Thursday, June 25, 2009

Are You In The Know?

Straight from the ACNM Communications Department, here are our top picks for happenings in midwifery for the week:

Authors of an Obstetrics & Gynecology article say they encourage midwifery care and “support future randomized trials to compare” home vs. hospital births. The statement comes in response to a letter from certified nurse-midwife Judith Rooks and Our Bodies, Ourselves Executive Director Judy Norsigian.

A midwife wrote an interesting article for Tuesday’s New York Times entitled “In a Lifeless Birth, a Midwife’s Opened Eyes.”

A fatal Metro collision happened between Washington, DC, and Silver Spring, MD—home of ACNM. Thankfully, the one ACNM staffer in the accident escaped with only a few bruises.

Saturday, June 27, is National HIV Testing Day.

Health reform is still hot, and ACNM is involved. We just posted legislation of interest to ACNM members here.

What else is going on in your world? Feel free to add to our list!

Friday, June 19, 2009

SOGC Says No More Automatic Cesareans for Breech Babies

Whether you’re aiming for a hospital, birth center, or home delivery, if you get the news that your baby is in the breech position, chances are you’ll be advised to have a cesarean section. But on Wednesday, the Society of Obstetricians and Gynaecologists of Canada (SOGC) released new guidelines for health professionals that turn the breech issue upside down. They state that health professionals should not automatically recommend cesarean sections for women carrying breech babies.

After a comprehensive review of research, SOGC concluded that vaginal breech birth is a safe option in some cases:

“The evidence is clear that attempting a vaginal delivery is a legitimate option in some breech pregnancies,” said Dr. AndrĂ© Lalonde, Executive Vice-President of the Society of Obstetricians and Gynaecologists of Canada. “The onus is now on us as a profession to ensure that Canadian obstetricians have the necessary training to offer women the choice to deliver vaginally when possible.”

Wednesday, June 17, 2009

The Article that President Obama is Reading

According to an article in the New York Times, President Obama is singing the praises of Atul Gawande’s “The Cost Conundrum,” which was recently published in The New Yorker magazine. Gawande’s piece investigates the geographic variations in health care cost per person, in particular McAllen, TX—the most expensive place in the US for health care. The piece is certainly impressive, calling attention to the fact that higher spending is often not associated with better health outcomes.

How’s this for a fun fact? When it comes to maternity care and primary care, midwives achieve positive patient outcomes using minimal costly interventions. Want to give us a hand with improving access to midwives? Tell your legislator to support the Midwifery Care Access and Reimbursement Act of 2009 (HR 1101 and S 662).

Thursday, June 11, 2009

Why Midwives Need to be on YouTube

According to this morning’s New York Times, there’s a new childbirth educator on the loose—YouTube. On the same Web site that broadcasts cute kittens, teenage pranks, and music videos, women are perusing for footage of real, unedited birth experiences.

In the article, professor Eugene Declercq of Boston University gives an interesting explanation as to what may be behind this emerging trend. He says that women used to regularly see sisters and neighbors give birth, but ever since birth moved into the hospital in the late 19th century, views of real birth are not so accessible.

So, is there a downside to unfettered access to birth videos online? In the article, ACNM Senior Practice Advisor Eileen Ehudin Beard, CNM, cautions that while it’s advantageous for women to be well informed as they prepare to experience childbirth, videos of complicated or difficult births could lead to an unhealthy fear of giving birth.

What do you think? Join the conversation about this post by clicking on “comments.”

Monday, June 8, 2009

An Inside Look at the PAC Reception

by Heather Bradford, CNM, ARNP
Chair, ACNM Government Affairs Committee

While at the Annual Meeting, I had the distinct honor of introducing US Representative Jim McDermott (D-WA) as the keynote speaker at the Midwives-PAC Reception on Sunday night at the Seattle Convention Center. He was welcomed by a roaring crowd of over 60 midwives and 100 nurse-midwifery students who, with standing room only, were chomping at the bit to discuss health care reform and how midwives are part of the solution. Rep. McDermott is a senior member of the U.S. House of Representatives and a psychiatrist known for advocating for affordable access to health care coverage. Since 1993, he has introduced universal health care legislation in every Congress, and is again leading the way in drafting comprehensive health care reform legislation with recommendations for a robust public option provision.

There were several highlights to his speech. When he used the phrase, equal pay for equal services, we all cheered and clapped, as we are once again advocating for equitable reimbursement with respect to Medicare Part B services with our Midwifery Care Access and Reimbursement Equity Act of 2009 (HR. 1101/S. 662), and trying to encourage Rep. McDermott to cosponsor our bill. It was refreshing to hear him talk about the value of having varying types of providers provide health care so patients have choices, and his history of supporting midwifery in WA when he served as a state legislator.

