Keep the phone call under five minutes unless the aide or legislator prolongs the conversation.

5. Listen to the legislator’s point of view.

6. Take down the name of the aide with whom you spoke so that you will have a contact person in case you need to contact the legislator again.

7. Thank them for their time, both on the telephone and with a note of thanks for the conversation that includes a concise summary of your opinion.

8. Do not call too often and risk becoming a nuisance.

9. Do not lie or try to talk your way around questions to which you do not know the answers. Say that you will get back to the legislator or aide, and then do so.

EMAILING TIPS

Email remains a controversial method of contacting your senators and representatives. Though it seems like a quick and easy way of getting your message to many officials, the use of email generators and other programs have made some offices less likely to respond to email. If you do choose to email your legislators, follow the guidelines under letter writing, and be sure to reference your address and that you are a constituent at the very beginning of your email. Those offices that filter emails often do so based on whether or not the author is a constituent.

Ultimately, FFOM recommends that you use email judiciously, relying more on the “old school” forms of communication to build the relationships that will be critical to forwarding the FFOM agenda in the coming years.

KEEP US POSTED!

Finally, please let us know when you have contacted someone so that our team can follow up with them. Our organization represents many constituents from all over the state and some parts of the country. The more we contact different officials, the more likely we are to find representatives that are willing to lend an ear, or better yet, champion a cause.

Afghanistan Midwives on NPR

by Jim Wildman

Midwife Farangis Sultani tells the story of a woman who was in a great deal of pain last winter. The woman was in labor — and her family had brought her to the Shatak village clinic after a three-hour walk on the back of a donkey.

Farangis delivered the woman's baby, but quickly determined there was a twin baby still inside the womb. "It was horizontal," she says. "If she delivered a baby that was horizontal, she was going to die."

The young midwife did what she could — and "with God's hand" — the second baby was born successfully. Mother and twin children were healthy — defying the statistics in Afghanistan's Badakhshan Province, where pregnant mothers and newborns die too often because villagers live too far from health care.

"These women are like guardian angels for infants and mothers," says Zafaran Natiqi, head of women's affairs in Badakhshan.

It's a career path that has the backing of elders in the province, even though Afghanistan's culture doesn't normally allow young and married women to work outside the home. Village councils actually vote to select the midwife candidates from their own community.

"I come from a very religious family," says Mawlawi Zabihulla Atiq, the leader of the provincial council. "I realize this is a necessity. It's how we can protect our pregnant women and daughters."

Farangis Sultani has recorded each delivery she's performed in a giant log book. She points an entry that describes what happened last winter:

When I helped that woman, I felt proud. It's an honor for me, for the people who trained me, and for my family.

Jim Wildman is a senior producer of Morning Edition, traveling with NPR's Renee Montagne on her reporting trip to Afghanistan.

FFOM Position Against AHCA 59-A

Florida Friends of Midwives believes that a woman has a right to choose her birth attendant and her place of birth. It has come to our attention that the Agency for Health Care Administration (AHCA) is currently seeking to amend the rules that govern the operation of birth centers in Florida. The proposed rule changes, should they be adopted, will restrict a woman's access to out-of-hospital birth for conditions that are widely accepted by the CDC and other regulatory bodies to be safe and normal factors not worthy of high risk status.

This past March, AHCA held an administrative hearing to review proposed birth center rule changes. Prior to that hearing our understanding was that any changes would serve the purpose of bringing birth center rules into greater symmetry with the rule that govern the practice of licensed midwifery. It was also our understanding that interested parties including state midwifery professional organizations and consumer advocacy groups would be kept apprised of further meetings and decision-making regarding this issue. Unfortunately it is now clear that there have been several meetings held in the last several months and additional language was been incorporated into the proposed rule changes based in large part from internal suggestions by the Board of Nursing. These proposed changes include: eradicating the option for vaginal birth after cesarean (VBAC) in birth centers; increasing mandatory prenatal testing without recourse; limiting access for any woman who has ever tested positive for Group Beta Streptococcus bacteria; removing the ability for licensed midwives in birth center settings to administer lidocaine; eliminating informed consent for multiparous women; and finally, restricting care providers including licensed midwives, certified nurse midwives, family practitioners or obstetricians, from practicing as they would in a hospital or out of hospital setting, including conducting physicals, evaluating risk score criteria or other limitations that bind them beyond their own practice regulations.

These changes were proposed in a way that does not follow the accepted and appropriate method for amending rules as per Florida's Sunshine law. It also effectively keeps the licensed midwives, certified nurse-midwives and obstetricians who own birth centers out of the process, as well as the women and families who utilize their services.

Please visit our website at www.flmidwifery.org for additional information including a copy of the most recent proposed rule changes and a template letter for contacting AHCA staff. Right now it is essential that consumers make our voices heard. Should this rule change be accepted, as many as one half of the women who currently choose to give birth in Florida's birth centers will be unable to do so legally.

Midwives for Haiti

Midwives for Haiti is a non-profit organization that was founded by Nadene Brunk, Certified Nurse Midwife. This Virginia based 501c3 organization was founded in 2004. Since its inception, Midwives for Haiti has provided Haitian women with the proper education and tools to keep women and babies safe during the birthing process.

Lack of proper prenatal care and skilled birth attendants makes Haiti the most dangerous place in the western hemisphere to have a baby. In Haiti 48 of 1,000 infants die during birth and 520 of 100,000 women die during labor. These statistics are detrimental to the social development and well-being of so many families in Haiti.

Midwives and Clinicians from all around the world come together through Midwives for Haiti and teach Haitian women proper prenatal care and teach the skill of being a proper birth attendant.

Midwives for Haiti depends on volunteers and donations to continue to help so many in that part of the western hemisphere. If you’d like to contribute in any way, please visit www.MidwivesforHaiti.org, or follow them on Facebook.

Response to the July AJOG Meta-Analysis Against Homebirth

Florida Friends of Midwives supports and aligns ourselves with the efforts of The Midwives Alliance of North America (MANA) and The Big Push for Midwives. In July's American Journal of Obstetrics and Gynecology, an article denounced homebirth for increased neonatal mortality. This conclusion was based on a study that our allied organizations have proven misleading. Florida Friends of Midwives endorses the following responses to the study from both MANA and The Big Push.

Response from the Midwives Alliance of North America:

A new meta-analysis rushed to on-line publication well before its availability in print, concluded that less medical intervention, which is a characteristic feature of planned home birth, is associated with a tripling of the neonatal mortality rate compared with planned hospital births. In a study published online on July 1, 2010 in the American Journal of Obstetrics and Gynecology (AJOG), researchers at Maine Medical Center in Portland, Maine analyzed the results of multiple studies from around the world. The lead investigator, Joseph R. Wax, MD, Department of Obstetrics and Gynecology, Maine Medical Center, stated, “Our findings raise the question of a link between the increased neonatal mortality among planned home births and the decreased obstetric intervention in this group.”

However, Canadian researchers whose data showing the safety of home birth in a well-organized and regulated system, were used in the meta-analysis, are sharply critical of the study. Dr. Michael C. Klein, a senior scientist at the Child and Family Research Institute in Vancouver and emeritus professor of family practice and pediatrics at the University of British Columbia said the U.S. conclusions did not consider the facts. “A meta-analysis is only as good as the articles entered into the meta-analysis—garbage in, garbage out. Moreover, within the article, Wax et al did their own sub-analysis of the studies in the meta-analysis, after removing out-of-date and low quality studies, and found no difference between home and hospital births for perinatal or neonatal mortality. Yet in the conclusion, they choose to report the results of the flawed total meta-analysis, which showed the increased neonatal mortality rate.” Klein said that this is apparently a “politically motivated study in line with the policy of the American College of Obstetricians and Gynecolgists (ACOG) who is unalterably opposed to homebirth.”

