ACNM Interviews CIMS' Birth Survey Team

The Coalition for Improving Maternity Services (CIMS) recently unveiled The Birth Survey Overall Results which offers ratings for mothers—by other mothers—on more than 9,500 providers and 2,300 birthing facilities across the US – all of which are accessible by expectant parents online at www.thebirthsurvey.com.

ACNM took a few moments to chat with Mayri Sagady Leslie, CNM, MSN, and Nasima Pfaffl, MA to discuss The Birth Survey and the history behind it.

In a 2009 ACNM Annual Meeting session, Leslie and Pfaffl will unveil detailed survey data that isn’t available anywhere else! They will present (Education Session #508) on Monday, May 25 at 12:30 p.m.

Q. What information is available on The Birth Survey (TBS)?
Nasima: The consumer reviews which were just released include …overall ratings and recommendations for birth facilities and care providers, and a seven-item set of questions on providers’ interpersonal and communication skills, state reported facility intervention rates, and information on finding good care.

Mayri: The information on TBS encourages families to be more informed consumers of health care. It promotes evidenced- based, quality maternity care that is consistent with the Mother-Friendly Childbirth Initiative model and increases both transparency and the public’s access to information.

Q: You mentioned that part of The Birth Survey project is a nationwide campaign to make facility-level intervention data available to the public. In which states is this information available?
Mayri: We now have [information] for facilities in ten states…We … just received intervention data from Maryland, our latest state! We also have links to data for facilities in VA, TX, AK, CA, FL, MA, NJ, NY, and UT. This kind of public reporting supports informed choice and fosters transparency, which has been shown to improve outcomes for mothers and babies. Check out http://www.thebirthsurvey.com/dev/Results/learn_start.shtml
to learn more about what data is available in your state and how to get involved with making this data more transparent in the other 80% of the US.


Q. How are you all promoting this new survey?

Mayri: CIMS itself is a coalition of many organizations throughout the country as well as professionals, advocates and families. Many of our own organizations have been extremely supportive along the way as TBS has grown, such as Lamaze International, Childbirth Connection, Birth Network National, Citizens for Midwifery, Choices in Childbirth, Midwives Alliance of North America, and of course the American College of Nurse-Midwives. But the real ‘miracle’ of the project, I think, is the grassroots nature of it.

Nasima: In the past year, we have trained more than 150 ambassadors to help spread the word about TBS in their local communities and to act as liaisons to their state departments of health to make available the facility-level intervention rates. This involves many dedicated individual grassroots activists and local level organizations who are promoting the project along with our national organizational supporters.


Q. How long did it take to make the consumer survey a reality?
Nasima: We have an amazing group of people who have worked countless hours over the last three years to develop and maintain TBS. We piloted in New York from 2007-2008. The survey launched nationally August 15, 2008 and the overall ratings results came online April 28. We have been training local-level ambassadors, spreading the word nationally about TBS, and fundraising. This progress is all the more amazing because we are a 100% volunteer powered group.

Q. Can’t consumers search Joint Commission or even state websites for this information? How is the Birth Survey different? What can a mother give or get?

Nasima: Much of the data collected by the Joint Commission or state agencies is not publicly available or very applicable to consumers when deciding where and with whom to birth. One such area is facility-level intervention data. A facility’s intervention rates directly impact a woman’s chance of experiencing an intervention- and she needs access to this information prior to choosing a birth setting. Women need access to this information to make more informed health care decisions.

Mayri: If you were selecting a car, you can look at consumer reports. But you cannot find a report that helps you, really tells you what you need to know when choosing where to have your baby in this country. And it’s critical to know intervention rates, because those rates are associated with complications for both mothers and babies. The two most important choices a mother makes in her pregnancy are what kind of provider they have and where they give birth. It’s so critical because mothers in US often make this choice blindly and some may have no choice at all. For the first time, women will be able to compare “apples to apples” in their town. And from the survey results, they can hear from other mothers what happened in their experiences and how they felt about their providers and places of birth.

Nasima: You’ll find other online reports that focus on quality and intervention rates for cardiac care and other health care, infection rates etc …but you just don’t find that many reports that touch on maternity care and none with the depth of TBS.

Q. In reviewing the feedback results, was there anything that surprised you? Any observations that would be of interest to CNMs and CMs?
Nasima: I saw in women’s free-text comments how women want a place to tell their birth stories and to have their voices heard. That was repeated over and over. I was surprised that of the women who had a c-section, 15% felt they were pressured into having a c-section.
For midwives, generally speaking, they are rated …highly on the overall ratings and on the specific interpersonal and communication skills questions. For more of a sneak peak of detailed results, visit our session at the ACNM conference.

Q. What’s next for The Birth Survey?
Nasima: In the summer of 2009, TBS will be adding free-text responses to the website. People love to read other people’s comments… so we are excited about this feature. And in 2010, detailed information on patients’ experiences with prenatal, labor, birth and postpartum care will be added to the website as searchable custom reports.

