Citizens for Midwifery Meeting in Rolla, MO!

This year, Citizens for Midwifery will hold its annual meeting in Rolla, MO and any and all interested birth activists are welcome to join us!

FoMM/MMA's very own Mary Ueland and Debbie Smithey have been nominated to receive the annual Susan Hodges award for excellence in consumer activism and that will be given during the public portion of the annual meeting.

This year our Annual Membership Meeting, including the election of members of the Board of Directors, will be held in Rolla, Missouri, on Saturday, November 8, 2008, from 1-2 pm, followed by a Gathering with other birth activists in the area from 2-4pm. The CfM Board members will be meeting in person throughout the weekend.

Location: These meetings will be held at Baymont Inn and Suites, 1801 Martin Springs Drive in Rolla, Missouri. Hotel phone: 573-364-7000.

Our Annual Meeting affords us the chance to review the past year and look ahead to the coming years – your questions and ideas are important! This is a great opportunity to meet with and talk to CfM’s Board of Directors in person. And of course we’ll count the ballots for the election of Board Members for the next year

Following the Annual Membership Meeting, a Birth Activist Gathering will bring together CfM members with Friends of Missouri Midwives and anyone else who is interested, including other consumer activists, midwives, and other birth professionals. CfM will give a brief presentation about our current work and projects, including our response to the AMA Resolution, an open discussion about "what’s next in MO" and how CfM can help, and how we can work together to sustain birth advocacy. This event is free and light refreshments will be served.

Please RSVP to molly@cfmidwifery.org if you plan to attend the meetings. CfM’s Board of Directors looks forward to hearing from many of you, and even seeing some of you in November!

Please pass this message along to other interested persons or organizations (including activists in our neighboring states of IL and KS, if you have contacts there).

Mark your calendars! I hope to see you there.

Postpartum Reading List

As a follow-up to the presentation I gave at the FoMM retreat about "Planning for Postpartum," this is my list of suggested postpartum reading (for my annotated list, see here):

Suggested Reading—Postpartum

After the Baby’s Birth, by Robin Lim

Mother Nurture: A Mother’s Guide to Health in Body, Mind, & Intimate Relationships, by Rick & Jan Hanson

The Year After Childbirth, by Sheila Kitzinger

The Post-Pregnancy Handbook, by Sylvia Brown

Mothering the New Mother, by Sally Placksin

What Mothers Do: Especially When it Looks Like its Nothing, by Naomi Stadlen

Postpartum Memoirs:

Misconceptions: Truth, Lies, and the Unexpected on the Journey to Motherhood, by Naomi Wolf

Operating Instructions, by Anne Lamott

Let the Baby Drive: Navigating the Road of New Motherhood, by Lu Hanessian

Callie’s Tally: An Accounting of Baby’s First Year, [or, What My Daughter Owes Me], by Betsy Howie

The 2008 FoMM Family Retreat

Over 90 friends of Missouri Midwives enjoyed a weekend together at Pin Oak Camp in the Lake of the Ozarks State Park Sept. 12-14.  It was a terrific time!

Friday night, we had a bountiful potluck dinner and lots of time to visit with old and new friends.  And there were S'mores!  The campground had a great firepit encircled by benches and logs for sitting and visiting.  The fire was a highlight of the weekend, especially for the kids, and we managed to get by with very few burns.

Saturday was full of insightful sessions, a productive business meeting, lovely crafting.  We even managed to stay on track with our schedule so that we had quite a bit of free time!  

Our sessions on Saturday included Fathers and Home Birth (where the guys actually talked about birth... don't tell!); Mothers (with kids) and Midwives (crafting!); Planning for Postpartum; Preparing for a Hospital Birth; and Celebrating Birth with Exercise, Yoga, and Dance.

The weather on Saturday, though a bit muggy, was a wonderful change from the expected rain.  It did not begin to rain until Saturday night, and on Sunday morning most of us were thankful for our sweatshirts! 

In our business meetings, we passed 7 (Seven!) proposals and killed one (following a helpful discussion).  We also held elections.  Our new president is Samanda R., vice-president is Jen K., Secretary is Allison D., and Treasurer is Jessica K.  There has been tremendous growth in Friends of Missouri Midwives over the past year, and we are eagerly looking forward to the future.

Many thanks are deserved for bringing this weekend together - Samanda and David, who did an amazing job of pulling everything together; Brian, who cooked us terrific meals; Kolbi, who waited for the parks folks on Sunday afternoon; the presenters of various sessions; and all of the attendees, who pitched in and made everything work!

Here are some pictures from the weekend.  If you have some you would like to share, email them to admin@friendsofmomidwives.org, and they will be uploaded to the Picasa page.

If you attended the retreat, please add your thoughts in the Comments section.

Looking forward to next year already!

The Birth Survey is Here!

Well, the moment we have been waiting for has arrived. The Birth Survey project has launched nationwide. This is an exciting moment!

Here are all the details and information about how you can help from the CIMS Grassroots Advocates Committee:

The Birth Survey Now Available Nationwide!

For years, consumers have enthusiastically shared online reviews of movies, restaurants, products and services, but readily available information about maternity care providers and birth settings was nearly unattainable--but no longer. The Birth Survey is now available to all women in the US who have given birth in the last three years. Women can now give consumer reviews of doctors, midwives, hospitals, and birth centers, learn about the choices and birth experiences of others, and view data on hospital and birth center standard practices and intervention rates.

Thank you to all the tireless volunteers who have worked so hard since 2006 to make this project a reality. And thank you to all our new project ambassadors and friends who are helping to make the Transparency in Maternity Care Project: The Birth Survey a reality.

To help spread the word about The Birth Survey, please:

• Send E-mails out to your contacts encouraging them to take thesurvey (e-mail text provided at end of this message). Suggested language is provided below. An automated “Invite a Friend” email tool can be accessed here. Invite your friends with a personalized message!
• Post the downloadable web banners and buttons to The Birth Survey on your personal or organizational websites. Download these here.
• Add a link to The Birth Survey Project in your email signature and on your website.
• Distribute postcards inviting women to take The Birth Survey. These cards can be downloaded here and printed as needed or preprinted cards can be ordered from CIMS here. Preprinted materials are currently being printed and will be mailed out in about two weeks.
• Send Press Releases to local press outlets. Press releases will be sent out nationally on Monday morning 8/18. A pdf press release that can be used for distribution by anyone will be available here on Monday. We encourage those of you who have been trained as a Marketing Ambassador and have signed a MOU to request a customizable press release by e-mailing admin@thebirthsurvey.com. We will provide these ambassadors with a customizable press release in which their personal contact information can be added if they plan to act as a local press contact.
  