Saraswathi Vedam, a nurse midwife and researcher at the University of British Columbia who is considered to be an expert on assessing the quality of literature related to homebirth, states that the study is deeply flawed for several reasons, particularly, “the authors’ conclusions are not supported by their own statistical analysis.” Vedam states that Dr. Wax et al acknowledges the consistent findings of low perinatal and neonatal mortality in planned home births across the best quality studies they reviewed “but amazingly Wax does not emphasize or even mention this in his sole conclusion.” This begs the question of whether the author’s analysis and reporting of reviewed articles on homebirth do not support his foregone conclusion about the safety of homebirth.

The Midwives Alliance of North America, a professional organization of over 1200 members, believes childbearing women and those involved in maternal and child health policy should be made aware of the flaws and erroneous claims in the Wax et al study. There is a substantial body of evidence-based literature from well-designed studies that establishes the safety of planned homebirth with a skilled birth attendant. The fact that the American College of Obstetricians and Gynecologists maintains its position in opposition to homebirth, despite the evidence of its safety and efficacy, makes one question ACOG’s motive in publishing Wax’s substandard study.

Midwives are the primary care providers in out of hospital settings. Whether their work is studied and scrutinized here in the US or abroad the findings are consistent. Trained midwives are qualified health professionals with the requisite expertise to provide mothers and newborns with outstanding care, using less intervention, resulting in maternal and infant outcomes as good as those in hospital settings under the care of obstetricians.

The American public, particularly women in the childbearing years and those who care for them, have a right to high quality research on childbirth. Research literature should not be used to cause undue alarm or limit a woman’s choice regarding care providers, including skilled midwives, and place of birth.

Response from The Big Push for Midwives Campaign:

As New York and Massachusetts moved to pass pro-midwife bills in the final weeks of their legislative sessions, the American Journal of Obstetrics and Gynecology fast-tracked publicity surrounding the results of an anti-home birth study that is not scheduled for publication until September. Described as unscientific and politically motivated, the study draws conclusions about home birth that stand in direct contradiction to the large body of research establishing the safety of home birth for low-risk women whose babies are delivered by professional midwives.

“Many of the studies from which the author’s conclusions are drawn are poor quality, out-of-date, and based on discredited methodology. Garbage in, garbage out.” said Michael C. Klein, MD, a University of British Columbia emeritus professor and senior scientist at The Child and Family Research Institute. “The conclusion that this study somehow confirms an increased risk for home birth is pure fiction. In fact, the study is so deeply flawed that the only real conclusion to draw is that the motive behind its publication has more to do with politics than with science.”

Advocates working to expand access to out-of-hospital maternity care questioned the timing of AJOG’s public relations efforts on behalf of a study that won’t be published until next fall.

“Given the fact that New York just passed a bill providing autonomous practice for all licensed midwives working in all settings, while Massachusetts is poised to do the same, the timing of this study could not be better for the physician groups that have been fighting so hard to defeat pro-midwife bills there and in other states,” said Susan M. Jenkins, Legal Counsel for The Big Push for Midwives Campaign. “Clearly the intent is to fuel fear-based myths about the safety of professional midwifery care in out-of-hospital settings. Their ultimate goal is obviously to defeat legislation that would both increase access to out-of-hospital maternity care for women and their families and increase competition for obstetricians.”

The United States recognizes two categories of midwives: Certified Nurse-Midwives, who are trained to practice in hospital settings and who also provide primary and well-woman care, and Certified Professional Midwives, who undergo specialized clinical training to provide maternity care in out-of-hospital settings. Research consistently shows that midwife outcomes in all settings are equivalent to those of physicians, but with far fewer costly and preventable interventions, including a significant reduction in pre-term and low birth weight births, and as much as a five-fold decrease in cesarean surgeries.

The Big Push for Midwives Campaign represents 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 includes educating state and national policymakers about the reduced costs and improved outcomes associated with births managed by CPMs in private homes and freestanding birth centers.

State of Florida Celebrates International Day of the Midwife

April 30, 2010 (Florida) -- May 5th is the International Day of the Midwife, a day set aside in 1991 by the International Confederation of Midwives and observed in over 50 nations worldwide. In 1992, Florida Governor Lawton Chiles joined in this celebration by adding Florida to the growing list of states and countries that observe this day.

The World Health Organization states: “On the International Day of the Midwife, we pay tribute to the work of the midwives who are key healthcare providers in facilities and communities. They provide the high‐quality and cost‐effective package of care desperately needed by millions of women around the world. The World Health Organization recognizes the contribution of midwives to the reduction of maternal and newborn mortality and renews its support to quality midwifery!”

Special Events Throughout Florida

In honor of this day, Florida Friends of Midwives, a non-profit consumer organization dedicated to promoting and supporting the practice of midwifery in Florida, will host events throughout the state, and support those hosted by sister organizations. On May 5th, The Florida School of Traditional Midwifery will host their annual celebration of the day in Gainesville, featuring special guests Jill Sonke and Cindy Nelly of the University of Florida Center for the Arts in Healthcare Research and Education (CAHRE). Sonke and Nelly have spearheaded arts in medicine missions in Rwanda, the Congo, and most recently Haiti. On May 6th in Sarasota, Florida Friends of Midwives will host an exclusive screening of Guerrilla Midwife, a documentary recently showcased at the Sarasota Film Festival. The film follows midwife Robin Lim along the streets of Bali and into the Acehnese refugee camps of the Indonesian Archipelago, where the midwifery model of care is put to the test, at the epicenter of the turmoil following the December 2004 Tsunami. And on May 8th, the Miami Florida Friends of Midwives chapter will show the film Laboring Under an Illusion, an anthropological exploration of media-generated myths about childbirth.

A Florida Midwife’s Perspective of International Midwifery

No stranger to the international disparity in childbirth practice, Orlando Licensed Midwife Jennie Joseph was the first foreign-trained midwife to be licensed under the Midwifery Practice Act in Florida in 1994. “I trained as a midwife in England 31 years ago and graduated in May of 1981 with the knowledge that midwifery was the 'gold standard' of care for women worldwide,” says Joseph. “Imagine my surprise on arriving in the US in 1989, where I quickly discovered a total lack of interest, understanding or even acknowledgment of the importance of midwives for a nations health.”

Ms. Joseph is executive director of The Birth Place, a free-standing birthing facility in Winter Garden, and the developer of The JJ WAY, a Maternal Child Healthcare delivery model for indigent women. “Today, I begin to have hope that American's are opening up to the benefits of midwifery in matters of choice, safety, empowerment and economy; that we realize that the midwifery model of care can be the vehicle that moves us higher up on the list of countries providing exemplary maternity care for it's citizens, and that truly 'a midwife for every mother' is not an impossible dream,” says Joseph. “A heartfelt thank you to all the midwives - past, present and future and Happy International Midwives Day!”

