The end of an era

I am saddened that this wonderful place will no longer be serving Missouri's birthing women. A dear friend of mine gave birth in this facility several years ago, and offers nothing but high praise for Dr. Allemann, the staff, and the Center itself.

I feel fortunate to have met Elizabeth on several occasions in the past few years. She is a strong, passionate woman dedicated to helping other women in an informed manner. She is a rarity among medical professionals, at least in my experience, and her gifts to so many birthing women will live on. She will still be practicing, thank goodness!, but will no longer be attending births. Elizabeth, I know you will be dearly missed and I wish you only the best on your new adventures...and some much needed sleep!

Columbia Community Birth Center to close at end of year

Wednesday, October 28, 2009 | 12:01 a.m. CDT

Ivy White, a certified professional midwife in Columbia, holds 6 week-old William Leigh at the Columbia Community Birth Center before an appointment Sept. 18. A law passed last summer made it legal for midwives like White to assist in the birthing process without the presence of a physician. ¦ Mike Pittman

BY Emmy Hayes

COLUMBIA — After operating for almost three years and delivering 175 babies, the Columbia Community Birth Center plans to close at the end of year.

The center was searching for a new physician to take the position of medical director after Elizabeth Allemann announced she would be leaving at the end of October, but the search was unsuccessful.

The Columbia Community Birth Center, a not-for-profit organization, opened in January 2007 and offered a number of female health services, including natural birth under the supervision of midwives.

According to certified professional midwife and the center's executive director, Ivy White, the closing isn't just about the vacant physician's spot, but also the change in the political scene for certified midwives.

"We're moving on. I think the political climate is becoming more friendly towards midwives, and the medical community has started accepting certified professional midwives," White said.

Allemann is leaving her position at the center to focus on herself and her family. She will remain a family physician and acupuncturist at her private practice in Columbia.

Allemann ran for the 19th District Missouri senate seat during the 2008 primary but dropped out quickly. She is an advocate for midwifery laws in Missouri.

"I am an advocate for women making their own options for their health care," Alleman said. "The more options we have, the better people's health is."

A 2007 law upheld by the Missouri Supreme Court legalized midwifery. Before the law, midwifery was illegal if done without a licensed physician.

Allemann says she is curious to see how the center closing will affect the strong home birthing presence in central Missouri.

"Out-of-hospital births are becoming less controversial and more acceptable, so I'm hoping the next incarnation of a birthing center will result in more support from the medical community," Allemann said.

Anastasia Pottinger, a Columbia photographer, received prenatal care from the birthing center but had her child at the hospital.

"I tried to make a bridge between the two, but the birthing center was a relaxing place," Pottinger said. "There was a fireplace, rocking chairs, art on the wall. It was different than walking into a hospital."

Pottinger was a regular at the birthing center and said 75 percent of her birth photography is from home births or the birthing center, and she showcased some of her photos at the center.

"Last week I took the pictures off the walls. I was happy, but sad," Pottinger said. "It was an end of an era."

National CPM Support NOW!!

All right Missouri birth supporters and advocates! Now is the time. We KNOW we can implement change...we did it here and we can do it nationally! Please sign this petition and/or call your legislator. It is so easy and only takes a few minutes. Give 'em a push!

The Big Push for Midwives

Push the Petition! We're Nearly 10,000 Strong!

Thank you for signing the petition supporting CPMs in health care reform.

We need to reach our goal of 10,000 names this week, as Congress moves closer to taking final action on health care reform legislation. All members of Congress need to know that support for CPMs and out-of-hospital birth in their state is strong!

Be sure to forward this message far and wide and ask your family and friends to lend their support to the cause.

Midwives, it is especially important for you to let your clients know that we need them to speak up!

If you live in one of the following states, we really need you to act. We can't allow Delaware's Congressional delegation to believe that only 11 people in the entire state support midwives and home birth! If you live in Delaware, spread the word NOW!