Thank you all for your support of this project. If you have questions please e-mail admin@thebirthsurvey.com.

Language for Distribution Below:

Longer Project Description for Distribution:

For years, consumers have enthusiastically shared online reviews of movies, restaurants, products and services, but readily available information about maternity care services was nearly unattainable—but no longer. The Coalition for Improving Maternity Services (CIMS) has developed www.TheBirthSurvey.com, a consumer feedback website where women provide information about the maternity care they received from specific doctors, midwives, hospitals, and birth centers. Families choosing where and with whom to birth can utilize this consumer feedback, along with data on hospital and birth center standard practices and intervention rates, to make more informed health care choices.

Have You Given Birth in the Last Three Years?

If so, take The Birth Survey and provide feedback on your doctor, midwife, birth center or hospital at www.TheBirthSurvey.com.

Help Spread the Word About The Birth Survey!

Forward this e-mail and download buttons, banners, and promo cards at www.thebirthsurvey.com. Are you interested in helping to get the word out about The Birth Survey in your community or working to obtain official facility level intervention rates? To get involved, contact us at info@thebirthsurvey.com.

Support this non-profit project by the Coalition for Improving Maternity Services (CIMS) by donating or becoming a member here and sign up for e-cims newsletter here.

For information visit www.thebirthsurvey.com or email info@thebirthsurvey.com.

Short Email Template for distribution:

Hi!

I found this great site, check out www.thebirthsurvey.com

The Birth Survey works by asking birthing women nationwide to provide feedback about their doctor, midwife, hospital, birth center or homebirth service. Responses are made available online free to other women who are deciding where and with whom to birth.

The Birth Survey is…

• FREE
• Available to women who have given birth in the US in the last three years
• Accessible online 24/7 at www.thebirthsurvey.com

Take the Birth Survey and provide feedback on your maternity care experience at www.thebirthsurvey.com. Help women in your community or around the US find quality providers and birth settings that are compatible with their needs and philosophies.

Help spread the word about The Birth Survey! Forward this e-mail and download buttons, banners, and promo cards at www.thebirthsurvey.com.

Support this non-profit project by the Coalition for Improving Maternity Services (CIMS) by donating or becoming a member at http://www.motherfriendly.org/online_contribution.php and sign up for e-cims newsletter at http://www.motherfriendly.org/e-cims.php

A Celebration of Legal Midwives in Missouri!

July 12, 2008 ~ St. James, Missouri

According to the Missouri Supreme Court, Certified Professional Midwives became legal to practice in Missouri on July 4, 2008.

It's a long story, beginning with a little word, "tocology" and ending with a historic Missouri Supreme Court decision that overturned a lower court's ruling. The Missouri Supreme Court stated that the physicians associations who sued the State over the new midwifery law (passed in 2007) had no right to be in court over this in the first place. So, the injunction that they had placed against the midwifery law in August of 2007 was thrown out, and the law stood as passed.

And Certified Professional Midwives became legal to practice in Missouri on the day we celebrate in honor of FREEDOM!

Since most people already had 4th of July plans, we had to postpone our statewide celebration a bit. (Actually, the St. Charles and St. Louis Friends of Missouri Midwives area chapters held celebrations the day the court ruling was handed down - June 24 - and a few days later at their usual monthly meetings.)

Our statewide celebration was planned rather last minute and the Nisbett's graciously offered their spacious home near Rolla.
Here are a few pictures from the Saturday afternoon party (July 12).

The Nisbett's have a dream yard for children...

Their house is really kid-friendly (and fun) as well.
All the kids had a blast!

Jesse and Emily (who take care of all of the accounting and web up-keep for Free the Midwives!) were at the party showing off their new little girl - Ellie.

Senator Mike Gibbons (President Pro Tem of the Missouri Senate)
showed up while we were eating lunch.
Here he is, chatting with folks in the kitchen.

After visiting for awhile and joining us for dessert, Senator Gibbons spoke to our group, congratulating us on the recent court ruling allowing professional midwives to practice freely and reminiscing about several funny incidents that happened at the Capitol, involving "the midwives." He said that every grassroots effort that he has seen in his 16 years as a legislator pales in comparison to the one that the midwives have put on at the Capitol.
Eventually he had to head off and hit the campaign trail again (for his Attorney General race).

Collene agreed to be MC for our afternoon program, which was mostly informal story-telling by those who had been involved in trying to legalize midwives in Missouri over the last thirty-some years.

Dr. David Stewart, Ph.D, and his wife, Lee, joined us for the day and spoke first. They told their story of having their first baby at home in Rolla without a midwife or a doctor in the 1960's, because there was no one to attend a homebirth at the time. They have been working to allow access to Missouri midwives and homebirth since 1967. David Stewart has written many books on the subject and is the founder of NAPSAC International (International Association of Parents and Professional for Safe Alternatives in Childbirth).

Keith and Kim Nisbett came next in the history as they moved to Missouri in the late 1980's and were shocked to find that they couldn't open the Yellow Pages and find a midwife. Keith told the story of writing up the first midwifery bill with their illegal midwife in their bedroom and taking it to the Capitol where he learned the legislative process over the next few years as the bill passed the House of Representatives many times. It was always blocked by a filibuster in the Senate, till families eventually burnt out and went home for a few years.

Margaret spoke next about Friends of Missouri Midwives organizing in the 1990's and deciding that a foundation of public education was necessary before success would ever be secured at the Capitol. (She's speaking way in the back in a white shirt in this picture.)

Then it was Debbie and Mary's turn to tell the story of how tocology really happened behind the scenes the day it was passed in the Senate.
Right in the middle of telling the tocology story, much to our surprise, we looked up and saw Senator Chris Koster (also a candidate for Attorney General, and a friend of ours at the Capitol) walk in! He took a seat and listened intently to all of the details that most of the legislators were never privy to hear about.
(Above, Chris Koster and Jonathan Smith listening.)

Then Collene told a touching story about the 2008 legislative session. She talked about how she was walking around the Capitol on one of the very last days, knowing that Senate Leadership was killing our bill behind the scenes.
She said that in desperation, she finally went into the little coffee room near the chamber and shut the door. She told us all how she had knelt down on the floor by the ice machine and cried out to God, "Why does this have to be so long and so hard and so painful? Why does our bill never pass? I've been coming to this place for 20 years and, God, you know how much I HATE it! I don't ever want to come back! Why can't our bill just pass?!"

