---------- Forwarded message ----------
From: Mary Ueland <better_birth@...>
Date: Aug 23, 2007 4:27 PM


Midwifery supporters join Attorney General's Office and file appeal to
Missouri Supreme Court on midwifery law (Jefferson City, Mo.) – Missouri's
midwifery supporters today joined with the Office of the Missouri Attorney
General to file an appeal to the Missouri Supreme Court in order to
reconsider the permanent injunction on the state's new midwifery law. The
coalition of Missouri homebirth families and their midwives said they are
mobilizing for the appeals process and praised the actions of Attorney
General Jay Nixon's office.

"Our members very much appreciate the decision of the Attorney General to
appeal this injunction to the Supreme Court," said Mary Ueland, Grassroots
Coordinator for the Friends of Missouri Midwives. "We are hopeful that the
Supreme Court will reverse this unfortunate judicial ruling, and
Missouriwill at long last decriminalize the practice of Certified
Professional
Midwifery, doing away with the threat of felony charges and seven years in
prison for practicing midwifery."

On August 8 Circuit Court Judge Patricia Joyce 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.

Assistant Attorney General John K. McManus and Midwifery Coalition attorney
Jim Deutsch argued in circuit court less than one month ago that
decriminalizing midwifery does indeed relate to health insurance, recalling
that the Missouri Supreme Court has already ruled health insurance is
interdependent on health services, and the two subjects are related. Deutsch
cited nine other states where Medicaid covers homebirths 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 homebirth
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.

Allan Schwarb, father to five children born at home and a Boeing employee,
is glad for the news of the appeal. "The judge was wrong to decide that
legal midwifery is not part of access to health insurance," he said. "While
safety is the number one reason my wife and I chose homebirths, money is
also a factor. While living in other states where midwifery is a legally
recognized healthcare profession, our care was covered by my Boeing
insurance with $5 co-pays. But when we relocated to Missouri, we discovered
that since midwives are felons here my insurance was useless."

Jessica Mattingly is a Blue Springs, MO mother due in September who wanted
the midwifery law to stand as she had hoped to use a Certified Professional
Midwife to deliver her baby. She cites skyrocketing c-section rates as one
of the primary reasons that mothers like her are looking for alternatives.
"Right now, if you are a pregnant woman delivering at a hospital, you have a
1 in 3 chance that you will come out of that hospital having had major
abdominal surgery. Beyond the additional risks for mothers and babies that
c-sections create, what does a c-section rate of more than 30 percent do to
our insurance rates, and how reliant are doctors and hospitals on these
increasing revenues?"

The decision to go to the Supreme Court is also strongly supported by Laurel
Smith, President of Friends of Missouri Midwives. "Physicians' groups don't
seem to realize that families today are not willing to suffer on the
battlefield of their turf wars," she said. "The days of medical groups
pouring money in to ensure that other health professionals cannot perform
services for which they are trained are coming to an end."

Ueland agreed with the notion that organized medicine's misuse of "Scope of
Practice" laws impairs healthcare access and increases costs to consumers,
especially those who reside in rural areas or who are disadvantaged. "
Missouri families who want safe, healthy, and economical healthcare have
long been frustrated by the choke-hold that organized medicine has
maintained on childbirth in our state. At a time when the majority of the
country – and the world – allow midwives to practice as professionals rather
than felons, Missouri is strangely out of step with the rest of civilized
society."

She added that people move to Missouri from states like California, Florida,
or Tennessee where Certified Professional Midwives are in the Yellow Pages
and ask her what the problem is with Missouri and midwives.

"The root problem is tough to pinpoint. One could criticize the state
legislature for cowering to the threats of organized medicine for several
decades so that they never passed midwifery legislation before now," Ueland
said. "Or one could make a fairly compelling argument that Judge Joyce's
service on the Board of Directors for St. Mary's Health Center in Jefferson
City is a mighty conflict of interest given her ruling on the case. But
instead of focusing on this water under the bridge, we are looking forward
to having the Supreme Court recognize not only the constitutionality of the
midwifery provision, but also the value of midwives to the public good and
their significant contributions to more consumer choice, increased
healthcare access and decreased costs within a top-tier healthcare system."