Midwives have a long and valued history in Florida. The state first passed legislation to license direct-entry midwives in 1931, and the first Certified Nurse Midwife was licensed in Florida in 1970. Florida’s midwives have continued to tirelessly serve the families of Florida and to ensure the continued availability of safe, evidence-based birthing options for Florida’s families.

About Florida Friends of Midwives: Florida Friends of Midwives is a non-profit grassroots organization dedicated to promoting the Midwives Model of Care and supporting the practice of midwifery in Florida. Florida Friends of Midwives was formed to support midwives who offer safe, cost-effective, evidence based care to Florida's families. For more information, please visit www.flmidwifery.org.

Response to Report on Decline in Maternal Health

This letter was printed in the Sarasota Herald-Tribune on Sunday, April 18th. Laura Gilkey is the Vice President of Florida Friends of Midwives.

I disagree with those who urged The Lancet to delay publicizing the recent decline in global maternal mortality ("Maternal Deaths see surprising decline worldwide," Sarasota Herald-Tribune, April 14, page 1A). It should be a beacon of hope that improved nutrition, access to prenatal care, and the availability of skilled attendants is increasing. In 80% of the world, those skilled attendants are midwives. After witnessing the work of Ibu Robin Lim in the Sarasota Film Festival screening of “Guerilla Midwife,” I am inspired to believe that the resurgence of traditional midwifery worldwide is no small factor in this global shift toward healthier birth.

However, one disturbing trend remains missing from the Lancet findings. In the United States, maternal mortality continues to rise sharply. According to the recently released Amnesty International report "Deadly Delivery," U.S. maternal mortality ratios have doubled from 6.6 deaths per 100,000 live births in 1987 to 13.3 deaths per 100,000 live births in 2006, placing us 41st in the world in this category. The report attributes the increase to inadequate access to family planning, less than optimal health, late or inadequate prenatal care, inadequate or inappropriate care during delivery, and limited access to post-natal care.

The United States spends more on health care than any other nation in the world, yet we are failing our pregnant women. We must prioritize accountability of data collection, increase access to midwifery and to prenatal care, eliminate inappropriate obstetric intervention, and mandate postpartum visitation for new mothers.

Action Alert: VBAC Ban in Florida Birth Centers

On Wednesday, March 24th, the State of Florida's Agency for Health Care Administration will move to permanently ban Vaginal Birth after Cesarean (VBAC) in Florida birth centers. Currently, women who choose to give birth normally after surgery must do so in a hospital that will allow it, which encompasses only half of those in the state, or at home with a Licensed Midwife and physician consult sign-off. VBAC's are currently not permitted in birth centers, but only because of a 'de facto ban' due to outdated language in the regulations. After a request that the language be updated to include legalized VBAC's at birth centers with Licensed Midwives and physician consultation, the State used the opening to move to make VBAC's illegal in state licensed birth facilities.

Allowing the pursuit of VBAC at home or at a state licensed birth center with a Florida Licensed Midwife will keep healthy, safe options open for Florida's families, and will dramatically reduce taxpayers' investment in unnecessary surgery.

For these reasons, I urge you to sign this petition and make your voices heard in support of legalizing VBAC's in Florida's licensed birth centers:

To: Florida Agency Health Care Administration

While we recognize the need to change outdated language in the rule, it is our position that the state consider similar language to that of F.S. 467. Such language would work to insure the patient received competent care from a licensed practitioner and respects the right of the patient to make an informed decision. We ask the State of Florida to remain a regulatory body and not take on the role of medical surrogate. (Sign here)

For more information, please visit http://www.vbacsummit.org/VBACBAN.html.

FFOM Hosts Maternal Health Weekend in Sarasota

Last weekend, Florida Friends of Midwives sponsored and co-sponsored several events aimed at improving maternal health care locally and throughout the country. Headlining the weekend was Sunday afternoon's panel discussion Maternal Health Care in the 21st Century: Sarasota and Beyond. Present for this and all other events was the world's leading midwife, Ina May Gaskin.

Ms. Gaskin began her visit to Sarasota with a Clinical Conference for the medical staff of Sarasota Memorial Hospital (SMH) on Friday, October 30. Her presentation was entitled "Combining the Best of Modern Obstetrics with Respect for Nature and Traditional Midwifery Approaches." Her objectives were threefold: to explore the knowledge base and skills common to traditional midwifery; to understand the need for both modern obstetrics and (authentic) midwifery; and to build positive relationships between the two professions (especially with regard to home birth midwives). Present at the conference were SMH Director of Maternal-Fetal Medicine Dr. Washington Hill; Sarasota County Health Department OB/GYN Dr. John Abu; Licensed Midwives Christina Holmes and Alina Vogelhut; and several members of the hospital staff and the community, including childbirth educators, nurses and retired physicians. The presentation will be available via podcast on the SMH Continuing Education website.

Friday afternoon found Ina May Gaskin touring both of Sarasota's freestanding birth centers (Birthways Family Birth Center and Rosemary Birthing Home), and having lunch with Sonia Pressman Fuentes, the co-founder of the National Organization for Women (NOW). Two of the most influential women in recent American history, the pair discussed the shift in birth culture in the last half century, the difference between American governmental structure and that of most European countries with better maternal outcomes, and the role of the feminist movement in changing the American perception of birth.

Saturday morning, October 31, Ina May Gaskin presented the Safe Motherhood Quilt Project at the Selby Public Library. Ms. Gaskin spoke to Sarasota's SNN News Channel 6 before the presentation, saying "In 2007, the World Health Organization reported that there are forty other countries that do better at preventing maternal death than the United States." Three panels of the quilt were shown in the library's Geldbart Auditorium, after having been hung from the atrium balcony during the week prior. These three panels contained 58 squares, each representing a woman who has died of pregnancy or childbirth related causes in America since 1982. Ms. Gaskin argues that simple measures such as a unified federal death certificate and an increase in percentage of hospital autopsies would dramatically improve U.S. maternal outcomes. The presentation was followed by a booksigning benefiting the project, as well as Florida Friends of Midwives (FFOM), a non-profit grassroots organization dedicated to promoting and preserving access to midwifery care in Florida. Ms. Gaskin signed copies of her classic Spiritual Midwifery, the gold standard prenatal education book Ina May's Guide to Childbirth, and her newest release, Ina May's Guide to Breastfeeding, said by Dr. Christiane Northrup to be "the best thing ever written on the subject."

Sunday afternoon at 3:00 pm, Ina May Gaskin met in the Hyatt Regency Sarasota Ballroom with Dr. Washington Hill once more, as well as Sarasota Healthy Start Coalition executive director Jennifer Highland and Representative Keith Fitzgerald, for a panel discussion called Maternal Health Care in the 21st Century: Sarasota and Beyond. The discussion was moderated by Sarasota Vice Mayor Kelly Kirschner, who shared his perspective as a City Commissioner that improved maternal health is a formula of community growth.
The panel was a free program which included refreshments and a 28 page Maternal Health Resource Guide, all made possible by the hard work of the sponsoring organizations and the generosity of several business partners. Approximately 250-275 people attended the discussion, including several guests of expertise in the field of maternal health and associated disciplines.
Dr. Washington Hill was the first to speak, pointing to a collaborative model of care as the standard for positive outcomes, and encouraging open communication between the many components of maternal health care and its providers.
Ina May Gaskin followed, discussing maternal death, its possible prevention and ways to move toward accurate recordkeeping, and the importance of prenatal health. She illustrated strategies in other countries with much better outcomes than ours, such as the Netherlands, which provides its new pregnant women with paid postpartum care.
Jennifer Highland, executive director of the Healthy Start Coalition of Sarasota County, then presented a staggering display of statistics illustrating Sarasota's place in Florida and the rest of the country in categories such as infant death, fetal death, smoking during pregnancy, breastfeeding rates and more. Jennifer suggested that Sarasota County's high cesarean section percentage be closely examined and reversed to improve preterm birth rates and NICU admissions, and that prenatal health be a priority of all parties involved.
Finally, Florida House of Representatives Health and Family Services Policy Council member Rep. Keith Fitzgerald gave the audience a history of health insurance, an overview of health care reform issues, and a call to action. When talking about the frequency of special interest groups' appointments with him and his colleagues, Fitzgerald asked: "Where are you?"

