City of Sarasota, State of Florida Proclaim October 4-8 Licensed Midwives Week

At next week’s City Commission meeting (Monday, October 4, 6:00pm), Sarasota Mayor Kelly Kirschner will proclaim October 4th through 8th as Sarasota Licensed Midwives Week. Mayor Kirschner’s recognition will pay tribute to the skilled, individualized care that Sarasota’s licensed midwives offer women and their families throughout the childbearing cycle. It will signify the strong contribution licensed midwives make to the health and well-being of our community's mothers and babies through appropriate care and treatment in all phases of childbirth.

The week has also been proclaimed Florida Licensed Midwives Week by the office of Florida Governor Charlie Crist, coinciding 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 announces 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."

HISTORY OF MIDWIFERY IN FLORIDA: Midwives have a long and valued history in Florida. The state first passed legislation to license direct-entry midwives in 1931. In the 79 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.

ABOUT 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.

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 week and during October to celebrate the more than 110 currently practicing licensed midwives. For more information of midwifery in Florida, please visit www.flmidwifery.org.

“We are humbled by the dedication of the mothers who worked so hard to have this week declared licensed midwifery week,” says licensed midwife Miriam Pearson-Martinez. “We hope that the events happening all over the state this week serve to raise awareness regarding the benefits of midwifery care.”

The proclamation in Sarasota will be read by Mayor Kirschner at the beginning of the City Commission meeting, Monday, October 4th, at 6:00 pm in Sarasota’s City Hall. Florida Friends of Midwives encourages all families who have benefited from the care of licensed midwives to attend this special recognition.

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 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.

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.

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.

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.

An Invitation to Join the Midwives and Mothers in Action (MAMA) Campaign

Come visit our new website at www.mamacampaign.org

• Sign up to be part of the campaign
• Endorse the campaign as an Individual or as an Organization
• Share your birth story
• Donate and volunteer

Please forward this invitation to family and friends.

The goal of the Midwives and Mothers in Action (M.A.M.A.) Campaign is to increase women's access to midwives and to quality, affordable maternity care by securing federal recognition of Certified Professional Midwives (CPMs). The MAMACampaign is a partnership between 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).

Contact Us: info@mamacampaign.org

MAMA Campaign

c/o NACPM
243 Banning Road
Putney VT 05346
or call Citizens for Midwifery's Info line at 888-236-4880

The Midwives and Mothers in Action (M.A.M.A.) Campaign is launched!

The goal of the M.A.M.A. Campaign is to increase women's access to midwives and to quality, affordable maternity care by securing federal recognition of Certified Professional Midwives (CPM). We have hired a federal lobbyist, a campaign manager will be hired by next week, and the M.A.M.A. Campaign website is almost complete.

This campaign is a partnership of the National Association of Certified Professional Midwives (NACPM), Midwives Alliance of North America (MANA), North American Registry of Midwives (NARM), Midwifery Education Accreditation Council (MEAC), Citizens for Midwifery (CfM), and International Center for Traditional Childbearing (ICTC). This historic partnership is now at work to get 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. We look forward to working with everyone who supports this work and in concert with other national initiatives to achieve our common goals.

Our federal lobbyist, a specialist in health policy, will move our agenda in Washington, D.C. Billy Wynne is a former Senate staffer, an expert in Medicaid and health care reform, with a diverse portfolio of connections. He is excited to be promoting the values and important services provided by Certified Professional Midwives and is implementing a strategy with the M.A.M.A. Campaign Steering Committee, based on our priorities, for achieving success in this Congress.

A campaign manager will be hired by next week to work with the network of volunteers already lining up to support the M.A.M.A. Campaign. A campaign website is nearing completion; watch for the website launch announcement at the end of this week!

Your support will be essential to the success of the campaign. Watch for weekly updates and action alerts about how you can become involved!

We look forward to working with you in this effort!

The M.A.M.A. Campaign Steering Committee

ACTION ALERT: Health Care Reform

Dear Midwifery Supporters,

Florida Friends of Midwives supports The Big Push for Midwives in their current federal legislative efforts. They have been hard at work presenting evidence in Washington that access to Certified Professional Midwives and out-of-hospital maternity care would save billions of US healthcare dollars while simultaneously improving birth outcomes.

Now, it's Florida's turn to show our support. Please read the following ACTION ALERT carefully, and take few moments to let our current administration know that this issue is important to you and your family.

Thank you,
Board of Directors
Florida Friends of Midwives
_____________________________________________________________________________________

As many of you may know, the White House issued a call this week asking citizens from across the country to send emails about what they would like to see in health care reform. Not long afterwards, the server accepting the emails crashed.

Why? Because it got flooded with emails about the President's birth certificate!

Now the press is reporting about it, just as they did when grassroots organizers for the legalization of marijuana set the record for the most number of emails sent during the transition-a mere 6000. We can top that!

It turns out there is another, lesser-known online form for submitting comments about health care reform. Let's use it!

If we top 6000 emails-and I know we can-we will set a new record and get the White House's attention on how strong support for out-of-hospital maternity care and Certified Professional Midwives is.

So please go to the following link and fill out the form with a short, simple message about why you want all women, including those on Medicaid, to have access to out-of-hospital maternity care and Certified Professional Midwives who are specially trained to provide it.

http://www.healthreform.gov/communityreports/comments.html

Pick one or two points to include in your own words: And always use the title, Certified Professional Midwives, spelled out.

Certified Professional Midwives are specially trained as experts in out-of-hospital maternity care and deliver babies in private homes and in freestanding birth centers.

Research consistently shows that low-risk women planning to deliver their babies at home under the care of Certified Professional Midwives experience outcomes equal to low-risk women who deliver in the hospital, but with far fewer costly and preventable interventions, including a five-fold decrease in cesarean section.

Babies delivered under the care of Certified Professional Midwives have significantly reduced rates of prematurity and low-birth weight, two of the leading contributing factors to racial and ethnic disparities in birth outcomes and to the costs associated with long-term care.

David Anderson, Professor of Economics at Center College with a specialization in the costs of out-of-hospital maternity care, calculates that increasing use of Certified Professional Midwives and of out-of-hospital maternity care by less than 10% would result in savings of $9.1 billion annually, while actually improving outcomes.

The state of Washington reports a savings of $3.1 million dollars over a period of two years to the state Medicaid system when women experiencing healthy, low-risk pregnancies give birth with licensed midwives instead of in the hospital.

The recent Milbank Report conservatively estimates savings of $2.5 billion dollars a year if the cesarean surgery rate is brought down to 15% in the U.S.

Certified Professional Midwives are the only providers specially trained in out-of-hospital birth in the event that hospitals become unsafe for healthy pregnant women during a disaster.

Thank you to everyone who is reaching out-it only takes a few minutes but it is so very helpful. We are making amazing progress in DC and now is not the time to let up! So please forward this to family and friends who can help, and thank you for doing your part to get Certified Professional Midwives and out-of-hospital maternity care included in health care reform.

ATTENTION MIDWIVES! Yes, we are shouting at you! Please send this action alert with a personal appeal to your networks of clients-it only takes a few minutes, and people are especially motivated to act when they get a personal request from their midwife.

STATE GROUPS! Please be sure to post this alert to your state lists!

Katherine Prown, PhD
Campaign Manager
TheBigPushForMidwives.org
414.550.8025
Envisioning a safer, less-costly model of maternity care in the United States.