Yesterday Asher and I went up to the State Capitol to attend a committee meeting on Bill SB93. This bill, proposed by Senator Margaret Dayton, would DRAMATICALLY limit women's right to give birth at home. Her bill is so broad that it would eliminate about 90% of women from being able to have a home birth. For example, a woman that had EVER had a miscarriage, or who had ever had an infection while pregnant would be exempt from homebirth FOREVER! She also wants to take away the right for VBAC women (Vaginal birth after Cesarean) to have a home birth-- which for some women (depending on where they live) is their ONLY chance to avoid another c-section, because in MANY hospitals a woman with a previous c-section isn't allowed to labor. Even though there are several new studies that show that VBACS are totally safe!
So to show my support for homebirth, I slung Asher in his sling- stuck a pink sticker on him that said " No on SB93, Allow midwifery to work" and went to the capitol. The committee meeting was really interesting- both sides got to talk to the issue. The midwives were REALLY upset that Senator Dayton (who just happens to be in BIG cahoots with the Utah Medical Association- which has a big lobby on the hill) hadn't even tried to compromise with them. Unfortunately, the bill passed out of committee 3 to 2. This means it will go to the Rules Committee and then to the floor! We are really hoping that a compromise can be worked out, or that it will die in the Rules Committee.
Please take the time to write to your senators and representatives to let them know how this bill takes away parent's right to choose what type of birth they want for their baby! Even if you personally wouldn't choose home birth, parents should still have the right to make the choice. Protect our freedoms! Here is a link that to the bill
http://le.utah.gov/~2008/bills
and this link will help you find your senator
http://www.le.state.ut.us/maps/amap.html
6 years ago
3 comments:
Heather
I agree with many of your points. However, while I support midwifery, and VBACs, the bill in question (that you actually link to) limits the scope of practice of midwives WHO ENTER AS APPRENTICES AND HAVE NO FORMAL EDUCATION when they work with patients who are at higher risk of serious complications. Specifically, it limits the scope of their practice to healthy people and excludes patients who have
i) pulmonary disease, renal disease, chronic or active hepatic disease, endocrine disease, neurological disease, a significant autoimmune disease, Group B streptococcus colonization or infection disease, or isoimmunization;
(ii) deep vein thrombosis or pulmonary embolus;
(iii) a significant hematological disorder or coagulopathy;
(iv) hypertension;
(v) diabetes mellitus;
(vi) a family history of a serious genetic disorder that may affect the current pregnancy;
(vii) a history of neonatal infection, cerclage or incompetent cervix, an infant below 2,500 grams or above 4,500 grams, a preterm singleton birth of 36 weeks or less, postpartum hemorrhage requiring transfusion, three or more consecutive miscarriages, a miscarriage after 14 weeks, or a stillborn;
(viii) a prior myomectomy, hysterotomy, or c-section;
(ix) current drug addition or abuse;
(x) positive HIV antibody or AIDS;
(xi) any condition, disease, or illness that would disqualify a certified nurse midwife, licensed under Chapter 44a, Nurse Midwife Practice Act, from delivering a child without assistance under the protocols of two or more general acute hospitals in Utah; or
(xii) any other condition that may present an unreasonable risk of harm to a pregnant woman or unborn child as determined by the division by administrative rule.
So basically women who are drug abusers, have AIDS, toxemia of pregnancy (the hypertension mentioned above), emphysema, blood clots, or a history of having an increased risk of death with a VBAC should not be taken care of by midwives without formal training.
Moreover, regarding the VBAC issue. You are right that in many situations, VBAC is the preferred method of delivery. However, all studies that have shown that VBAC is the best solution and safe for a woman have been performed after a trial of labor in a hospital because the lethal risk of uterine rupture increases to 7-9/1000 patients at best (completely otherwise healthy) to 27/1000 patients (if the first C-section had a myomectomy). This means that VBAC patients should be closely monitored so that any complication can be corrected.
I'm a believer in allowing women to make choices that affect her health. Some would use the Pro-Choice lobby's cry, "Our bodies, our decisions." Yet, in some cases, like those outlined above, her decisions affect more than herself. As such, I believe that society has an obligation to protect the unborn fetus, and child. While home birth and use of midwives are wonderful for those, like you, who are healthy, imagine the complications and tragedy for a child who has anoxic brain injury after birth.
I have personally cared for 4 women who were involved in midwifery care and home delivery who developed complications that could not be handled by the midwife. By the time they had arrived in the hospital, in 3 of the 4, the mothers died despite our best efforts to save them. In 2 of the 4, the babies also died. That is a gut wrenching statistic.
The Utah law only attempts to limit the scope of practice for midwifes who do not have the training or experience to protect the unborn.
Nathan,
Thanks for your comment about the bill, I appreciate you taking the time to read it!
I agree with you that a midwife with no formal education and who isn't licensed by the state shouldn't deliver babies. Women who aren't healthy or who have medical problems shouldn't give birth at home-- it is too much of a risk for the mother and the midwife. Most midwives won't take a patient if they have any of the conditions listed.
The problem with the bill is that they broadened the criteria of a medical problem to be too broad. For example, under the criteria of pulmonary disease and renal disease- I would be disqualified from EVER having another baby at home because I have mild asthma(for which I am not treated) and have had a kidney infection in the past. It is kind of like saying that because you once had a cough in the past you are sure to get pneumonia in the future.
With such broad definitions it would be hard for any woman to qualify at home and would make it harder for midwives to identify good home birth candidates.
The midwives want to ensure that women and babies are protected from unnecessary risk just as much as the Utah Medical Association. What they would like is a compromise on the language of the bill.
Right now it looks like they have been able to compromise on most parts of the bill, but the issue of VBACS, breeches and twins is still being debated and will probably have to be decided by a legislative vote.
I am SO sorry to hear about those mothers you treated-- what a sad situation. The one part of the bill that I REALLY agree with is that ALL midwives must be licensed by the state. Right now they aren't required to and lots of them won't license because they don't want the restrictions on what they can and can't do. I don't think that is safe and would really like to see it as a requirement that all midwives are licensed (and I know several midwives who wouldn't like me saying that!).
It will be interesting to see where this bill goes-- I just want to make sure that I will still have the opportunity to deliver at home in the future if I have another healthy pregnancy.
I just saw this today and thought you might find it interesting (and infuriating): http://www.aolcdn.com/tmz_documents/0617_ricki_lake_wm.pdf
I haven't looked into it much more that than, other than reading about "The Business of Being Born" which I noticed someone else mentioned on a comment on your blog. Have you seen it yet? I am going to try and get a copy from the library to watch it. Seems very interesting! Especially that the American Medical Association is specifically responding to the movie and the media it's gotten...
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