A consumer-based grass-roots organization dedicated to promoting and protecting midwifery in Florida. Our members are families, midwives, students and birth advocates committed to organizing the community to support midwives and to assure the continued availability of midwifery care throughout Florida.
Showing posts with label maternal mortality. Show all posts
Showing posts with label maternal mortality. Show all posts
Bumi Sehat Haiti is currently looking for Midwives skilled and willing to volunteer their time in Haiti. They especially need volunteers during July through September 2010.
They are a village based clinic, established in response to the earthquake in January 2010. Their primary focus is maternal and infant needs in Jacmel, Haiti. Bumi Sehat Haiti is helping to provide access to high quality health services to Haiti’s women—a population that has faced a disproportionate burden of disease well before the January earthquake. Maternal mortality rates are shockingly high—670 deaths per 100,000 births. In comparison, the U.S. maternal mortality rate is 11 deaths per 100,000 births, according to World Health Organization statistics. BSH's clinic in Jacmel, is active and busy, with hundreds of women seeking prenatal, birth and postpartum care. Women from surrounding tent camps and shelter's are encouraged to come for free health care.
The need is great and the people are hopeful. Please find us at www.bumisehatbali.org and follow the links for further information on volunteering.
Items for On-Line Auction-Need for Financial Support for Haiti
It has been five months to the date that the earthquake happened in Haiti that devastated 60-80% of Jacmel where the Bumi Sehat birth clinic is located. Thanks to supporters, the clinic is up and running and is steadily busy with births and prenatals as well as educational classes for mothers. The clinic is in need of funds to support the women of Jacmel.
Bumi Sehat is holding an on-line auction to raise funds for a few projects at the clinic site in Haiti. They are looking for artwork, jewelry, gift certificates (preferably nationally recognized stores as the auction will be available to anyone in the US), airline tickets, etc. to be donated for this auction. Please contact Heather Maurer at embracethegoddess@yahoo.com if you have an item to donate.
Purchase a Bumi Box
Bumi Boxes are still available for purchase to support birthing mothers and will need to be bought on a continuous basis to support new birthing mothers. They contain all the supplies for each birthing woman and her new born baby.
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.
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.
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.
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
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.
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.
CIMS, the Coalition for Improving Maternity Services, a group working toward transparency in maternity care, announced last week that the 2007 US birth statistics, just released, show that 31.8% of births are via cesarean section. The percentage of cesarean deliveries has increased by 50% since 1996 and is more than double the World Health Organization’s recommended rate of 15%.
Currently, cesarean rates vary widely across the US. The 2007 birth data highlight this variation; for instance, a woman giving birth in New Jersey has a 73% higher chance of having a cesarean than a woman in Utah.
This strong variation in rates isn’t only geographic; it is also seen among individual hospitals in a community. For example, in 2006, New York City, one of the few places facility-level rates are available, St. Vincent’s Staten Island Hospital had a rate of 44.5% compared to 17.2% at North Central Bronx Hospital. Many believe that this variation is due to high risk sicker mothers and babies that these hospitals serve; however, that is only part of the story. Extensive research has shown that these huge variations are strongly linked to the practices and policies of individual hospitals and providers not just the health status of mothers and babies.
“Most women believe that they will only have a cesarean section if they experience complications in pregnancy or labor. But research tells us that most of the factors affecting a woman’s risk of a cesarean have nothing to do with her health or that of her baby. One of the most effective strategies for avoiding a preventable cesarean is choosing a provider and birth setting with a low cesarean rate. In the United States, we are seeing increased public reporting of outcomes and procedure rates for facilities in surgical and cardiac care, but, access to maternity care data remains almost non-existent,” says Amy Romano, MSN, CNM, a transparency expert for CIMS.
C-section can be a life-saving procedure, but it is a major surgery that carries extensive risks for both mother and baby, risks that are not present in a vaginal birth. Research conducted by the World Health Organization shows that these risks of cesarean outweigh the benefits when the c-section rate exceeds 15%. Currently, women have no way of knowing if their local hospitals exceed this recommended rate.
“Women can unknowingly increase their risk of unnecessary surgery based on their selection of where and with whom to birth. To enable women to make informed choices, maternity care data must be available at the facility level. Whether requiring a c-section or planning a natural birth, women need data in order to choose the facility that most closely matches their needs,” said Elan McAllister, Founder of New York’s Choices in Childbirth and Co-chair of the Transparency in Maternity Care Project.
Transparency empowers consumers, and studies have shown that public reporting of intervention rates and outcomes leads to better healthcare. New York and Massachusetts are the only states with legal mandates to require release of facility-level maternity care obstetrical intervention statistics such as cesarean sections. Unfortunately, such information remains unavailable in most parts of the country, but a CIMS project is working to change this fact.