She said that she stopped and thought about it before she said it, but then she ended her prayer with, "But I will come back if I must."

Then she recounted the last agonizing day of session and the feelings she had as she left the Capitol, tears stinging her eyes when, once again, our bill hadn't passed... not because it wasn't a good bill, not because it didn't have majority support or any other good reason. But simply because it was all about a few men who wanted to ensure their campaign donations in an election year. She had gone home and cried and wondered why things were so unjust.

And then she nearly brought the whole roomful to tears when she said, "And now I see why God didn't let that bill pass and gave us something better instead. Now I'm so happy that I didn't get what I asked for when I was crying in the little coffee room. Justice was served, and better than I could have imagined or asked for."

Afterwards, Senator Koster (above, speaking) added his own funny stories about "midwives in the Capitol".

... And then we posed for pictures!
Mary, Senator Koster, Debbie

Lastly, we all took a big group picture, and people began to head for home, feeling extremely thankful that midwifery had become legal in Missouri in a way that was far beyond anything we had ever imagined or hoped for. We also went away, realizing the gravity of the situation and the need for us to guard our new-found freedom vigilantly.

President's Editorial - Response from MANA President to Res. 205

President’s Editorial
July 11, 2008

Midwives Alliance of North America
611 Pennsylvania Avenue SE # 1700
Washington, DC
20003-4303

Contact:
Geradine Simkins
president@mana.org
888-923-MANA (6262)
info@mana.org
http://www.mana.org

Doctors Ignore Evidence,
AMA Seeks to Deny Women Choices in Childbirth

One wonders what process the American Medical Association (AMA) House of Delegates used to determine that “Resolution 205 on Home Deliveries” was a prudent and reasonable proposal to adopt. AMA Resolution 205 attempts to outlaw a woman’s choice to birth at home or in a freestanding birth center by calling for legislation to establish hospitals and hospital-based birth centers as the safest place for labor, delivery and postpartum recovery. Further, Resolution 205 seeks to establish that hospital-based midwives who work under the control of physicians are the only safe midwifery practitioners.

The Midwives Alliance of North America, which has represented the profession of midwifery since 1982 and whose members are specialists in homebirth, finds AMA’s Resolution 205 to be arrogant, patronizing and self-serving. We have three major objections to Resolution 2005. First, Resolution 205 patently ignores the vast body of scientific evidence that has documented homebirth to be a safe, cost-effective and satisfying option for women who prefer this alternative to hospital birth. Second, AMA Resolution 205 is seriously out-of-step with the ethical concept of patient autonomy in health care (encompassing both informed consent and informed refusal), which has gained widespread acceptance in the medical community. And third, Resolution 205 distracts from other critical issues in maternity care to which healthcare professionals should be giving substantial attention, including increasing access to care, improving perinatal outcomes, reducing health disparities and fostering client satisfaction. AMA Resolution 205 is anti-homebirth, anti-midwife, anti-choice and is unsupported by scientific evidence.

Why is the American Medical Association not asking the real questions instead of trying to debunk existing research evidence on the safety and efficacy of homebirth and attempting to corner the market on maternity care? For example, why are midwife-attended births far more likely to have fewer interventions, fewer postpartum infections, more successful breastfeeding rates, healthy infant weight gain and result in more satisfied, empowered mothers ready to embrace their newborns and parenting experiences? Why are so many women across the nation left emotionally traumatized by their childbirth experiences in hospitals and consequently why do rates of postpartum depression, anxiety and post-traumatic stress continue to escalate?

It is ironic that the AMA should have a quarrel with a known safe birth option such as homebirth at the same time when the epidemic rise in coerced or elective cesarean sections puts healthy mothers and infants at greater risk than normal vaginal birth and causes excess strain on the limited resources of our healthcare system. The rate of cesarean sections in the United States is unacceptable—one in three pregnancies end in major abdominal surgery—and the decline in availability of vaginal birth after cesarean (VBAC) is deplorable. It is unethical to expect that women and infants should continue to bear the brunt of increasing medical malpractice risks by over-treating them with obstetric technologies such as c-sections while denying them safe evidence-based options such as VBAC. It is past time that the AMA in collusion against homebirth with the American College of Obstetricians and Gynecologists (ACOG) realizes that women and their partners are choosing to labor and deliver at home and in freestanding birth centers to avoid ethically unsupported obstetric interventions.

Modern medical ethics have evolved to embrace autonomy—patient choices and patient rights—over medical recommendations based on paternalism or physician preference. In almost all areas of modern medicine, except obstetrics, the locus of control rests firmly with the client or patient and not with the medical provider. It is a commonly held principle that it is not appropriate to force medical treatment upon clients or patients against their will, including medications, blood transfusions, chemotherapy or even life-saving surgeries. Informed consent has appropriately become the gold standard in healthcare decision-making. Why then do the AMA and ACOG believe that they can promote legislative efforts to deny women choices in maternity care providers and childbirth settings? In the 21st century this concept is outdated and absurd.

The AMA and its members might consider using their considerable energy, intelligence and resources to focus on promoting the health and well-being of mothers and babies and devote less time to limiting women’s access to midwifery services. All maternity care providers should band together to reduce the unacceptably high rates of maternal and infant mortality and morbidity in the United States, increase access to maternity care for all women, reduce unnecessary cesarean sections, encourage vaginal birth and VBACs for healthy women, reduce health disparities of women and infants in minority populations, and promote increased breastfeeding. These challenging but attainable goals would improve the health of mothers and babies far more impressively than reducing the rates of homebirth.

The Midwives Alliance joins the other individuals and organizations, including individual AMA and ACOG members, who have grave concerns about the AMA taking the stand articulated in Resolution 205, and calls for the AMA to abandon this resolution. Midwives everywhere honor and respect the numerous friendly physicians with whom we already partner and look to the day when midwives and obstetricians will consistently work collaboratively to support women’s choices in childbirth and provide the best possible and most appropriate range of services for every situation.