The other highlight of the night was his encouragement for us to teach our legislators about midwives. There was a real “aha” moment, especially among the students, when he essentially said that if you don’t contact your legislators and let them know about your profession, they won’t know about you and will never be able to stand up for you. But if you do your part and advocate for yourself, you can really make a difference. As Chair of the Government Affairs Committee, this was music to my ears. Often I find many midwives only want to deliver babies and leave the grassroots lobbying to a select few. But unfortunately we can’t do it alone! Thank you, Rep. McDermott, for inspiring a room of over 160 to get in touch with our legislators and speak out.

So at the end of the night I was able to walk the Congressman and his staff out. We discussed how HR 1101/S. 662, our equitable reimbursement bill, is a reimbursement bill (which follows his agreement that equal services deserve equal pay), that ACOG was supportive of midwives receiving 100% under Medicare, and that the bill had been scored by the Congressional Budget Office at zero (meaning it wouldn’t cost the government a dime). And with those words I proceeded to the bar to order a glass of wine to toast with my colleagues a successful event. Because that is what the Midwives-PAC is all about – access to legislators. By soliciting dollars from ACNM members, the Midwives-PAC facilitates the direct exchange of information between members of Congress and midwives and gives us the opportunity to speak out about our profession and our health care policy agenda.

Thursday, June 4, 2009

Stories from Seattle

by Ann Darlington, CNM

I live in Seattle and want to share an unexpected convention highlight that came for me in a yellow cab. Late one night after convention-style celebrating, two friends and I took a taxi back to their hotel. Our driver was a quiet, pleasant Somali man who listened to us midwives jabbering about the convention. As my friend Mary Lou reached to hand him the cab fare, he took her hand, drew it to his heart, and patted their joined hands against his chest three times (an unusual and moving gesture for a man from his world). He told her that he loves midwives, because they take such good care of his wife and family. When she joined us on the steps to the lobby, she shared this with us with tears in her eyes. A light went off for me—Muslim man, works nights, wife sees local midwives—so I scurried back to the cab, introduced myself, and asked what clinic his wife attends. As I had guessed, his wife has had her babies with my NeighborCare practice. Small world!

Another small world story: The Local Host Committee midwives had two beautiful handmade quilts to raffle off at our hospitality booth. The mothers of two different Seattle midwives made and donated the quilts to help raise money to defray our convention costs. When I was working the booth, a midwife from Ohio named Marsha Atkins totally fell for one of the quilts. Marsha asked how in the world she could win this precious work of art—she just had to have it. Naturally (and logically) I suggested she buy more tickets, so she did—an arm's length. She stroked the tickets with a prayer and a blessing, a “c’mon baby, come back to mama” and carefully laid them into the ticket collection basket.

The next day the raffle tickets were drawn, and Marsha Atkins won! She was ecstatic—whooping and smiling and crying. (Girl got mojo.) It turns out that 15 years ago, Marsha attended the birth of another Seattle midwife, Mary-Paul Backman, when Mary-Paul was active duty Navy at Bethesda and Marsha was active duty Air Force at Georgetown. As Mary-Paul tells it, Marsha “took over my prenatal care as a favor to a mutual friend who felt I needed someone strong-willed to get me to take better care of myself during my pregnancy….Believe me, I met my match in Marsha. My husband and I were both active duty and busy and she reminded us that we would only get the one chance to do that pregnancy ‘right.’ Watching her teach the OB residents on L&D was part of what inspired me to be a midwife. There was such a difference in how midwives taught and the OBs taught.”

A couple of lessons for and by midwives: what goes around, comes around, and we are but one or two separations from each other. Midwives share a small and beautiful world.

Wednesday, June 3, 2009

Seattle Delivered; What's Next?

by Melissa Avery, CNM, PhD, FACNM, FAAN
President of the American College of Nurse-Midwives

The 54th Annual Meeting of the American College of Nurse-Midwives was indeed an exciting gathering that resulted in an outpouring of enthusiasm from midwives, other women’s health experts, and our corporate partners alike. Two particular highlights for me were the purple bus advertisements for midwifery and the winning student video.

The ACNM Washington State Chapter was a fabulous local host group! To promote midwifery, the chapter worked with Titan Outdoors to design and purchase several large ad wraps, which were displayed on Seattle city buses. The women and babies featured on the ads are actual midwife clients.

The Why I Am Becoming a Midwife video contest had several excellent entries; the winning entry from the Columbia University students was truly inspirational.

Building on the momentum from the Seattle meeting, I’m already looking forward to the 55th Annual Meeting, which will take place in Washington, DC in June 2010. What an exciting time it will be to meet in the nation’s capitol. I encourage you to join me. As stated on the buttons distributed at the ACNM business meetings in Seattle, “I am a midwife—the future is in my hands.”