To help expectant parents to make informed health care decisions about where and with whom to birth, CIMS developed the Transparency in Maternity Care Project: The Birth Survey. CIMS has trained local level ambassadors across the US to interface with their state departments of health to work to make facility-level intervention rates available to the public. As intervention rates are obtained, including the rate for c-sections, they will be included in publicly accessible free reports.
Transparency of health care information is increasing across the US and maternity care must be included in this movement. Otherwise, women are choosing their place of birth blindfolded and potentially increasing their chances of having an unnecessary cesarean section as rates across the country continue to rise above recommended levels.
The adage “healthy baby, healthy mother” is touted by people everywhere. One half of that equation – the mother – must provide care for herself and her newborn for at least a couple of decades. However, we have seen a rise in the maternal mortality rates here in this country. In 2003 and 2004, the maternal mortality rates rose to 12 per 100,000 and 13 per 100,000 respectively (http://www.kaisernetwork.org/Daily_Reports/rep.index.cfm?DR_ID=47116). To make that easier to understand, 1 in 7692.31 women will die during childbirth or the six week post-partum period. The United States of America boasts advanced technology, state-of-the-art gadgets, and renowned research facilities. Why then are we experiencing a surge in what was once thought of as a third-world country issue? Perhaps we need to look no further than the rising c-section rates.
The CDC statistics have shown a continued increase in the c-section rates here in this country to the tune of 50% in the last ten years (www.int.com/articles/2008/04/22/opinion/edlanger.php). The truth is that 1 out of every 3 pregnant women will undergo a c-section. A c-section is a major abdominal surgery that carries the same risks as any other abdominal surgery, yet women are increasingly being convinced of all the benefits involved in a c-section. “You won’t have bladder dysfunction.” “You’ll avoid vaginal tearing.” “You can schedule your baby’s birthday!” All of these so-called benefits are given much more emphasis than the risks: injury to intestines or bladder (still think you can avoid that bladder dysfunction?), injury to the baby, post-partum hemorrhage, infertility, death. In fact, women are 3 times more likely to die during a c-section than a vaginal birth according to a large study published in the Lancet (http://www.wddty.com/03363800369784516151/c-section-aftershocks.html, Lancet, 1999; 354: 776). I would like to assert the clear correlation between the rising c-section and maternal mortality rates and make the case women everywhere to be on high alert.
Let’s examine some probable causes as to how the c-section rate is affecting the maternal mortality rate. In the United States, we have seen a rise in obesity, which seemingly sets up pregnant women for a c-section. Speculation and early research claims obese women have weaker contractions due to obesity-related health problems (http://www.medicineonline.com/news/12/8821/Obese-pregnant-women-may-have-weaker-contractions.html). “Fetal distress” may also be cited as a reason for c-section in obese women when, in fact, the monitors are simply not working through the mother’s fat tissues. Another cause of the rising c-section rate is the increasing number of older first-time mothers. It would seem that many women delay having families in order to complete higher education and start careers. Older women are much more likely to end up with a c-section regardless of whether they are high risk or low risk (http://www.webmd.com/baby/news/20070312/older-moms-have-more-c-sections). Furthermore, hemorrhage and sepsis are the leading causes of maternal mortality throughout the world – both of which are risk factors in c-sections (www.who.int/reproductive-health/publications/interagency_manual_on_RH_in_refugee_situations/ch3.pdf). While we could discuss all of these causes in further depth, I trust that my assertation that the rising c-section rate is increasing the maternal mortality rate has been made clear.
I’m a believer in the saying that “prevention is the best medicine,” and I would like to further assert that simple preventative measures can both lower the c-section rates and the maternal mortality rates. First of all, I suggest every single pregnant woman learn as much as she can about the pros and cons of c-sections and other medical interventions. Perhaps with more knowledge, women wouldn’t be so apt to choose an elective c-section. Secondly, eat a healthy, balanced diet and get plenty of exercise. No one can go wrong with that recommendation, whether young, old, male, female, white, black, green, or polka-dotted. Thirdly, seek consultation from a midwife. Midwives have lower rates of c-sections and can provide excellent prenatal care for most pregnant women. Finally, know your rights as a patient and exercise your right to refuse treatments. If no medical indications show a necessity for c-section, simply repeat these words: “I do not consent.” Your doctor may not like hearing those words, but it is his or her responsibility to respect your wishes as his or her patient. You are the boss, you are paying them for their services, and you certainly wouldn’t take insubordination from an employee.
Bumi Sehat Haiti is currently looking for Midwives skilled and willing to volunteer their time in Haiti. They especially need volunteers during July through September 2010.
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