Or Utah, South Dakota, Vermont, New Hampshire, West Virginia and Wyoming! Surely there are at least 100 people in each of these states who can let their elected officials in DC know how much they support access to midwifery care!

Most states have hundreds of signatures, some close to 1000. But if you live President Obama's home state of Hawaii, or in Senator McCaskill's home state, Missouri, or in her neighbor state, Kansas, Congress needs to hear your voices today!

We can't afford to allow any members of Congress to think that there are fewer than 100 midwifery supporters in ANY state! If you have family or friends in any of the states mentioned, please reach out to them.

Those are states with fewer than 100 signatures but we need ALL the states to give the petition one more Push over the top so we can reach our goal and put Congress on notice that we want access to CPMs now!

http://tinyurl.com/Support-CPMs-Petition

Grassroots Network...Take Action!!

Dear Friends,

As the Senate and House are in the final weeks and days of preparing their Health Reform bills for floor debate, THIS IS THE TIME to write letters and anything else you can do to make sure your Senators and Representatives in Washington, DC, know that you want CPMs included at the federal level!

This e-mail includes three things to as soon as possible!

1. The MAMA Campaign continues working in DC to have Certified Professional Midwives included on the federal list of Medicaid Providers. Please write a brief letter to your Senators and Representatives today! They need to hear from their constituents! Even if you think your Congress people have already decided not to vote for any health reform bill, write to them anyway about CPMs. You can find all the needed information (including sample letter language and links for finding who your representative and senators are and how to contact them) at the Take Action page of the MAMA Campaign website: http://www.mamacampaign.org/contact-your-legislator/

2. The National Women's Law Center has produced a brief video "A Woman Is Not a Preexisting Condition!" that you can see at: http://awomanisnotapreexistingcondition.com/
They have an email setup right on that page to send emails to Congress about this issue, which has a section to add your own words. This is a great opportunity to add some sentences about CPMs, birth centers, and out of hospital birth in general. Thanks to Susan Jenkins for sending this information!

3. The Big Push for Midwives is encouraging everyone to sign their petition supporting CPMs and out-of-hospital birth. This is easy to do, and you are encouraged to forward this request to others. The petition sign-up is at: http://tinyurl.com/Support-CPMs-Petition. Find the full text of the Big Push notice at the end of this message.


This is our chance! Let's make sure Congress "gets it" about Certified Professional Midwives!

Sincerely,
Susan Hodges, "gatekeeper"

The Glow

The Glow of pregnancy...don't we all wish we had it? Personally, I do not think I look pretty when I am pregnant and I look in the mirror. I do, however, FEEL pretty. I feel alive, earthy, connected to every woman in the universe. But, I don't Glow and I know it.
My friend, M, does. She is pregnant with her third baby right now, only a few months along. Her hair is shiny, her cheeks are rosy, and she has just the tiniest baby bump protruding under her shirt. She is magnificent and I love watching her blossom.
I'm certain to a non-birth junkie this sounds strange, perverse even, but I can rest assured that those of you out there who suffer from the same affliction I do completely understand what I mean. Lucky for me, she does not mind that I feel the need to compliment her every time I see her or offer to carry her basket. I lavish upon her (or at least try to) the attention I feel each pregnant woman deserves.
All pregnant women carry in them more than babies, they carry hope. They carry hope that only innocence can provide, hope that the future is brighter, hope that the next "generation" will learn from us, but most of all hope that miracles really do exist. That is why in Uganda, the Chagga say: "Pay attention to the pregnant woman! There is no one as important as she!"

Disaster Preparedness ~ Midwife style

Below is a great article written by Deborah Smithey, CPM, about being prepared for routine maternity care during times of disaster. She makes some excellent points! To read the article on the Missouri Midwives Association site, click here.