~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
References

1. K.C. Johnson, B.A. Daviss, Outcomes of Planned Home Births with Certified Professional Midwives: Large Prospective Study in North America, British Medical Journal 2005; 330: 1416 (18 June).
2. Royal College of Obstetricians and Gynaecologists and Royal College of Midwives Joint Statement No. 2, April 2007. See http://www.rcog.org.uk/index.asp?PageID=2023
3. Wiegers TA, Keirse MJ, Van der Zee J, Berghs GA. Outcome of planned home birth and planned hospital births in low risk pregnancies: prospective study in midwifery practices in the Netherlands. BMJ 1996; 313:1309–13.
4. Olsen O. Meta-analysis of the safety of the home birth. Birth 1997; 24:4–13.
5. Ogden J, Shaw A, Zander L. Deciding on a home birth: help and hindrances. Br J Midwifery 1997;5:212–15.
6. Canadian Institute for Health Research Giving Birth in Canada:
Regional Trends From 2001-2002 to 2005-2006.
http://secure.cihi.ca/cihiweb/en/downloads/Childbirth_AiB_FINAL_E.pdf
7. CMAJ Maternal mortality and severe morbidity associated with low-risk
planned Cesarean delivery versus planned vaginal delivery at term
http://www.cmaj.ca/cgi/reprint/176/4/455.pdf
8. Listening to Mothers II Report (2006.) Childbirth Connections,
http://www.childbirthconnection.org/article

News coverage of the Legalizaton of CPMs in Missouri

Midwives Brace for Future Battle - Post Dispatch

Legalization of Midwifery...a technicality that began with a tuck

Door Opens for Midwifery - Columbia Tribune

Feature Story

On home birth in Ohio

Press Release - 6/24/08

News from Missouri Midwife Supporters
CONTACT: Mary Ueland (417) 543-4258, grassroots@friendsofmomidwives.org
FOR IMMEDIATE RELEASE: Tuesday, June 24, 2008

Missouri Women and Families Declare Victory
Independence Day Comes Early for Midwives as State Supreme Court Upholds Right to Practice
JEFFERSON CITY, MO (June 24, 2008)—Today's Missouri Supreme Court decision is a tremendous victory for Missouri families, who have been working for 25 years to gain legal access to professional midwives. The ruling increases access to maternity care in the state and allows women and families more birth options and affirms their ability to exercise their rights to choose how their babies are born.

In a 5 to 2 ruling, the Court upheld a law that legalizes Certified Professional Midwives (CPMs) who practice in the state. The Court determined that the physician groups that brought the suit to overturn the law lacked standing because their only interest in the case was economic.

“The Missouri Supreme Court made the right decision today, and after 25 years of legislative struggles to ensure more birth options for families, we are very excited,” said Mary Ueland, Grassroots Coordinator for Friends of Missouri Midwives (FOMM). “Now, we can commence with creating a system in Missouri where CPMs are part of a team of caregivers, where mothers are truly informed and able to determine their own birth preferences, and where midwives can appropriately transport when the need arises, without fear of reprisals, and without intimidation and harassment of the parents.”

The decision makes legal Certified Professional Midwives (CPMs) and removes the threat of prosecution to professional midwives who assist families who choose out-of-hospital birth. State and national birth and midwives advocates hailed the ruling as a triumphant and historic moment in Missouri’s history and evidence of a tipping point at hand on the national scale.

“Certified Professional Midwives must pass rigorous exams to obtain the credential, and participate in continuing education and peer review to keep current. They practice according to their Practice Guidelines within national standards for CPMs,” said Debbie Smithey, president of the Missouri Midwives Association, “Missouri was one of only nine states to prohibit CPMs from practicing, and now the number drops to eight states remaining.”

The Court’s opinion summary is posted online. The ruling makes Missouri the 23rd U.S. state to allow professional midwives.

“Today’s victory over Big Medicine is a real shot in the arm to the growing campaign to legalize midwives across the nation,” said Susan Jenkins, legal counsel for the National Birth Policy Coalition and a consultant to the Missouri midwives. “This case confirms the message that’s been reverberating loud and clear in both the mainstream media and the blogosphere ever since the American Medical Association launched its attacks against midwives and home birth last week—physicians do not have the right to speak for patients when it comes to deciding who delivers their babies. Missouri families now have legal access to CPMs, who provide high-quality, cost-effective care and fill significant gaps in the state health care system.”

Across the nation, many have stepped up to help in a case that has been likened to a David-and-Goliath battle, with midwives supporters hosting bake sales and garage sales to stand up to the enormously well-financed Missouri State Medical Association, an affiliate organization of the AMA. In February, an amicus curiae (friend of the court) brief was submitted by:
Citizens for Midwifery (CfM)
Midwives Alliance of North America (MANA)
National Association of Certified Professional Midwives (NACPM)
Our Bodies OurselvesThe National Birth Policy Coalition (NBPC)

The amicus brief submitted by the coalition urged the Court to reverse the injunction against the midwives law and made the case that increasing access to trained and qualified CPMs and out-of-hospital birth is beneficial to Missouri citizens.

The new Missouri Midwifery law was supposed to take effect Aug. 28, 2007, but the Missouri State Medical Association (MSMA) organized a well-financed challenge to the new law and was granted a temporary restraining order on July 3. Then on Aug. 8, Circuit Court Judge Patricia Joyce, who serves on the Board of Directors for St. Mary’s Health Center in Jefferson City, disallowed the Certified Professional Midwives provision contained within HB818 regarding portability and accessibility of health insurance.

Judge Joyce ruled the provision was unconstitutional and unrelated to health insurance, despite hearing from Assistant Attorney General John K. McManus and Midwifery Coalition attorney Jim Deutsch that decriminalizing midwifery does indeed relate to health insurance as they recalled that the Missouri Supreme Court has already ruled health insurance is interdependent on health services, and the two subjects are related.

During the Circuit Court appeal to Judge Joyce on Aug. 2, Deutsch cited nine other states where Medicaid covers home births attended by Certified Professional Midwives and many others where CPMs receive private insurance reimbursement. Both McManus and Deutsch argued that families obviously cannot get health insurance reimbursement for their midwives if their providers are considered felons by the state. They agreed that legalizing Certified Professional Midwives is a first step to home birth families being able to have their maternity care providers covered by insurance. They also cited the lower cost of midwifery care, which in turn could encourage insurance companies to lower their rates for healthy women.

Midwives Supporters Seek Donations to Help Pay Legal Fees
To help pay for the legal fees incurred over the past year, families across Missouri have undertaken fundraising efforts, including bake sales, garage sales, and other community fundraising events. “Through our own efforts, we have steadily chipped away at our legal bills, but we still need help,” said Laurel Smith, President of Friends of Missouri Midwives. Smith added that donations to help pay the legal fees of the coalition of midwives and their supporters can be made at http://www.freethemidwives.org/.