Questions were then taken from audience members, who asked about tort reform, individual OB/GYN's c-section rates, and women's intuition--among many other things.

After the panel discsussion, Florida Friends of Midwives (FFOM) hosted the tribute An Evening with Ina May Gaskin in the Boathouse of the Hyatt Regency Sarasota. Guests received keepsake tickets, signed a book of gratitude for Ms. Gaskin, and viewed a tribute DVD of her work and its manifestation through the midwives and midwife-assisted births here in Sarasota. Special thanks to Radio-Free Carmela and the Transmitters and Tanya Radtke for providing music for the evening. Net proceeds of approximately $2500 will help FFOM in their strategy to protect Florida's midwives and their laws, and to improve public awareness of the Midwives Model of Care.

Safe Motherhood Quilt Project in Sarasota This Week

Beginning today, three panels of The Safe Motherhood Quilt Project are on display at the Selby Public Library. The Safe Motherhood Quilt Project is a national effort developed to draw public attention to the current maternal death rates in the United States, as well as to the gross underreporting of maternal deaths, and to honor women who have died of pregnancy-related causes. The three panels currently on display in Sarasota represent 58 mothers who have died of pregnancy or childbirth related causes in the US since 1982. There are several other panels throughout the country just like them.

Project founder and world's leading midwife Ina May Gaskin will be presenting these panels on Saturday, October 31st, at 11:00 am. Following her presentation she will sign copies of all three of her books (Spiritual Midwifery, Ina May's Guide to Childbirth, and Ina May's Guide to Breastfeeding), in benefit for Florida Friends of Midwives and The Safe Motherhood Quilt Project.

News from the MAMA Campaign

Florida Friends of Midwives endorses the MAMA Campaign. Please read this update, including an incredible list of accomplishments in just a few short months.

What a summer this has been for Midwives and Mothers in Washington, DC! Now, as the health care bills pick up speed in Congress this fall, we need your support and your dollars more than ever. Billy Wynne, our lobbyist, wrote to us this past week: “You should feel very good about the massive education campaign you’ve undertaken and the broad support you’ve gained …now it’s crunch time!”

Just since May, the MAMA Campaign has accomplished a lot by acting quickly and effectively.
We have:

• Drafted an amendment to recognize and reimburse CPMs in Medicaid
• Hired a national health policy and lobbying firm to guide our advocacy work in DC
• Held a “fly-in” of more than twenty MAMA activists to Washington, DC, in June who met with over 30 key congress members
• Traveled to DC nearly every week since then and followed up with supporters to keep the pressure up
• Prepared a cost-analysis based on Medicaid data from a health policy study in Washington State that was submitted to the Congressional Budget Office on our behalf by Chairman Waxman’s office
• Met with 8 top Medicaid officials in Baltimore in July, an unusual opportunity for a provider group new to Capitol Hill
• Monitored and adjusted our strategy weekly as the proposed legislation twists and turns through Congress
• Secured the support of important national groups: Childbirth Connection, the National Women’s Law Center, the National Women’s Health Network, Raising Women’s Voices, Our Bodies Ourselves, the Coalition for Improving Maternity Services, American Association of Birth Centers, and state midwifery and consumer groups

And we have continued to manage the campaign using the pro-bono skills and expertise of top leadership in six national midwifery and citizen organizations as well as activated superb grassroots support across the country.

Over these next weeks we will continue to have opportunities to include Certified Professional Midwives in the health care bills. However, the time is growing short and we really need your help. As Billy says, it’s crunch time!

Every step of the way you have stood behind us. Thank you! Together we have raised $100,000 for the Campaign this summer – 2/3 of our goal and a truly stunning fundraising coup for our movement! We are so grateful to you!!

Now we need your help to get across the finish line!
Will you give $10, $25, $50 or even $100 to continue our work for federal recognition of CPMs? Just click to donate.

Will you help us identify potential major donors? Write to president@nacpm.org with ideas.

And of course, be sure to keep the letters to your legislators coming – we need that “dull roar” from the states and districts to move our provision over the top! Constituents are the ones that legislators are listening to. That’s you! Find letter templates and instructions on our website.

Thank you so much! We look for to hearing from you!

Mary Lawlor, CPM
President, NACPM
National Co-Chair, MAMA Campaign

Susan Hodges
President, Citizens for Midwifery
National Co-Chair, MAMA Campaign

Florida Celebrates Licensed Midwives Week October 5-9

Governor Charlie Crist has signed a proclamation observing October 5 through the 9 as Licensed Midwives Week in the State of Florida, upholding midwives for being “dedicated to the care of pregnancy and childbirth and treat[ing] each woman’s pregnancy according to her unique physical and personal needs.” Governor Crist’s proclamation also recognized midwives for their role in the need to “improve birth outcomes in the State of Florida and ensure that women are given proper care and treatment in all phases of childbirth.”

In honor of this week, Florida Friends of Midwives (FFOM), a non-profit grassroots organization dedicated to promoting and supporting the practice of midwifery in Florida, will be hosting various community events throughout the state this month to celebrate the more than 110 Licensed Midwives in the Sunshine State.

Florida Licensed Midwives Week coincides with National Midwifery Week, a time to recognize the contributions of Certified Nurse Midwives (CNMs), Certified Midwives (CMs) and Certified Professional Midwives (CPMs) nationwide. The American College of Nurse Midwives (ACNM) publicly announced the week with an introduction to midwifery. “The heart of midwifery care for women and newborns lies more in the nature of that care than in its specific components. Midwifery practice has a firm foundation in the critical thought process and is focused on the prevention of disease and the promotion of health, taking the best from the disciplines of midwifery, nursing, public health and medicine to provide safe, holistic care.”

Midwives have a long and valued history in Florida. The state first passed legislation to license direct-entry midwives in 1931. In the 77 years since, Florida’s licensed midwives have continued to tirelessly serve the families of Florida and to ensure the continued availability of safe, evidence-based birthing options for Florida’s families. In 1992, Governor Lawton Chiles declared the first-ever Licensed Midwives Week. More women than ever before are seeking out licensed midwives for maternity care. According to the latest data from the Florida Council of Licensed Midwifery, births managed by Licensed Midwives in the state grew by about 5.5% from 2005 to 2006.

“We are honored every day to serve Florida’s mothers, babies, and families,” says Sarasota Licensed Midwife Alina Vogelhut, LM. “It means so much for our profession to be honored by Governor Charlie Crist and the State of Florida.”

