2013:
The consumers in Arizona worked REALLY hard and through the legislative process to update the rules and regulations that govern home birth. A Midwifery Scope of Practice advisory committee and the Arizona Department of Health Services worked together for countless hours to revise the rules and regulations governing Licensed Midwives. The rules were finalized in July of 2013. Because of those revisions to the rules, home birth midwives are able to attend VBACs, starting July of 2014. HERE are the revised statutes as they stand today.
2014 Update:
Senate Bill 1157 (SB1157) was dropped in January 2014. If passed as proposed, it would make it a prohibited practice from here forward for midwives to attend VBAC (new practice under revised rules & regs), breech (midwives have always been able to do with doctor consultation), and multiples (midwives are not currently able to do anyway). It also seeks to influence the way in which midwifery rules are revised to make them even more onerous to change in the future.
My initial reaction left me with an incredible headache and heartache. We did not spend hours organizing and following due process to have a “little language change” affect the rights for home birth that were achieved with respectful dialogue and thoughtful consideration. After sleeping on it, I got involved and started writing letters and making phone calls yesterday.
As consumers of healthcare, we must ALL speak up for our right to self-determination. I encourage you to get involved. If you are willing to take a stand with us, please scroll down to find the contact information for the representatives we are seeking to respectfully influence. The key words are To Be Respectful. We want to add to the dialogue and present ourselves as the informed, albeit passionate, people that we are.
Here is the body of the letters that I wrote to the sponsors of the bill, as well as to the State Senate Health & Human Services committee members:
SB 1157 is taking away our freedom to access the healthcare provider of our choice. Our options as consumers of healthcare are being limited. This bill will eliminate access that was deemed safe and effective by Director Humble and the Midwifery Scope of Practice committee after many hours of testimony and a thorough evaluation of the most current scientific reviews of evidence-based maternal healthcare.
The right to self-determination is exactly what the women of Arizona spoke up for when it comes to our right to birth at home. Two years ago, we, the people, organized a position statement, the process of law ruled, and the Midwifery Scope of Practice Committee was formed. Director Humble presided over open, transparent government proceedings and listened to hours of testimony, evidence and the voice of the people. The committee thoughtfully considered all the evidence and revised the scope of practice. They agree that in most situations, we the consumers, have the right to choose our provider, and we can choose a hospital, a birth center or the privacy of our home.
As a consumer, I, and others like me, are seeking alternatives to “modern medicine”. One reason is because forty-seven countries do a better job at keeping women and children alive in childbirth than we do. Home birth in the USA accounts for less than 1% of the national statistic when it comes to maternal care. Midwifery care is not responsible for the deplorable state of the maternal health care system. We will not “lay down” any more. We will use our voices and be heard. The bill to limit our choices as an “emergency measure” is the government entering our homes, our lives, and limiting our freedoms once again.
You may be thinking, “This is just a very vocal minority of passionate women”. As one consumer wrote, “Even if we are a minority, our country and the government [were] designed in order to protect the rights of the minority against tyranny from the majority. The majority of women may want to march in and out of hospitals, but that doesn’t mean that I, as a part of the minority, should be cattle-prodded into the hospital machine against my informed decisions.”
Please do not limit our choices, our right to choose our provider. We are intelligent, college-educated women choosing home birth. There is nothing “lay” about midwives in Arizona as a whole. Midwives in Arizona are required to sit for a national licensing test – we are making the informed decision and choosing trained, professional providers.
Please re-consider your position on SB 1157. This bill is eliminating access to safe and effective health care for families that want to birth at home. All Arizona families, women and infants deserve equal rights wherever they choose to birth.
Respectfully,
Krystyna Bowman
Chandler, AZ
Note: to the committee members I wrote “Please vote NO on SB 1157,” instead of, “Please re-consider your position on SB 1157. ”
List of research on home birth:
http://www.mana.org/research/section-a-best-available-studies-grouped-by-design-level-of-evidence
Maternal Mortality Rates:
https://www.cia.gov/library/publications/the-world-factbook/rankorder/2223rank.html
Home birth in the USA:
http://www.cdc.gov/nchs/data/databriefs/db84.htm
How to get involved: Call, Write, Fax, Tweet!! Thank you for your help – we appreciate you adding your voice to our concerns.