Missouri is a priority of The Big Push for Midwives Campaign <http://www.thebigpushformidwives.org/>, a nationally coordinated campaign to advocate for regulation and licensure of Certified Professional Midwives (CPMs) in all 50 states, the District of Columbia and Puerto Rico, and to push back against the attempts of the American Medical Association Scope of Practice Partnership to deny American families access to legal midwifery care. The Big Push for Midwives Campaign is the first initiative of the National Birth Policy Coalition (NBPC). Through our work, we are playing a critical role in the building of a new model of U.S. maternity care delivery at the local and regional levels. At the heart of this new model is the Midwives Model of Care, which is based on the fact that pregnancy and birth are normal life processes.

Media inquiries about the Missouri Supreme Court case should be directed to Mary Ueland at (417) 543-4258, grassroots@friendsofmomidwives.org. Media inquiries about The Big Push for Midwives Campaign should be directed to Steff Hedenkamp at (816) 506-4630, RedQuill@kc.rr.com.

Friends of Missouri Midwives http://www.friendsofmomidwives.org/
Missouri Midwives Association http://www.missourimidwivesassociation.org/
Show-Me Freedom in Healthcare http://www.showmefreedompac.org/
Free the Midwives http://www.freethemidwives.org/
The Big Push for Midwives http://www.thebigpushformidwives.org/

NOTE: The Missouri Supreme Court’s ruling today legalizes Certified Professional Midwives and how they practice within their scope of practice for pregnant women, and has nothing to do with abortion, c-sections, or epidurals.

The Midwifery Amendment 376.1753. Notwithstanding any law to the contrary, any person who holds current ministerial or tocological * certification by an organization accredited by the National Organization for Competency Assurance (NOCA) may provide services as defined in 42 U.S.C. 1396 r-6(b)(4)(E)(ii)(I).

** * Tocology is the science of midwifery or obstetrics. The National Organization for Competency Assurance (NOCA) certifies more than 160 credentials, most of which are in the medical field. The Certified Professional Midwife (CPM) and Certified Nurse Midwife (CNM) are the only tocological certifications under NOCA. CNMs are already allowed to practice under their own statute. There are no ministers certified by NOCA. Therefore, the CPM is the only credential affected by this language.

** This portion of the US Code says “services related to pregnancy (including prenatal, delivery, and post partum services).”

Missouri Wins!!

The Missouri Supreme Court ruled today in favor of Missouri families by rejecting the case of the Missouri State Medical Association, et al. over language that was signed into law last year to legalize certified professional midwives in Missouri. The ruling was based on the fact that the MSMA et al did not have "standing" in the case - which means they have no true legal interest in the case as the only possible effect for them would be economic. Our lawyers made a terrific case on that!

You can see the opinon and summary here - http://www.courts.mo.gov/Courts/PubOpinions.nsf/0f87ea4ac0ad4c0186256405005d3b8e/f291298ad8cf21978625747100797615?OpenDocument The plantiffs have 10 days to request a rehearing. We've been told is it very rare for the SC to agree to rehear a case, but the decision won't be "final" until that's over. So keep praying.

If you'd like to help, the Missouri organizations and families who joined the case have $32,000 in legal fees still to pay. You can make donations of any size at freethemidwives.org.

The result of today's decision is that certified professional midwives are now legal in Missouri!

New Maternity Care Handout from Citizens for Midwifery

There is a nice new handout available from Citizens for Midwifery called "What Does Good Maternity Care Look Like?" that presents three models of good maternity care side-by-side--The Midwives Model of Care, the Ten Steps of Mother-Friendly Care, and Six Care Practices that Support Normal Birth. The handout is a nice, simple representation of the compatibility between all of these evidence based models of healthy, effective maternity care!

Home Birth

I recently finished reading the book, Mamatoto. (I wrote more about this book here.) This book is a look at birth in a variety of cultures around the world and explores various customs in various cultures. I liked this quote from the book about homebirth:

"'Home birth' can mean different things to different people. It can mean a bedroom, dimly lit and scented with myrr; a sweatbath perched on a Guatemalan hillside, or a birthing pool in an English flat; a warm fireside in a Himalayan kitchen; the packed-snow sleeping platform of an Inuit igloos; or a one-room shack in Jamaica, with a washing line dividing the family bed and the children waiting on the other side for a first glance at the baby who will be held up for them to see. When a woman gives birth at home, she and her family have a degree of control over the event; it's their domain."

Another favorite quote is this:

"Pay attention to the pregnant woman! There is no one as important as she!"

(Chagga saying, Uganda)

Pregnant women in Missouri want and need midwives. We need our legislators to pay attention! :-)

Fundraiser!

There is a fundraising auction and raffle for Friends of Missouri Midwives and Free the Midwives set up at Hyena Cart (it will be active until Sunday, 3/16). Some of the items donated are a fitted cloth diaper, wool soaker shorts, beautiful yarn if you knit/crochet, project bags, stuffed toys, newborn hat/booties, and wool soaker/t-shirt set! Please visit and bid on some lovely items and support Missouri midwifery at the same time!

Supreme Court Oral Arguments - Links

Post will be updated as more coverage is released.

Official Information from the Supreme Court - includes mp3 of today's oral arguments

Press Release from Missouri Midwife Supporters - .pdf file

Videos -
6:42 long video of interviews with Sen. Loudon and Mary Ueland

News Articles -
Missourinet 3/5/08 - includes the above linked video - original article
KWMU 3/5/08 - original article
The following three links are to the same text article, with different videos on each page:
Kiefer Family
Mary Ueland
Senator Loudon

Columbia Missourian 3/5/08 - AP article - needs comments!
Joplin Globe - 3/5/08 - AP article - start a discussion!
SE Missourian 3/5/08 - AP article - needs comments!
St Louis Examiner 3/5/08 - AP article - needs comments!
St. Louis Post Dispatch 3/5/08 - brief of AP article

The Loudons on YouTube

Little mom, big baby

Great column in the Columbia Tribune

Posted by permission of the fabulous Kolbi Doyle:

Law should allow midwives to practice home births
Published Sunday, March 2, 2008

Editor, the Tribune: My hospital birth was not a horrible experience, but afterward I began researching childbirth, childbirth providers and locations. At the University of Missouri library, I scoured the medical journals for all comparisons of obstetricians, family practice doctors and midwives. I found no studies that show outcomes to be unfavorable when using a midwife in a planned home birth.