Are we ready for the next disaster?
Click here for printable version

By Deborah Smithey

Man-made and natural disasters can occur at any time, as evidenced by September 11, 2001 and Hurricane Katrina in 2005. Missouri should be prepared for weather, epidemic, and terror-related disasters. What if hospitals are overwhelmed by casualties, disease or infection? Many first responders are not prepared to deal with the special needs of pregnant women and infants. Where will women give birth during the next disaster?

FEMA strongly encourages each state to prepare an out-of-hospital scenario that works well under such conditions. During Katrina, babies birthed unassisted in the Superdome and on the third floor of Salvation Army Corp Community Centers opened our eyes to the need for a better plan.

The Trust for America’s Health reports that Katrina overwhelmed the institutional facilities we often depend upon for health care. In addition, doctors and nurses were forced to perform without the technology upon which they heavily rely.

Women and infants are disproportionately and adversely affected by disasters. Missouri women generally expect to give birth in hospitals; 99% of births occur there. But during an emergency, hospitals may not be immediately accessible. In the case of pandemic flu, hospitals may not be safe for pregnant women and infants.

Certified Professional Midwives (CPMs) are trained to work in homes and other out-of-hospital settings. Many midwives serve the Amish and Mennonite communities, and so are accustomed to working without electricity or other modern conveniences. Yet their statistics are as good or even better than those of doctors working in hospitals with the same risk population. In the event of a disaster, women could expect excellent birth outcomes by calling a midwife to their homes. In fact, CPMs were among the first responders when Katrina ravaged New Orleans. These midwives are astute in out-of-hospital births with limited technology. They are highly educated in the natural process of birth and in discerning the physiological needs of mother and newborn.

In February 2006, the National Working Group for Women and Infant Needs in Emergencies* was formed to ensure that the health care needs of pregnant women, new mothers, and infants are adequately met during and after disaster situations. Access to out-of-hospital maternity care by CPMs fits with this mission.

Certified Professional Midwives should be part of Missouri’s disaster preparedness plan. The CPM is the only maternity care provider credential that requires experience in out-of-hospital settings. At present, there are approximately 1400 CPMs in the United States. Experienced, community-based certified professional midwives are scattered across the state of Missouri. Many other states already include CPMs in their emergency disaster plan. I urge all Missouri policy makers to ensure pregnant and birthing women and their newborns are safely cared for when the next disaster strikes.

* Members of the National Working Group for Women and Infant Needs in Emergencies include the National Association of Certified Professional Midwives, the Midwives Alliance of North America, the American College of Nurse Midwives, the American College of Obstetricians and Gynecologists, the Association of Maternal and Child Health Programs, the American Association of Birthing Centers, Centers for Disease Control and Prevention, March of Dimes, National Association of County and City Health Officials, and the White Ribbon Alliance for Safe Motherhood.

Hope

As a birth activist in an area rampant with birth hostility, misinformation, lies and propaganda, it can be hard to keep hope alive. During my pregnancy, I took time for myself and tried not to think about the hundreds of other women in the area who were not getting the wonderful care I was. Now that my baby is getting older, I feel the familiar pull of other women....calling me back to birth work, calling me with their questions, their fear, their unknowns. I'm not yet ready to leave my little cherub for these ladies full time, but I'm working my way back to them.
I feel the hope that we can change the birth culture. One woman, one birth story, at a time. I feel the hope that more women are waking up, asking questions, seeking the kind of care they deserve. I feel the hope that our group can flourish and educate. I feel the hope that change is on the horizon.

Coalition for Improving Maternity Services fires back!

Cause Announcement from Make Mother-Friendly Care a Reality!

Sept. 22, 2009

Dear Producers of The Today Show,

The Coalition for Improving Maternity Services (CIMS) and the undersigned organizations are disappointed with The Today Show’s misrepresentation of midwives and home birth that aired on Sept. 11, in a segment titled “The Perils of Midwifery,” later changed to “The Perils of Home Birth.” This biased and sensational segment inaccurately implied that hospitals are the safest place to give birth even for low-risk women and mischaracterized women who choose a home birth with a midwife as "hedonistic," going so far as to suggest that these women are putting their birth experiences above the safety of their babies. Neither could be further from the truth.