Midwifery in Florida

In Florida, two types of midwives are allowed to practice: Certified Nurse-Midwives and Licensed Midwives (a Florida state licensure), also known as direct-entry midwives. Throughout the state, about 11.2 percent of births are estimated to be managed by midwives, rather than by OB-GYNs. Many birth centers and midwives have reported a significant increase in business in the past year. This increase is believed to be a result of various factors, primarily a greater number of women seeking alternative birthing choices due to an unhealthy increase in caesarean sections and other unnecessary interventions that frequently occur in hospital settings. In a 2006 report on Florida Licensed Midwives, midwives had a caesarean section rate of 6.3 percent compared to a 36.64 percent statewide average in hospitals the same year.

For more information of midwifery in Florida, please visit www.flmidwifery.org.

About Florida Friends of Midwives

Florida Friends of Midwives is a non-profit grassroots organization dedicated to promoting the Midwives Model of Care and supporting the practice of midwifery in Florida. Florida Friends of Midwives was formed to support midwives who offer safe, cost-effective, evidence based care to Florida's families. For more information, please visit www.flmidwifery.org.

A Letter from the MAMA Campaign

Dear Florida Supporters of Midwifery--

As Florida constituents you all are in a unique and special position to help encourage federal recognition of CPMs by helping The MAMA Campaign.

The MAMA Campaign is an effort by six national organizations to include CPMs as Medicaid providers in the evolving healthcare reform legislation currently under consideration. Visit www.mamacampaign.org for more information about the campaign and to signup for news and alerts.

This week, the MAMA Campaign is trying to get letters from constituents sent to the offices of Senator Nelson and/or Congresswoman Kathy Castor of the 11th district in Florida. Anyone who lives in Florida can write as a constituent to Senator Nelson. We only need people who are constituent’s of Congresswoman Kathy Castor to write to her. To find out if you or someone you know lives in Castor’s Tampa Bay area district, visit http://www.govtrack.us/congress/findyourreps.xpd?state=FL&district=11.

Congresswoman Castor is on the House Energy and Commerce committee and Senator Nelson sits on the Senate Finance Committee. These committees will make decisions about changes to Medicaid in the current health care reform efforts, including whether or not CPMs will be added to the list of approved Medicaid providers. Hence, as Floridians, you are in a special position to help influence these critical legislators. This inclusion of CPMS as federal Medicaid providers would be an important step in increasing access to CPMs across the country.

Both Congresswoman Kathy Castor and Senator Bill Nelson have indicated some support for our amendment. But ours is only one of many potential amendments to the health care bills, all demanding their attention. We need you to write a letter of encouragement to Senator Nelson and/or Congresswoman Castor, telling them to take action on this issue.

Please forward this letter writing request to other Floridians who support midwifery. If you have clients, friends, relatives or ANYONE who is a constituent who will write a letter to Representative Castor and/or Senator Nelson please ask them to do so. It is important to send letters as soon as possible! These personal letters from constituents are critical and make a huge impact. Please write and fax or email a short letter TODAY!

MAMA CAMPAIGN INSTRUCTIONS AND TALKING POINTS FOR E-MAILED OR FAXED LETTERS FROM CONSTITUENTS OF SENATOR NELSON OR REPRESENTATIVE CASTOR

1. Handwritten or typed letters may be faxed to the number provided below.

2. Please fax your letter to the legislator’s Washington, D.C. office. This is the best way to get the letters to them quickly and effectively. If you are unable to send a fax, the next best thing is to send your letter by using the legislator’s web-based e-mail form. If you would like to help but can’t fax a letter, or send an email, a phone call to their Washington, D.C. office, is also helpful.

Rep. Kathy Castor (FL-11th)(Tampa): Visit http://www.govtrack.us/congress/findyourreps.xpd?state=FL&district=11 to see if you are a constituent.

DC Fax: (202)225-5652
DC Phone: 202-225-3376
Web Email Form: https://writerep.house.gov/writerep/welcome.shtml

Sen. Bill Nelson (FL)
DC Fax: 202-228-2183
DC Phone: 202-224-5274
Web Email: http://billnelson.senate.gov/contact/email.cfm

3. Please include the following crucial language in your letter; this is what you are asking your legislator to do:

FOR REP. CASTOR: "I am a constituent and I ask that the Congresswoman support efforts to improve the maternity care system by adding Certified Professional Midwives to the list of providers covered by Medicaid. Will Congresswoman Castor raise this issue with Energy & Commerce Chairman Henry Waxman as a priority for her, to see if we can get this important provision in the final House bill? It’s so crucial that we expand access to maternity care as a component of health reform.”

FOR SEN. NELSON "I am a constituent and I ask that the Senator support efforts to improve the maternity care system by adding Certified Professional Midwives to the list of providers covered by Medicaid. Will Senator Nelson please raise this issue with Finance Committee Chairman Max Baucus as a priority for him, to see if we can get this important provision in the final Senate bill? It’s so crucial that we expand access to maternity care as a component of health reform.”

4. A short letter is sufficient. But, if you wish to write an expanded, more personalized letter, at the end of this document are a list of talking points to help you explain why Senator Nelson or Representative Castor should ask their appropriate chairman to add this amendment to the bill. You do not need to use all the talking points. We encourage you to make this a personal letter from you. We do not want these to look like form letters. We do suggest, because the chairmen are looking for cost-savings wherever they can find them, that you might want to emphasize the second and fourth bulleted points in the list of talking points below.

Note: For clarity’s sake, please be sure to write out “Certified Professional Midwife” rather than “CPM”.

5. Share a brief personal detail if possible and relevant, for example: “Two of my children were born at home attended by Certified Professional Midwives. I believe all women regardless of their income should have access to the safe, high-quality, cost-effective care provided by Certified Professional Midwives.”

6. Sign off with your name, address, and contact information.

7. If Senator Nelson’s or Representative Castor’s office would like more information about our efforts to pursue this important Medicaid improvement, they may contact Mary Lawlor with the National Association of Certified Professional Midwives at president@nacpm.org or on her cell phone at 917-453-6780. She and other Campaign members will be in D.C. during the next few weeks and may be available to meet his/her staff.

8. Please send the MAMA Campaign a copy of your letter. Email it to info@mamacampaign.org or FAX to 802-536-4142.

Again, anyone who lives in Florida can write as a constituent to Senator Nelson. We only need people who live in Congresswoman Kathy Castor’s district to write to her. To find out if you or someone you know lives in Rep. Castor’s district which includes: Tampa and St. Petersburg and parts of Hillsborough, Pinellas and Manatee counties, visit http://www.govtrack.us/congress/findyourreps.xpd?state=FL&district=11. PLEASE forward this writing request to other Floridian’s who support midwifery. These letters are incredibly important.

If you haven’t already, please sign up with the MAMA Campaign at www.mamacampaign.org to get e-alerts and find more information and handouts. Please donate to the campaign at www.mamacampaign.org. Thanks so much for all you are already doing and for all you will do this week!

THANK YOU!

Nasima Pfaffl
Citizens for Midwifery/MAMA Campaign
321-733-6156
nasima@cfmidwifery.org

Talking Points :

CPMs are highly-trained, credentialed clinicians who provide effective, evidence-based maternity care. They are the only maternity care providers specifically trained in attending births outside the hospital and, by assisting in births at home and in birthing centers, offer women an important choice in how their babies are delivered.

I support the basic principal that health reform should make obtaining care MORE AFFORDABLE for all American. Adding Certified Professional Midwives to the Medicaid list would SAVE MONEY by reducing health care costs immediately.