Through word of mouth and a lot of legwork, I eventually found two midwives. One was a Mennonite who was not comfortable coming out of her community. The other was a Certified Nurse Midwife (CNM) who was one of two at the time working legally in the state - now there is one. My husband and I both liked the midwife and her philosophy of pregnancy and childbirth. The birth of my second child at home was an amazing, empowering and relaxed experience.

I later learned about the Certified Professional Midwives certification. The educational requirements are as thorough as the CNM requirements, and the apprenticeship requirements are above and beyond what is expected of CNMs.

My insurance company would have allowed me to deliver in a hospital for one $10 copay but would not cover my midwife. I had no choice but to pay $3,000 out of pocket. It was worth every penny.

There is no scientific or moral reason not to allow these highly skilled midwives to practice in Missouri and for our insurance companies to cover the superior care they provide.

Kolbi Doyle



And here's the link

Press Release - Next Week's Supreme Court Hearing

Big news - check out the press release!

CNN spot on rising C-section rates

Watch the Video

Another OBGYN perspective on homebirth

I was interested to learn from the Women in Charge blog that ACOG isn't the only organization of OBGYNs to have an opinion about homebirth. The Royal College of Obstetricians and Gynaecologists also has a statement about Home Births (a joint statement issued with the Royal College of Midwives, which tells you something right there!) which stands in dramatic contrast to the ACOG press release officially opposing homebirth.

Some choice quotes from the Royal College of Obstetricians and Gynaecologists statement include:

"There is no reason why home birth should not be offered to women at low risk of complications and it may confer considerable benefits for them and their families. There is ample evidence showing that labouring at home increases a woman's likelihood of a birth that is both satisfying and safe, with implications for her health and that of her baby."

And....

"Birth for a woman is a rite of passage and a family life event, as well as being the start of a lifelong relationship with her baby."

And...

"Overall, the literature shows that women have less pain at home and use less pharmacological pain relief, have lower levels of intervention, more autonomy and increased satisfaction."

Interesting reading!

Avoiding Induced Labor

From Medical News Today

Thanks to everyone's hard work and persistence...

...Wednesday, Feb. 20th, 2008 was a very good day for midwifery at the Missouri Capitol!

We scored a huge victory when the Senate Committee on Pensions, Veterans Affairs, and General Laws (Senator Jason Crowell, chairman) voted 5-1 to combine SB870 and SB1021 and then 5-1 "Do pass" on the combined bill.

The Committee in executive session, discussing combining the midwifery repeal bill,
and the midwifery licensure bill.

"Okay, I'll deliver cookies to the third floor representatives' offices. And you do the Senate side..."
Carissa and Anna

In previous years, midwifery bills have just barely squeaked out of the General Laws committee, even though there has always been a large amount of support from the whole Senate body. I believe this change to an overwhelming amount of support was largely due to the increasing amount of people who have become involved in educating their legislators about midwifery and advocating for it to become a priority in the Missouri legislature.

If you were one of those people faithfully attending in-district meetings, sending emails and letters, making phone calls, etc, you can claim part of this victory!

We literally saw the attitudes of the committee members change over the past week or two as more and more people have contacted them in support of legalizing and licensing Certified Professional Midwives in Missouri. Keep it up! It's an election year, and they want to know what the hot topics are, and also which side the majority of their constituents support!

Part of the hard working crew that volunteered all day Wednesday at the Capitol.
(Unfortunately, all the families from Southeast Missouri had already left when we thought to take a picture. The crowd was much bigger for most of the day!)

Cookie Day, Feb. 13, 2008, Missouri Capitol

Here they come, laden with boxes and bags and strollers full of cookies, all to be given away to lawmakers!

The entrance to the alcove where the action was all morning! Kelly and Laurel behind the welcome table, Jonathan on the left. Summer's squatting in the foreground to talk to a child...

Susan (left) reports back on her visits and cookie deliveries (Mary and Alicia and the right). We're all shocked that she has just had a very friendly 20 minute visit with one of the older State Representatives who's always grumpy and says nasty things about the midwives if he even sees them walking down the hall.
"How did you get in to see him?!" we all ask in amazement.
Susan smiles.
"Well, I was just delivering cookies at his office, when he stepped out of the door and asked if we had brought him his favorite kind, Oatmeal Raisin. I apologized that they were chocolate chip, but said they were good anyway. Then I glimpsed his big plushy leather sofa inside the office door, and pointed at my pregnant belly. In my sweetest, nicest voice I said, 'I'm pregnant and need to put up my feet for a few minutes. How 'bout we go sit in your office and chat?' And then we found out that he is friends with my brother... and soon we began talking about midwifery. He told me what he thought, and I got to clarify some stuff with him... Anyway, I like him, and I think that I'll go visit him again. He just might vote for us!"

Koda, Kyan, Ruth, and Kalee delivering cookies - they were so pleased that their assignment sheet listed Senator Graham's office as one to deliver to. Unfortunately, they didn't get to see him, just his secretary who was very happy with the cookies.

After lunch, and several hours of cookie delivering, those who were still there gathered round in the alcove for a Friends of Missouri Midwives meeting. It was neat to hear from so many new people who showed up for Cookie Day why birth and midwifery are important to them.

Cookies, Complications, Icy Roads, and Lots of Willing Workers!

This year, Friends of Missouri Midwives' fourth annual "Cookie Day" at the Capitol coincided with an ice storm that hit southern Missouri.

The roads in the southern half of the state didn't exactly inspire even die-hard midwifery supporters to venture past their driveways. So, most of the carefully wrapped cookie packages went back into people's freezers to wait for the weather to warm and thaw the roads a bit.

But Cookie Day had been planned for a long time, and half of the state was still planning on coming, so the decision was made to move ahead with the Cookie Plans.

'Twas the day before Cookie Day, and...

Kelly was busy coordinating who was bringing how many bags of cookies, and when they would arrive and making sure that she would be ready to greet crowds of people with directions and lists of their legislators and name stickers and midwife buttons... and she was baking cookies.

Margaret was trying to arrange for a local business/restaurant to donate lunch and drinks for the families who would be busy delivering cookies, talking on the phone to people who didn't understand what they needed to do... and baking cookies.

Laurel was responding to emails, and trying to keep things flowing smoothly, planning the FoMM meeting, trying not to panic when the House operations guy said that he didn't see anywhere that Friends of Missouri Midwives had reserved the alcove for the 13th of February, as well as giving people advice on how to make the best impression possible at the Capitol... and she was baking cookies.