Unfortunately, The Today Show did not do its homework on the evidence regarding the safety of home birth and midwifery care. The segment featured an obstetrician who presented only the American College of Obstetricians and Gynecologists’ (ACOG) position in opposition to home birth, but it did not make any attempt to present the different viewpoints held by the many organizations that are committed to improving the quality of maternity care in the US. We are deeply saddened that the show did not take the opportunity to note that both CIMS and The National Perinatal Association respect the rights of women to choose home births and midwifery care, and that the respected Cochrane Collaboration recommends midwifery care because it results in excellent outcomes.

There is no evidence to support the ACOG position that hospital birth for low-risk women is safer than giving birth with midwives at home. What the research does show is that the routine use of medical interventions in childbirth without medical necessity can cause more harm than good, while also inflating the cost of childbirth. However, the current health system design offers little incentive for physicians and hospitals to improve access to maternity care practices that have been proven to maximize maternal and infant health.

“Birth is safest when midwives and doctors work together respectfully, communicate well, and when a transfer from home to hospital is needed, it is appropriately handled,” says Ruth Wilf, CNM, PhD, a member of the CIMS Leadership Team.

That is why the national health services of countries such as Britain, Ireland, Canada, and the Netherlands support home birth. In those countries, midwives are respected and integrated into the maternity care system. They work collaboratively with physicians in or out of the hospital, and they are not the target of modern day witch hunts. These countries have better outcomes for mothers and babies than the US.

Childbirth is the leading reason for admission to US hospitals, and hospitalization is the most costly health care component. Combined hospital charges for birthing women and newborns ($75,187,000,000 in 2004) far exceed charges for any other condition. In 2004, fully 27% of hospital charges to Medicaid and 16% of charges to private insurance were for birthing women and newborns, the most expensive conditions for both payers. The burden on public budgets, taxpayers and employers is considerable.

As US birth outcomes continue to worsen, it should come as no surprise to The Today Show that childbearing women are seeking alternatives to standard maternity care. After all, American women and babies are paying the highest price of all—their health—for these unnecessary interventions, which include increasing rates of elective inductions of labor and cesarean sections without medical indication.

To the detriment of childbearing families, the segment “The Perils of Midwifery” totally disregarded the evidence. Although the reporters acknowledged that research shows home birth for low-risk women is safe, that message was overshadowed by many negative messages, leaving viewers with a biased perception of midwifery care and home birth. CIMS makes these points not to promote the interests of any particular profession, but rather to raise a strong voice in support of maternity care practices that promote the health and well-being of mothers and babies.

One of the ten Institute of Medicine recommendations for improving health care is to provide consumers with evidence-based information in order to help them make informed decisions. The Institute recommends that decisions be made by consumers, not solely by health care providers. The Institute maintains that transparency and true choice are essential to improving health care. We remain hopeful that the medical community will soon recognize the rights of childbearing women when it comes to their choices in childbirth and will respect and support these choices in the interest of the best possible continuity and coordination of care for all.

We urge The Today Show to provide childbearing women with fair and accurate coverage of this important issue by giving equal time to midwives, public health professionals, researchers of evidence- based maternity care, and especially to parents who have made choices about different models of care and places of birth.