As national attention to the Missouri midwifery case grows, midwifery
supporters from across the country are getting involved to show their
support of the Supreme Court appeal. A recent study on direct-entry
midwifery prepared by the Georgia legislature reported that, "When a state
has an underground network of healthcare providers, it has a responsibility
to deal with the problem through regulation rather than prosecution."

Ueland said she agrees with the Georgia study and that the time is now for
Missouri to deal with midwifery and decriminalize the profession. "We are
hopeful the Supreme Court will rule that legal access to midwives relates to
access to health insurance. And with this ruling that will decriminalize
Certified Professional Midwives and remove the threat of prosecution,
Missouri finally will join the 40 other states where professional midwives
are allowed to assist homebirth families."

*The Certified Professional Midwifery defendants and midwifery supporters
who are listed on the appeal to the **Missouri** Supreme Court include:***
· *Friends of **Missouri** Midwives (FoMM).* A nonprofit
organization representing the interests of Missouri families who choose to
have safe, alternative, out-of-hospital childbirth options. FoMM was created
to support, promote and protect the rights of Missouri families to make
choices about how, where, and with whom their babies will be born and to
promote access to the midwifery model of care. **
· *Kelly & Dallion Rehm, and Eric & Jessica Kerr**.* Two families
expecting babies to be born after August 28th, the day the new law was to
take effect. They were planning home births with legal, well-trained CPM's.
Now the new law has been struck down, they will have to choose between
breaking the law, birthing at home without a trained attendant or the
expense and interventions of a hospital birth.* *
· *Columbia** **Community** **Birth** **Center**, Kim James, CPM;
Ivy White, CPM; and Dr. **Elizabeth** Allemann, MD.* Columbia Community
Birth Center is the only licensed birth center in the state of Missouri. The
Center is a place where families give birth in a comfortable home-like
setting. James and White received their CPM credentials in 1995. Dr.
Elizabeth Allemann is Medical Director of the birth center.**
** · *Missouri** Midwives Association.* An organization dedicated to
promotion, protection, support and education for midwives in Missouri.
**
* *
DEFINITIONS AND Resources:
The Midwives Model of Care is based on the fact that pregnancy and birth are
normal life processes.
The Midwives Model of Care includes:

- Monitoring the physical, psychological, and social well-being of the
mother throughout the childbearing cycle
- Providing the mother with individualized education, counseling, and
prenatal care, continuous hands-on assistance during labor and delivery,
and
postpartum support
- Minimizing technological interventions
- Identifying and referring women who require obstetrical attention

The application of this woman-centered model of care has been proven to
reduce the incidence of birth injury, trauma, and cesarean section.
*Copyright (c) 1996-2007, Midwifery Task Force | All Rights Reserved*


Friends of Missouri Midwives:
www.friendsofMOmidwives.org<http://www.friendsofmomidwives.org/>

Missouri Midwives Association:
www.missourimidwivesassociation.org
Show-Me Freedom in Healthcare: www.showmefreedompac.org
Free the Midwives:
www.freethemidwives.org
Citizens for Midwifery: www.cfmidwifery.org

Midwives Alliance of North America: www.mana.org
North American Registry of Midwives: www.narm.org
American Public Health Association: www.apha.org
Columbia Community Birth Center:
www.birthcolumbia.org<http://../Documents%20and%20Settings/Red%20Quill/Local%20S\
ettings/Documents%20and%20Settings/Red%20Quill/Local%20Settings/Documents%20and%\
20Settings/Red%20Quill/Local%20Settings/Temporary%20Internet%20Files/Local%20Set\
tings/Temp/www.birthcolumbia.org>
Film: "The Business of Being Born: www.thebusinessofbeingborn.com
World Health Organization: www.who.org – The World
Health Organization says this about the controversy facing Missouri:
"Available
evidence indicates that midwifery care results in equal outcomes of care,
with some advantages accruing from midwife care, most notably a lower
frequency of interventions and enhanced maternal satisfaction. Therefore,
the evidence is strong that antenatal care by midwives and doctors results
in equivalent medical outcomes." (Dec. 2003)

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