Debbie was busy re-drafting legislation, taking phone calls from happy people, frustrated people and confused people at the Capitol and all around the state, setting up meetings with elected and appointed officials, texting the others who were coordinating Cookie Day, emailing information and bill drafts to the legislators and staff who needed it... and supervising the cookie baking that her children were doing.

Mary was trying to keep 17 attorneys and law students from across the country organized and informed who were busily working (all pro bono) on the amicus brief to counter the AMA's brief that was filed with the Missouri Supreme Court. The AMA's amicus brief alleged that allowing Certified Professional Midwives to legally practice was a threat to the health and well-being of Missouri mothers and their babies. The midwife-supporting attorneys were all working together to thoroughly refute that allegation and inform the Court that midwifery is not dangerous; in fact it is sound public policy. With the deadline for submission to the court fast approaching, things had escalated to a mad scramble online and over the phone as various versions and sections of the brief and interest statement circulated in cyber-space. The fact that Mary's electricity (read: internet, too!) had gone out and her little sisters were busily baking cookies made the day even more interesting

The night before Cookie Day... Debbie and Mary had both made it safely over the icy roads and arrived at La Casa, the "midwives" rental house in Jefferson City - and were busy responding to emails, editing the media alert, and typing up instruction sheets for Cookie Day.

MEDIA ALERT

Homemade Cookies Open Doors to Talk about Home Birth

Midwives supporters come from across Missouri to meet with lawmakers

WHAT:

Valentine’s Day is coming a bit early this year to policy makers at the State Capitol Building in Jefferson City, Missouri. That’s because midwifery and home birth supporters from across the state will come Wednesday with more than 1,021 home baked cookies and valentines, made by home birth families from across the state for their fourth annual “Cookie Day” at the Missouri Capitol. Cookie Day is an effort to show appreciation to lawmakers for their efforts to change Missouri’s currently hostile midwifery law.

Senate Bill 1021 will establish a state regulatory board for licensing Certified Professional Midwives, or CPMs. The bill, sponsored by Sen. John Loudon, R-Chesterfield, is currently being considered by the Senate Pension, Veterans’ Affairs and General Laws Committee.

Missouri’s existing midwifery law is considered one of the most restrictive and hostile in the nation, making the practice of midwifery by anyone other than a physician a Class C Felony.

“Our Annual ‘Cookie Day’ is a fun opportunity for the people of Missouri to come and advocate for midwifery and the right to choose their own health care providers. Of course we always have pregnant women who show up, hoping that this year will be the year when they won’t have to worry about their midwife being arrested for attending their birth,” said Mary Ueland, Grassroots Coordinator for the Friends of Missouri Midwives. “There is a new momentum to our efforts this year as more public attention is focused on this issue, and as it becomes very clear that more and more states are adopting the CPM credential as the basis for the licensure of out-of-hospital midwives.”

WHEN AND WHERE:

From 10 a.m. to 4 p.m. on WEDNESday, FEBRUARY 13 at the Capitol Building, 201 W Capitol Avenue, Jefferson City, Missouri. Cookie Day “home base” is in a 3rd floor rotunda area alcove.

WHO:

Cookie Day 2008 is co-sponsored by the Friends of Missouri Midwives, Missouri Midwives Association, Show-Me Freedom in Healthcare, and Free the Midwives.

PushNews Response to ACOG statement

The Big Push Campaign has posted a new press release--"ACOG: Out of touch with Needs of Childbearing Families."

"Trade Union claims out-of-hospital birth is “trendy;” tries to play the “bad mother” card"

“'It will certainly come as news to the Amish and other groups in this country who have long chosen home birth that they’re simply being ‘trendy’ or ‘fashionable,’” said Katie Prown, PhD, Campaign Manager of The Big Push for Midwives 2008. “The fact is, families deliver their babies at home for a variety of very valid reasons, either because they’re exercising their religious freedom, following their cultural traditions or because of financial need. These families deserve access to safe, quality and affordable maternity care, just like everyone else.”

What do you think of this ACOG statement?

ACOG made public today its statement about home birth. Since it's copyrighted, I'm not going to reproduce it; go here to read it in its entirety.

Some tidbits to whet your appetite:

The American College of Obstetricians and Gynecologists (ACOG) reiterates its
long-standing opposition to home births. While childbirth is a normal
physiologic process that most women experience without problems, monitoring of
both the woman and the fetus during labor and delivery in a hospital or
accredited birthing center is essential because complications can arise with
little or no warning even among women with low-risk pregnancies.

...ACOG does not support programs that advocate for, or individuals who provide,
home births.

Unless a woman is in a hospital, an accredited freestanding birthing center, or
a birthing center within a hospital complex, with physicians ready to intervene
quickly if necessary, she puts herself and her baby's health and life at
unnecessary risk.

Choosing to deliver a baby at home, however, is to place the process of
giving birth over the goal of having a healthy baby.

So... tell us what you think!

Ode to My Midwife

Previously published in the summer 2007 issue of the Friends of Missouri Midwives newsletter:

Ode to My Midwife…

Midwifery model of care

Inspiration

Dedication

Wisdom

Integrity

Friendship

Empathy

--Thank you!

Two Dreams

Last night I dreamed that I was at a conference in a nice hotel. After lunch, a group of mothers and babies were heading upstairs to rest. We got to a door at the end of a hallway and woman we knew blocked it and shook her head significantly. We turned back and another friend blocked another exit with the warning that "they" were coming for us. Any homebirth mother and homeborn baby needed to leave the building immediately because we were going to be captured. The atmosphere was tense and we held our babies tightly and were really anxious. We finally found a way out through the basement where my aunt was waiting in a "getaway" car to take us to California.

----

Two years ago when I was pregnant with my second baby, I dreamed I was walking through a hospital and saw that all the women were laboring in beds with their arms and legs strapped down flat. One woman said, "but I wanted to give birth side-lying" and the nurse then spun her bed around so IT was on its side (perpendicular to the floor) so the woman was now "side lying" in the air strapped to a vertical bed! After I saw this, I started sneaking into all the rooms and unstrapping the women and encouraging them to "be free!"

------------------------------------------------------------------------------------------------

I was going to post my personal "analysis" of the meaning of these dreams in the context of our legislative efforts in MO, but then I decided that the symbolism is pretty self-evident without my additional commentary!

Malpractice Insurance & Midwives

Midwifery advocates working on legislation are often met with the question/response, "but what about malpractice insurance? Families need to have some recourse in the event of problems during birth." This is often a close-the-door pseudo-question asked with an air of finality--as in, "now, that settles that. We're all finished here."