Q. How can midwives or their patients get more involved?
Nasima: We always need volunteers to help with the leadership, development, and maintenance of TBS. Also, many midwives around the country hand out our postcards to their clients. Midwives can access web buttons, banners, and cards at www.thebirthsurvey.com under “PR Materials.” Both midwives and the general public can get involved by taking one of our monthly ambassador training webinars [insert over webinars http://www.thebirthsurvey.com/Training.html } to become a local ambassador. Lastly, developing a good list of midwives is challenging. If midwives see that their contact information on TBS is out of date we would love for them to email updated information to admin@thebirthsurvey.com. This is critical to help expectant parents contact providers after researching on TBS.

Interested in learning more about The Birth Survey? Please visit www.thebirthsurvey.com where you will find more information, including promotional materials to share with clients (banner ads, postcards, etc) or email info@thebirthsurvey.com . Attending ACNM Annual Meeting? See Mayri and Nasima for Education Session #508—on Monday, May 25 at 12:30 p.m.

Health Care Ethics and Alcohol Advice

The Journal of Medical Ethics recently published an article entitled “You can’t handle the truth”; medical paternalism and prenatal alcohol use.” The article explores what advice health care professionals should communicate to pregnant women about alcohol consumption. Author Collin Gavaghan proposes that a total abstinence policy displays “scant regard for the autonomy of pregnant and prospectively pregnant women.” American midwives and women, what do you think about this UK study?

Midwives are Women’s Health Heroes

Out of nearly 100 nominees from 12 countries, the midwives of Fair Haven Community Health Center Midwifery Group won OBOS Pick for the 2009 Our Bodies, Ourselves Women’s Health Heroes Awards. These midwives have invested decades of dedication and care in the lives of countless women. Check out their nomination video here:



Don’t forget to be your own women’s health hero by celebrating National Women’s Health Week. From May 10 to 26, events are being held online and around the country to help you make your health a top priority.

South Coast Midwifery is on YouTube

A two-part YouTube series from South Coast Midwifery presents a modern account of natural childbirth and chronicles the experiences of ten mothers. Give the videos a five-star rating on YouTube to help South Coast Midwifery win the Birth Matters video contest.

Seattle, Here We Come!

It’s time for midwives and their fans to start getting excited about the ACNM 54th Annual Meeting & Exposition. This special annual event is geared toward midwives and other women’s health experts, but also includes free activities for anyone interested in midwifery and women’s health. Here’s what you can look forward to:

Become a Midwife Forum
If you’re interested in a career in women’s health, visit the Washington State Convention & Trade Center for a free, interactive career event on Saturday, May 23, noon – 3 pm. Meet practicing midwives, interact with student midwives, and experiment with birth simulators, pelvic models, and more.


Celebrate Midwifery Party
If you already went to midwifery school, show your school spirit at the Celebrate Midwifery Party, Monday, May 25, 8 pm – midnight. The school that shows the most spirit will win a free student registration to the 55th ACNM Annual Meeting in Washington, DC. Start celebrating now by submitting song requests to ylandon@acnm.org. Include your name, school, and requested song. You may also dedicate the song to a particular person or class.
This event is open to registered meeting attendees only.


Tuesday Night at the Movies
Come to the Sheraton Seattle Hotel, Metropolitan Ballroom A, Tuesday, May 26, 7:30 pm – 10:30 pm for free admission to two pregnancy and birth films: Home Delivery and Laboring Under an Illusion: Portrayal of Childbirth in the Mass Media.

Happy National Nurses Week!

As part of National Nurses Week, certified nurse-midwife Ruth Lubic was on TV plugging birth centers and midwifery on Washington, DC's News Channel 8. Check it out!

Swine Flu Update from ACNM

by guest blogger Robbie Prepas, CNM, JD
Chair of the ACNM All Hazards Preparedness Committee

Pregnant women have a higher risk for developing complications from the flu than do non-pregnant women of childbearing age. ACNM is alerting all midwives to provide counseling and education to pregnant women and their families about swine flu precautions and optimal care for pregnant women with flu-like symptoms.

Resources for Midwives
Please refer to the ACNM Web site for links to information from the CDC, specifically "Interim Guidance - Pregnant Women and Swine Influenza: Considerations for Clinicians," along with other excellent resources for midwives. It is important to disseminate information at your practice sites and throughout your communities about the optimal strategies for caring for pregnant women with flu symptoms, as well as alternative sites for perinatal care in the event of a pandemic. Please assist us in spreading the word about the importance of advance planning as this situation with swine flu unfolds.

Information for Women
Visit mymidwife.org for steps you can take to reduce your chance of being exposed to flu. Stay tuned to Share with Women for special information for consumers from the Journal of Midwifery & Women’s Health.

Happy International Day of the Midwife!

At ACNM, we're participating in a 24-hour virtual celebration of International Day of the Midwife. Join in the celebration by creating a word collage about midwifery at wordle.net, and post the link to your creation in a comment to this blog post.