Each mother on Medicaid who chooses an out-of-hospital birth with a Certified Professional Midwife would lower Medicaid costs, since Medicaid would otherwise be paying for a hospital birth at greater cost and with much greater likelihood of an expensive cesarean section.

Research demonstrates that midwives who attend births outside the hospital (at home or in a birth center) have much lower rates of unnecessary and potentially dangerous medical interventions such as inductions and cesarean-sections with at least as good outcomes in terms of maternal and infant mortality, at substantially lower costs.

Because Certified Professional Midwives provide thorough individualized care that promotes healthy pregnancies, the babies are healthier – more are full term and full weight, avoiding costly health problems.

Of the twenty-five states that now provide a path to licensure for Certified Professional Midwives, only 9 include CPMs in their state Medicaid programs, so low-income women on Medicaid have difficulty obtaining services. This falls short of genuine and consistent patient choice and access. Certified Professional Midwives and women who want access to them are seeking federal Medicaid reimbursement for their services as one important step to increase access to this kind of maternity care.

All women deserve to have access to quality, comprehensive maternity care, in the communities where they live, with a choice of qualified provider and services that are fully recognized and reimbursed by both private and public payers.

As the #1 reason for hospitalization, but with declining quality outcomes in the U.S., it is essential for health care reform to include maternity care.

Tickets on Sale Friday for An Evening with Ina May Gaskin

Tickets to An Evening with Ina May Gaskin go on sale via PayPal on Friday, 9/18, at approximately 10:00 am. Only 150 guests will have the privilege of dining with Ina May, so please get your tickets early!

Tickets include dinner, a cash bar, and live music with Radio Free Carmela and the Transmitters at the gorgeous Boathouse of the Sarasota Hyatt Regency Hotel. Doors will open at approximately 5:30 on November 1st, immediately following the free panel discussion Maternal Health Care in the 21st Century: Sarasota and Beyond, at the same hotel. The panel discussion is free but reservations are strongly recommended, and may be made by emailing laura@kangaroopromotions.net.

Links to buy tickets may be found Friday morning on the Florida Friends of Midwives website (http://www.flmidwifery.org/) as well as on the blog http://www.borninsarasota.blogspot.com/.

Tickets are $35 for the event only, or $60 with a signed book of your choice--Spiritual Midwifery, Ina May's Guide to Childbirth, or her newest--not even released yet--Ina May's Guide to Breastfeeding!

I hope to see many of you there...this is the opportunity of a lifetime to pay thanks to someone who is directly responsible for paving the way to the availability of direct-entry midwifery we all care about so deeply. Thank you and I can answer any questions you have!

Laura Gilkey, Vice President
Florida Friends of Midwives

An Evening with Ina May Gaskin

Ticket Only $35.00 Ticket and Signed Copy of Ina May's Guide to Breastfeeding $60.00 Ticket and Signed Copy of Ina May's Guide to Childbirth $60.00 Ticket and Signed Copy of Spiritual Midwifery $60.00

FFOM Wants to Hear Your Birth Story

Due to the volume of quick responses, the ACOG website survey on homebirth was password protected after 18 hours. The effort to flood them with positive birth stories was an immediate success. Visit the Citizens for Midwifery Grassroots Network and The Big Push for Midwives campaign for more information. Thanks for your support!

The ACOG survey demonstrates that the opposition to home birth is powerful and organized. Midwives and consumers of midwifery care need to stay informed, and be ready to support midwives politically. Stay connected to events and actions in Florida by joining Florida Friends of Midwives. There is an e-group, forums, and a newsletter to keep you informed of important events.

We still want to hear your positive birth story! To tell your birth story to support midwives, please submit it to the Florida Friends of Midwives website. Follow the instructions below, and email birth stories to stories@flmidwifery.org.

How to Submit Your Birth Story:

If you would like to submit of your birth with a Florida midwife, here is what to do:

1. Submit your story in a .txt or .doc format. All stories should be accompanied by photographs in .jpeg, .jpg, .eps format.

2. Include your name and a title for the story.

3. Stories should be ¾ page to 1 ½ pages. Try to separate your story in to several paragraphs.

Please spell check your story before you send to us! It sounds very basic, but it is important and helps us get the stories up sooner. We will make corrections if necessary, but you will help us out greatly if you spend some time checking your story for accurate spelling and grammar.

We will notify you if your story is used and provide you with a link to view it on the website. Again, please be aware that we may edit your story for grammar, punctuation, spelling and length if necessary. It may take us up to a month to post your story, if it's used. Try to be patient with us.

VERY IMPORTANT! You MUST include a statement with your story that you give FFOM permission to print your story. We cannot publish it to the web without this statement!

Florida Friends of Midwives Endorses MAMA Campaign

Florida Friends of Midwives endorses the MAMA Campaign, a collaborative effort by the National Association of Certified Professional Midwives (NACPM), Midwives Alliance of North America (MANA), Citizens for Midwifery (CfM), International Center for Traditional Childbearing (ICTC), North American Registry of Midwives (NARM), and the Midwifery Education Accreditation Council (MEAC). This partnership is now at work to gain federal recognition of Certified Professional Midwives so that women and families will have increased access to quality, affordable maternity care in the settings of their choice.

Help ensure that low income women on Medicaid all across the country can choose midwifery care – Donate Today! Any amount you can give will help Certified Professional Midwives be recognized under federal Medicaid law. If every supporter in Florida donated $25 and if busy midwives and birth centers donated $500 or $1,000, we would be well on our way to meeting our fundraising goal. Help us sustain the work of organizing and lobbying that it takes to make our voice heard in Washington, DC. Donate today at www.mamacampaign.org.

Heads Up on Infant Mortality Campaign

September is Infant Mortality month. Did you know that 1,687 babies died before age one in 2007 in the state of Florida alone? The 2009 Campaign for Healthier Babies is drawing attention to infant mortality by knitting one baby hat for every baby who didn't reach their first birthday.

"Too many babies are being born too soon, too small, or too sick to survive," said Jennie Joseph, CPM, Executive Director of Commonsense Childbirth. Please join Jennie in her endeavor to promote early prenatal care and save the lives of our children!

How you can help:

* knit or crochet one or more baby hats
* teach someone how to knit or crochet a baby hat
* donate to the campaign
* encourage all pregnant women to start prenatal care right away - we can help, no one is turned away

The hats will be displayed at a rally in September (date & time TBA). You can help by knitting or crocheting one or more infant hats and bringing or mailing your hat(s) to:

The Birth Place
1130 E. Plant Street
Winter Garden, FL 34787
Call: (407) 656-6938
Email: Elena@TheBirthPlace.org

FFOM Welcomes Ina May Gaskin to Sarasota

Sarasota, FL (July 31, 2009) -- On November 1, 2009, Sarasota will host a discussion entitled 'Maternal Health Care in the 21st Century: Sarasota and Beyond.' The program will feature a distinguished panel of internationally recognized speakers. The Sarasota-Manatee Chapter of the National Organization for Women (NOW) is sponsoring the event, along with co-sponsors Florida Friends of Midwives and the Sarasota Commission on the Status of Women. The discussion will take place at the Hyatt Regency Sarasota. The public is welcome to attend at no cost.