Reading the current issue of Midwifery Today finally helped me respond to that question and also to discern what I have always felt that questions of legislation and legalization of midwifery should not involve a need for, or a requirement of, malpractice insurance. It also helps explain why bringing up malpractice insurance need not be an avenue for closing discussion.

From author Judy Slome Cohain: "Mandatory malpractice insurance does not enable a person to sue for malpractice. Any midwife or citizen can be sued at present--insurance or no insurance. Mandatory malpractice insurance can only do one thing: increase the profitability of lawsuits."

When looking through this lens, it becomes clear that lawyers and insurance companies have more to gain from legislation mandating insurance policies for midwives than do birthing women and their families.

The article in Midwifery Today is called "Mandatory Malpractice Insurance: Increases CS Rate & Profitability of Litigation, Decreased Planned Homebirths."

Last year when the issue of malpractice insurance was raised repeatedly in the discussion of our midwifery legislation we discovered that there were no other laws (that we could find) mandating that ANY other type of professional have malpractice insurance, including OBs. If no other professionals in the state of Missouri are required by law to carry malpractice insurance, why is the issue even been raised when discussing midwifery? Yes, most hospitals do require malpractice insurance for their OBs as a condition of employment, but it is not a state regulated requirement that they have it.

Terrific piece about birth

Birth: Medical Event or Natural Process?

Excellent article with thorough citations.

Newsweek

Newsweek article on The Business of Being Born

Neonatal Mortality Rankings

Unicef just published new statistics ranking countries on the state of children.

The United States is tied for 33rd (through 41st) in neonatal mortality (at 5) with these countries: Belarus, Croatia, Lithuania, Malaysia, Malta, Qatar, Slovakia, United Arab Emirates, United States.

Quotes from Birth Book

In the early 70's, Raven Lang was a self-trained midwife in Santa Cruz, CA. She and her sister midwives opened a birth center and served many women before one of the midwives was arrested in an undercover sting operation by a law enforcement couple posing as homebirth clients. Birth Book was the first woman authored, empowerment model, homebirth-oriented book to come out of the childbirth and midwifery movement of the 70's (published even before the better known and also much beloved classic, Spiritual Midwifery). This book has recently been reprinted on a very limited basis and is being sold by Citizens for Midwifery. This week I was delighted to read it at last and I wanted to share some quotes from the introduction of the book that felt relevant to me when thinking about midwifery in Missouri:

“Birth has not only reached the absurdity of having to be relearned, it also has the absurdity of becoming a criminal offense if we are to go ahead with our ideals and do things the way we desire. And so, because of the system, midwifery as practiced in this book is against the law. It has become political. We didn’t make it that way. For us it is a beautiful, personal, spiritual, sexual experience. And for us to have that, we become criminals.”

“None of this would have happened if we had waited for organized medicine to come around, or if we had been scared of the laws we would break, or if we had waited for money. I want now to say POWER TO THE PEOPLE, AND YOU CAN DO IT IF YOU WANT.”

More from the Post Dispatch

Monday's front page carried this article about the birth center in Columbia.

I also found this section on the history of midwifery (don't know where it was in the paper).

And the "Talk of the Day" is about midwives in Missouri. Go add your comments!

Article in the St. Louis newspaper

Michelle Munz of the Post Dispatch did a terrific job with this article about midwifery in Illinois and Missouri. I only wish they had an avenue for posting comments about the story on the website.

I'll give first quote status to the opposition. After several paragraphs in which Munz has sumarized some of the extensive statistical evidence regarding the safety of planned homebirth with a certified professional midwife:

But such statistics can't tell the whole story, said Dr. Gordon Goldman, the Missouri section chair of American College of Obstetricians and Gynecologists."Most of the time, they are going to get away with" a midwife
birth, Goldman said. "But when (a death) happens — even if it's one in 1,000 — it's 100 percent for you and your baby."

This quote amuses me in light of the fact that the informative sidebar states that the BMJ study showed an infant death rate of "1.7 per 1,000, consistent with low-risk births at hospitals." The infant death rate itself is not amusing. It is a very sad fact of life that even in the best of circumstances, some babies don't make it. What amuses me is Dr. Goldman's double standard, and his random choice of a death rate that is actually lower than hospitals acheive for "low risk" births.

Some of my favorite quotes that resonate with what midwifery is all about:

Kris gets into the tub, equipped with a heater to keep the water warm. The temperature and buoyancy are soothing. About 15 minutes later, the midwife notices a twinge in Kris' grunting.
"That sounded pushy. Are you feeling like you're wanting to push?" the midwife says.
"Yes," Kris answers, the first word she has spoken in hours.

~~~

It was a difficult birth, Jenny recalled. She pushed for nearly an hour.
The midwife felt the umbilical cord wrapped around the baby's neck. She had
Jenny get on her hands and knees and lift one leg. That allowed the baby's
shoulders to come loose and tumble out of its cord. The new mom scooped up her baby girl in the warm water. It was a joyous and peaceful moment, she said. It was exactly what she wanted.
"I felt like the bionic woman," Jenny said. "I was completely exhausted, but I felt a sense of pride I never felt before."

~~~

She spends two more hours at the house, cooking scrambled eggs, cleaning and completing her notes. She packs her equipment in a rolling suitcase. She leaves Kris with a list of things to look out for, like excessive bleeding or if Drew catches a fever.
The midwife hugs Kris and tells her how amazing she was. The midwife will be back tomorrow to check on the family.
As always, she has her cell phone in her pocket, waiting for the next call.

There is also a beautiful audio slideshow accompanying the article.

Homebirths to be covered by insurance in New Hampshire!

Both the House and the Senate in New Hampshire have passed bills that mandate insurance companies to cover home births! The two bills were slightly different, so not quite ready for the Governor's signature, but the bills passed by big margins. This is a terrific development for home birth and perhaps and example that will be useful for other states.

Read more about this news here.

This is exciting news for NH and just makes me reflect on what we're working towards here in Missouri--simply the right to skilled midwifery care in our homes. It has been a difficult struggle to get this idea of legal midwifery accepted here in Missouri and so it is a refreshing change to know that in other states not only is home birth "accepted," but is also now covered by insurance! Missouri is falling even more behind the times!

St. Louis Post Dispatch Slideshow

There is a lovely slideshow of a midwife attended homebirth currently available on the St. Louis Post Dispatch website! This is what we're working towards--making births like this readily available to women throughout Missouri! :-)