Find your state legislators and tell them you oppose SB 1157:
http://www.azleg.gov/alisStaticPages/HowToContactMember.asp
SB 1157 sponsors:
Senators
Dr. Kelli Ward
Republican – District 5
1700 W. Washington
Room 306
Phoenix, AZ 85007
Phone Number: (602) 926-4138
Fax Number: (602) 417-3165
kward@azleg.gov
John McComish
Republican – District 20
1700 W. Washington
Room 307
Phoenix, AZ 85007
Phone Number: (602) 926-5898
Fax Number: (602) 417-3020
jmccomish@azleg.gov
Representatives
Eric Meyer
Democrat – District 11
House of Representatives
1700 W. Washington
Room 121
Phoenix, AZ 85007
Phone Number: (602) 926-3037
Fax Number: (602) 417-3111
emeyer@azleg.gov
David W. Stevens
Republican – District 25
House of Representatives
1700 W. Washington
Room 312
Phoenix, AZ 85007
Phone Number: (602) 926-4321
Fax Number: (602) 417-3146
dstevens@azleg.gov
David Livingston
Republican – District 22
House of Representatives
1700 W. Washington
Room 341
Phoenix, AZ 85007
Phone Number: (602) 926-4178
Fax Number: (602) 417-3154
dlivingston@azleg.gov
TWITTER:
The sponsors of SB1157 can be reached on Twitter at
@kelliwardaz
@JohnMcComish
@DrEricMeyer
@LivingstonLD22
Health & Human Services Committee:
Nancy Barto – Chairman
Republican – 15
1700 W. Washington
Room 307
Phoenix, AZ 85007
602-926-5766
nbarto@azleg.gov
Kelli Ward – Vice-Chairman
(see info listed above)
Ed Ableser
Democrat – District 26
1700 W. Washington
Room 303A
Phoenix, AZ 85007
602-926-4118
eableser@azleg.gov
David Bradley Democrat – 10
1700 W. Washington
Room 313
Phoenix, AZ 85007
602- 926-5262
dbradley@azleg.gov
Katie Hobbs
Democrat – 24
1700 W. Washington
Room 308
Phoenix, AZ 85007
602- 926-5325
khobbs@azleg.gov
Judy Burges
Republican – 22
1700 W. Washington
Room 302
Phoenix, AZ 8500
602- 926-5861
jburges@azleg.gov
Kimberly Yee
Republican – 20
1700 W. Washington
Room 302
Phoenix, AZ 85007
602- 926-3024
kyee@azleg.gov
You summed it up nicely. I hope they hear us.
Thank you, Michelle – I am thankful for your feedback. It will take a lot of us – all the raindrops gather together and eventually turn into a waterfall. We did it before, we will do it again…and again…until the culture around birth embraces that birth is…Birth <3
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I think some important issues are still very confusing on this bill and the whole topic. For one, I think it is important that there be a way to clarify definitions to the public. For example, it is very confusing for the mother-to-be that is not in the medical profession to know what the difference is between a Licensed Midwife and a Certified Midwife. The differences are very profound. This in an of itself I think should be addressed.
A mother who wants to deliver at home should have every right to do so. However, if the mother has very clear high risk factors, it could be devastating to attempt a home birth without a medical professional. There are amazing licensed midwives out there but we need to remember that they are not medical professionals and this could open the door to devastating outcomes.
As a point to keep in mind, no doctor or Certified Nurse Midwife would attempt to deliver high risk deliveries outside the hospital environment. This is because of evidenced based research that shows that both mom and baby are at a substantial risk in these scenarios.
Mother want the perfect birth and to have as little medical intervention as possible. And ideally, that is what they will be able to have in a home birth. But at the end of the day, the MOST important thing is the outcome…. healthy mom and healthy baby. This bill was unfortunately dropped. It did not put any type of permanent ban on the scope of practice for Licensed / Lay midwifes, it only postponed the practice of delivering HIGH RISK births at home UNTIL research on the safety of the practice could be established.
Thanks for your thoughtful comments, Sharon. I agree that a Healthy Mom, Healthy Baby is the top priority in every birth scenario, regardless of location. I believe that we can honor the midwives that are qualified, professional, and motivated from a perspective of helping families have healthy births. I would like to think that if a family risked-out due to certain factors, the honorable midwife would recognize the limits of what can be done safely at home and transfer the care of the patient with respect and in such a way that the patient is still treated with dignity.
I completely agree, honorable midwives would be able to recognize the safety issues here. But the bill only puts limits on these high risk situations, so why would we not want to put that safeguard in place until we really have time to assess how risky this is. Mostly I wanted to clarify the statement above, that this bill was not to change lay midwifes scope of practice “from here forward” It actually just proposed a halt to high risk only deliveries until a sufficient amount of data could be gathered to actually know the risks.
But for the record, I think that moms should be able to birth where they feel comfortable. Birth isn’t an illness so it shouldn’t be treated as one. But if there is a serious health risk, they need to be responsible and know that safety and getting a healthy baby delivered is more important than where& how they deliver. 🙂
In the end we all want the same thing, happy and healthy moms and babies. As a labor and delivery nurse, I just know how devastating it can be when things don’t go well, especially when they could have been prevented with the right resources & care
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