The panelists for this discussion are:
--Dr. Washington Hill, MD, FACOG, Labor and Delivery Medical Director and Maternal-Fetal Medicine Director at Sarasota Memorial Hospital;
--Ina May Gaskin, MA, CPM, Founder and Director of The Farm Midwifery Center;
--Rep. Keith Fitzgerald, PhD, Florida House of Representatives, District 69; and
--Jennifer Highland, MPH, Executive Director of the Healthy Start Coalition of Sarasota County.

The discussion will be moderated by Kelly Kirschner, MA, Sarasota City Commissioner and Vice Mayor, and will last approximately an hour and a half. Time will be allotted for audience questions and answers, as well as refreshments following the program.

This panel will review current trends in maternity care in Sarasota within the context of the U.S. and the world and target paths to improving maternity care locally and nationwide. Topics for discussion include:

• maternal mortality,
• obstetric intervention rates and risks,
• legislation,
• legal reform and malpractice concerns,
• insurance coverage,
• community education and awareness,
• the midwifery model of care,
• informed consent and refusal,
• transparency in maternity care,
• the availability of prenatal care (including education, counseling, and doulas), and
• the upcoming expansion of Sarasota Memorial Hospital to include new labor and delivery rooms.

Hosting a panel discussion about maternal health care issues was the brainchild of Sonia Pressman Fuentes, co-founder of the National Organization for Women (NOW). “After spending a lifetime improving the legal status of women and fighting gender discrimination in the US and the world, it is exciting for me to be involved in a field new to me, that of improving maternal health care options for women in Sarasota, the US, and the world,” says Fuentes. Joining her in planning the event is Laura Gilkey, local childbirth advocate and board member of Florida Friends of Midwives. "With a panel representative of obstetrics, midwifery, legislature and public health, perhaps Sarasota can begin a conversation that will pave the way toward becoming a national model of community healthcare reform through improved maternity care," says Gilkey.

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For more information, please contact Laura Gilkey at laura@kangaroopromotions.net / (941) 915-8115. Interviews are available at the request of the press. Planning and agenda updates for the panel will be posted on the website www.borninsarasota.blogspot.com.

About the National Organization for Women (NOW): The National Organization for Women (NOW) is the largest organization of feminist activists in the United States. NOW has 500,000 contributing members and 550 chapters in all 50 states and the District of Columbia. Since its founding in 1966, NOW's goal has been to take action to bring about equality for all women. NOW works to eliminate discrimination and harassment in the workplace, schools, the justice system, and all other sectors of society; secure abortion, birth control and reproductive rights for all women; end all forms of violence against women; eradicate racism, sexism and homophobia; and promote equality and justice in our society.

About Florida Friends of Midwives (FFOM): Florida Friends of Midwives (FFOM) is a non-profit grassroots organization dedicated to promoting the Midwives Model of Care and supporting the practice of midwifery in Florida. Florida Friends of Midwives was formed to support midwives who offer safe, cost-effective, evidence based care to Florida's Families. Our members are consumers and birth advocates with a common goal: to preserve the legal protection afforded to Florida's midwives and birth centers. We are committed to organizing the community to support midwives and to assure the continued availability of midwifery care in the State of Florida.

About the Sarasota Commission on the Status of Women (SCSW): The Sarasota Commission on the Status of Women (SCSW) was re-established in Sarasota County to empower women through education, research, and advocacy.

ABOUT THE PANELISTS:

Dr. Washington Hill, M.D., FACOG
Labor and Delivery Medical Director / Maternal-Fetal Medicine Director, Sarasota Memorial Hospital
B.A., Rutgers University, College of South Jersey, Camden, New Jersey, 1961
M.D., Temple University School of Medicine, 1965
Obstetrics and Gynecology Residency, William Beaumont General Hospital, 1970
Post Graduate, Maternal-Fetal Medicine Fellowship, University of California, San Francisco, 1984
Board Certification, American Board of Obstetrics and Gynecology with Special Competence in Maternal-Fetal Medicine, 1989 with Recertification 1978, 1993 and 1998

Dr. Hill is the Past President of the Medical Staff and Chairman of the Department of Obstetrics and Gynecology at Sarasota Memorial Hospital, Sarasota, Florida. He is currently Director of Maternal-Fetal Medicine. He is also Clinical Professor Department of Obstetrics and Gynecology at University South Florida College of Medicine, Tampa Florida and Clinical Professor Department of Clinical Sciences OB/GYN Clerkship Director-Sarasota Campus Florida State University College of Medicine Tallahassee Florida. After earning his medical degree at Temple University and interning at Walter Reed General Hospital in Washington, D.C., Dr. Hill spent the next nine years as a Medical Officer in the United States Army. During this time, he conducted his residency training in Obstetrics and Gynecology at William Beaumont General Hospital in El Paso, Texas. Upon finishing his residency, he was an Obstetrician and Gynecologist in Germany for three years. After twelve years of private practice in Obstetrics and Gynecology, Dr. Hill completed a fellowship in Maternal-Medicine at the University of California, San Francisco and Children’s Hospital of San Francisco in 1984. While there, he was also a Research Fellow at the Cardiovascular Research Institute. Following completion of his fellowship in Maternal-Fetal Medicine, he has practiced this subspecialty for over 20 years first at the Sutter Perinatal Center and the University of California-Davis School of Medicine, Sacramento, California, and then at Creighton University, School of Medicine, Omaha, Nebraska; Meharry Medical College, and Vanderbilt University School of Medicine, Nashville, Tennessee. He served as Chairman of the Department of Obstetrics and Gynecology at Meharry Medical College, School of Medicine, educating minority medical students and residents from 1990 until 1992, when he took his current position as Director of Maternal-Fetal Medicine and the Perinatal Center of Sarasota Memorial Hospital in Sarasota, Florida. Dr. Hill is a leader in Maternal-Fetal Medicine. He has a strong interest in education, patient care, teaching and clinical practice. He is a regular participant at conferences which teach perinatal healthcare providers management and use of research in caring for high risk pregnancies. He has been a leader in the development of a center of excellence known throughout the nation for the care of high risk pregnant patients. Dr. Hill is a frequently sought after speaker in the community and at medical centers around the nation in high risk pregnancy management. He is Board Certified in Maternal Fetal Medicine and Obstetrics and Gynecology. He also serves around the country as a consultant for maternal-fetal medicine and medical legal issues. In his “spare time,” he likes to travel, especially to Africa on medical missions and will be happy to recruit to go also. He also enjoys sports, music and collecting African artifacts when not engaged in his teaching duties. Dr. Hill is the author of at least 60 articles in refereed journals and the book, “Ambulatory Obstetrics.” He contributes regularly to the medical literature and provider education. A native of Camden, New Jersey, Dr. Hill is married to Pauline Hill.