Sincerely,
Coalition for Improving Maternity Services
Academy of Certified Birth Educators
Alaska Birth Network
Alaska Family Health and Birth Center
American Association of Birth Centers
American College of Community Midwives
American College of Nurse-Midwives
Bay Area Birth Information
Birth Network of Santa Cruz County
Birth Works International
Birthing From Within, LLC
BirthNet
BirthNetwork National
BirthNetwork of Idaho Falls
BirthNetwork of NW Arkansas
Choices in Childbirth
Citizens for Midwifery
DONA International
Doulas Association of Southern California
Evansville BirthNetwork
Harmony Birth & Family
Idaho Midwifery Council
Idahoans for Midwives
InJoy Birth and Parenting Education
International Childbirth Education Association
International MotherBaby Childbirth Organization
Lamaze International
Madison Birth Center
Midwives Alliance of North America
Motherbaby International Film Festival
Nashville BirthNetwork
National Association of Certified Professional Midwives
North American Registry of Midwives
Oklahoma BirthNetwork
Perinatal Education Associates, Inc.
Reading Birth & Women's Center
Rochester Area Birth Network
Sage Femme
The Big Push for Midwives Campaign
The Tatia Oden French Memorial Foundation
Triangle Birth Network
Truckee Meadows BirthNetwork

About Us
The Coalition for Improving Maternity Services (CIMS) is a coalition of individuals and national organizations with concern for the care and wellbeing of mothers, babies, and families. Our mission is to promote a wellness model of maternity care that will improve birth outcomes and substantially reduce costs. The CIMS Mother-Friendly Childbirth Initiative is an evidence-based mother-, baby-, and family- friendly model of care which focuses on prevention and wellness as the alternatives to high-cost screening, diagnosis, and treatment programs.

References:
1. The Perils of Home Births, http://www.msnbc.msn.com/id/21134540/vp/32795933#32795933
2. Birth Can Safely Take Place at Home and in Birthing Centers,
http://www.pubmedcentral.nih.gov/picrender.fcgi?artid=2409129&blobtype=pdf
3. Offers All Birthing Mothers Unrestricted Access to Birth Companions, Labor Support, Professional Midwifery Care, http://www.pubmedcentral.nih.gov/picrender.fcgi?artid=2409134&blobtype=pdf
4. ACOG Place of Birth Policies Limit Women's Choices Without Justification and Contrary to the Evidence, http://childbirthconnection.com/article.aspClickedLink=790&ck=10465&area=27
5. Ratifiers and Endorsers of The Mother-Friendly Childbirth Initiative,
http://www.motherfriendly.org/ratifiers.php
6. Choice of Birth Setting, http://www.nationalperinatal.org/advocacy/pdf/Choice-of-Birth-Setting.pdf
7. Position Statement on Midwifery, http://www.nationalperinatal.org/advocacy/pdf/Midwifery.pdf
8. Midwife-led versus other models of care for childbearing women,
http://cochrane.org/reviews/en/ab004667.html
9. Evidence-Based Maternity Care: What It Is And What It Can Achieve,
http://childbirthconnection.com/pdfs/evidence-based-maternity-care.pdf
10. Lamaze Healthy Birth Practices,
http://www.lamaze.org/ChildbirthProfessionals/ResourcesforProfessionals/CarePracticePapers/tabid/90/Default.aspx
11. Millennium Development Goals Indicators, United Nations, http://mdgs.un.org/unsd/mdg/Data.aspx
12. National Vital Statistics System, Birth Data, http://www.cdc.gov/nchs/births.htm
13. Induction By Request, http://www.marchofdimes.com/prematurity/21239_20203.asp
14. Cesarean Birth By Request, http://www.marchofdimes.com/prematurity/21239_19673.asp
15. Crossing the Quality Chasm: A New Health System for the 21st Century,
http://www.iom.edu/CMS/8089/5432.aspx
16. The Mother-Friendly Childbirth Initiative, http://www.motherfriendly.org/mfci.php

Coalition for Improving Maternity Services
1500 Sunday Drive, Suite 102
Raleigh, NC 27607

Tel: 919-863-9482
Fax: 919-787-4916

www.MotherFriendly.org

Making Mother-Friendly Care A Reality
CIMS is a not-for-profit organization recognized as tax-exempt under Internal Revenue Code section 501(c)(3). Our mission is to promote a wellness model of maternity care that will improve birth outcomes and substantially reduce costs.

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