Ina May Gaskin, M.A., C.P.M.
Founder / Director, The Farm Midwifery Center
State University of Iowa, Iowa City, Iowa, B.A., English, Summa cum laude, Highest honors
Northern Illinois University, DeKalb, Illinois, M.A., English
North American Registry of Midwives
Certified Professional Midwife
Tennessee Licensed Certified Professional Midwife

Ina May Gaskin, MA, CPM, is founder and director of the Farm Midwifery Center, located near Summertown, Tennessee. Founded in 1971, by 1996, the Farm Midwifery Center had handled more than 2200 births, with remarkably good outcomes. Ms. Gaskin herself has attended more than 1200 births. She is author of Spiritual Midwifery, now in its fourth edition. For twenty-two years she published Birth Gazette, a quarterly covering health care, childbirth and midwifery issues. Her most recent book, Ina May’s Guide to Childbirth was released in 2003 by Bantam/Dell, a division of Random House. She has lectured all over the world at midwifery conferences and at medical schools, both to students and to faculty. She was President of Midwives' Alliance of North America from 1996 to 2002. In 1997, she received the ASPO/Lamaze Irwin Chabon Award and the Tennessee Perinatal Association Recognition Award. In 2003 she was chosen as Visiting Fellow of Morse College, Yale University. Ms. Gaskin has lectured widely to midwives and physicians throughout the world. Her promotion of a low-intervention but extremely effective method for dealing with one of the most-feared birth complications, shoulder dystocia, has resulted in that method being adopted by a growing number of practitioners. The Gaskin maneuver is the first obstetrical procedure to be named for a midwife. Her statistics for breech deliveries and her teaching video on the subject have helped to spark a reappraisal of the policy of automatically performing cesarean section for all breech babies. As the occurrence of vaginal breech births has declined over the last 25 years, the knowledge and skill required for such births have come close to extinction. Ms. Gaskin’s center is noted for its low rates of intervention, morbidity and mortality despite the inclusion of many vaginally delivered breeches, twin and grand multiparas. Their statistics were published in “The Safety of Home Birth: The Farm Study,” authored by A. Mark Durand, American Journal of Public Health, March, 1992, Vol. 82, 450-452. Ms. Gaskin was featured in Salon magazine’s feature “Brilliant Careers” in the June 1, 1999 edition. She is the originator and coordinator of The Safe Motherhood Quilt Project, a national effort developed to draw public attention to the current maternal death rates, as well as to the gross underreporting of maternal deaths in the United States, and to honor those women who have died of pregnancy-related causes since 1982. Her newest book, Ina May's Guide to Breastfeeding, will be released October 1st, 2009.

Rep. Keith Fitzgerald, Ph.D.
Florida House of Representatives, District 69
University of Louisville, B.A., 1979
Indiana University, Ph.D., 1987

Representative Keith Fitzgerald was elected to represent State House District 69 in 2006. His district includes the northern part of Sarasota County and a small portion of Manatee County. Representative Fitzgerald was born in Springfield, OH and grew up in Louisville, KY. He holds a B.A. from the University of Louisville, and a Ph.D. from Indiana University. Representative Fitzgerald has lived in Sarasota and taught political science at New College of Florida since 1994. He and his wife, Angela Baker, have nine-year-old twins. Representative Fitzgerald is a lifelong public servant. From the time when he worked in high school and college as a reading tutor for dyslexic children until his present job as a college professor at New College of Florida, he has been an educator. As a Ph.D. in political science, he has studied politics his whole life, taught at colleges and universities and conducted scholarly research. Representative Fitzgerald serves as the Democratic Ranking Member on the Policy Council and as a member of the Finance and Tax Council, Health and Family Services Policy Council, Select Policy Council on Strategic & Economic Planning and the Military and Local Affairs Policy Committee. Representative Fitzgerald also serves as Policy Chair for the House Democratic Caucus. His prior leadership positions include service on the Advisory Council of Faculty Senates, the Board of Trustees at New College of Florida and the Sarasota City Charter Review Board.

Jennifer Highland, M.P.H.
Executive Director, Healthy Start Coalition of Sarasota County
University of South Florida, M.P.H. Public Health, 1995

Jennifer’s passion for helping mothers and infants began, of course, with the birth of her children. Most of her early career in Louisiana, Georgia and Texas was as a registered nurse working in hospital settings, in clinical nursing and staff development. Her education positions allowed her to utilize her graphic art skills in the development of printed educational materials and newsletters for hospital staff and nurses. After she moved to Florida and became a mother, Jennifer volunteered for the Breastfeeding Advocates of Sarasota County and completed her Master of Public Health Degree from USF, graduating in 1995. Jennifer was the Project Coordinator for the first and on-going national breastfeeding promotion campaign, “Loving Support Makes Breastfeeding Work,” through her employment with Best Start, Inc., in Tampa. She then became trained as a Childbirth Educator and taught at Sarasota Memorial Hospital. Her work at Healthy Start began in 2001 as the Contract/Quality Manager. Her role expanded to include professional education. In 2006 she became the Executive Director.

MODERATOR: Kelly Kirschner, M.A.
Sarasota City Commission (District 3 Commissioner / Vice Mayor)
B.S. Foreign Service, Georgetown University
M.A. Latin American Studies, Georgetown University

Kelly is a lifelong Sarasotan. He has served the Sarasota community as President of the Alta Vista Neighborhood Association as well as having been an active member of the Coalition of City Neighborhood Associations. Believing strongly in public service, Kelly has worked for the White House Office of Public Liaison; served as a Peace Corps Volunteer; and led a USAID community conservation project in rural Guatemala. Kelly lives with his wife, Tracy, son, Bodhi, and daughter, Selby, in District 3.

EVENT SPONSOR: Sonia Pressman Fuentes, JD
The National Organization for Women (NOW)
B.A. Cornell University 1950
J.D. University of Miami School of Law 1957

Sonia Pressman Fuentes, who was born in Berlin, Germany, of Polish parents, came to the U.S. with her immediate family in 1934 to escape the Holocaust. She graduated as valedictorian of her high school in Monticello, New York, Phil Beta Kappa from Cornell University, and first in her class at the University of Miami (FL) School of Law. She was an attorney for the U.S. Department of Justice, the National Labor Relations Board, the Equal Employment Opportunity Commission (EEOC), and the U.S. Department of Housing & Urban Development in Washington, D.C. She was the first woman attorney in the Office of the General Counsel at the EEOC and drafted a number of the Commission’s landmark guidelines and decisions. She was a co-founder of NOW, WEAL (the Women’s Equity Action League), and FEW (Federally Employed Women) and a charter member of VFA. She was the longest-serving board member in the history of NWP (National Woman’s Party). She also served as an attorney and executive, respectively, at the headquarters of GTE Service Corporation and TRW Inc., and was the highest-paid woman employee at each of those headquarters. In 1993, she retired from the federal government, thereafter wrote her memoir, Eat First—You Don’t Know What They’ll Give You, The Adventures of an Immigrant Family and Their Feminist Daughter, and embarked on new careers as a writer and public speaker. For further information, see her website.

EVENT COORDINATOR: Laura H. Gilkey, BLA
Florida Friends of Midwives (FFOM)
B.L.A. Landscape Architecture, University of Florida, 2000

Laura Gilkey serves on the Board of Directors for Florida Friends of Midwives, and is the Florida Coordinating Ambassador for The Birth Survey: The Transparency in Maternity Care Project. Laura is an endorser of The Mother-Friendly Childbirth Initiative and a member of the Coalition for Improving Maternity Care Services. She is a project coordinator and quilter for Ina May Gaskin's Safe Motherhood Quilt Project, intended to raise awareness about American maternal mortality. Laura has recently joined the Planning and Evaluation Committee for the Healthy Start Coalition of Sarasota County, whose mission is to improve the health and well-being of Sarasota's pregnant women, infants, and small children. Professionally, she is the marketing manager for Michael A. Gilkey, Inc., landscape architecture studio, and is the owner of Kangaroo Promotions, Inc., a creative marketing firm in Sarasota.