Archive for July, 2010

URGENT–Midwifery Bill Action Alert UPDATE—It’s working, now keep calling!!!

Mass Midwifery Supporters–you ROCK!!!

Thanks to your calls, Rep. Spiliotis has lifted her hold on the Midwifery Bill!

Against all the odds, the bill is on the move again and headed toward the finish line at the eleventh hour, so KEEP THE CALLS TO THE SPEAKER’S OFFICE COMING.  If you have the time, please forward this message to all of your family and friends here in the Commonwealth, asking them to reach out, too!

Call, email, or fax the Speaker and the State House today (Saturday) in support of the Midwifery Bill, House 4180. The legislature is still in session so please keep the calls coming!!!

Speaker DeLeo’s number is:
Telephone: 617-722-2500
Facsimile: 617-722-2008
E-Mail: Robert.DeLeo@state.ma.us

Even if you’re not a constituent, please call him as he serves as Speaker for the State and is responsible to all residents of the Commonwealth.

Please keep the phones lit and keep spreading the word!!!

Thanks so much for your continued support!!!  We’re almost there!!!

Ann Sweeney
Mass Friends of Midwives (MFOM)
www.mfom.org
617-901-2777-c

29 July 2010 at 7:58 pm 1 comment

More good news: “Mum’s kiss” protects newborns

Those New Zealanders–they come up with all the cool ideas!

–Christina

29 July 2010 at 10:21 am Leave a comment

URGENT Action Alert: Please post to all lists!!!

Dear Midwifery Supporters,

Good news!!!  We are steps away from getting the midwifery bill—that so many of us have worked on for so long—passed this legislative session, which ends THIS SATURDAY, 31 July.

Even if you have already done so, please call and/or email your OWN Mass Rep. and Senator today, tomorrow, or day you can this week, and ask your own representative to reach out to Speaker DeLeo, asking him to bring the bill to the House floor for a vote and to help the bill pass THIS SESSION. Note that the bill is now known as House 4810:  An Act Relative to Certified Professional Midwives and Enhancing the Practice of Nurse-Midwives.

Who’s your rep?  You can find them at the following link: http://www.wheredoivotema.com/bal/myelectioninfo.php

Text of the bill can be found at the following link:  http://www.mass.gov/legis/bills/house/186/ht04/ht04810.htm

Thank you again to the whole coalition for all of your excellent work.  We could not have come this far without everyone’s expertise, experience, passion, and all the good work you are already doing to address this critical issue.

Keep the pressure on!!!

Best,

Ann Sweeney
MFOM
617-901-2777

P.S.  We’ve recently heard that there is a surprising amount of misinformation about the midwifery bill among many representatives, especially regarding the items below, so please share/forward this email to your representatives or their staffers who might help correct the record for other Representatives.

1.       The Mass Medical Society strongly objects to CNMs functioning without direct MD supervision, yet has articulated no sound basis for this objection. Nationally, ACOG already supports the elimination of direct supervision of CNMs by physicians, acknowledging that it is not required for safe practice, and 44 other states no longer have such requirements. This requirement is the reason full-scope CNM services are not now accessible in high-need Massachusetts communities such as Lawrence and Worcester. Requiring such supervision creates excessive and unnecessary liability for physicians, so it is even more puzzling to witness the continued opposition of the Massachusetts ACOG chapter to this feature of the bill.

2.       Some legislators have been led to believe that the bill would provide new prescription writing privileges for nurse-midwives, when this is not really the case. Nurse-midwives already have prescription writing privileges but can now exercise these privileges only if an MD is technically providing supervision, which amounts merely to a review of sample prescriptions on a quarterly basis. Because of hospital accrediting rules, this clause prevents CNMs from admitting patients in labor under the midwives’ own names, prevents them from serving on hospital committees which determine maternity care policies, and bars them from any control of their own practice environment. This undermines the ability of CNMs to provide the most effective care. (By the way, CNMs already have independent prescription authority in most other states, for example: NM, NH, WA, AK, OR, and the District of Columbia.)

3.       Although the legislation has already been rewritten to accommodate concerns about the age at which a midwife could begin training (it was changed from 18 years to 21 years), legislators are still being misled about this fact. (There are, by the way, no such age requirements that we have been able to find in the Massachusetts statutes with respect to the education of nurses.)

4.       Another objection is that the bill does not require a midwife to carry malpractice insurance. In almost all states, malpractice insurance is not required by statute, and it would be unfair to single out one professional group in this regard. Some would argue that such a requirement would violate equal protection clauses. Because the ‘risk pool’ of homebirth midwives across the country is small, malpractice insurance has never been available for homebirth midwives, despite the concerted efforts of national and local organizations over several decades. Requiring CPMs to adhere to a standard that is impossible is another mechanism to restrain trade and prevent access to home birth midwives. Childbearing women who want to be protected by malpractice insurance have the option of delivery in facilities, where such insurance coverage is required.  Moreover, the Massachusetts legislature could, like a few other states, make disclosure of this absence of malpractice insurance coverage part of a required informed consent procedure. The malpractice insurance issue is NOT a credible objection to this bill.

27 July 2010 at 12:17 pm Leave a comment

Nice comment on nursing a toddler in public

I was on the T the other day, and my almost two-year-old son wanted to nurse. He’s a pretty energetic, always-on-the-go kid, so basically I think he figures that if we’re on the T and we have to be sitting down, well, heck, he’s there, the breast is there, so he might as well.

This was the Orange Line, midday but still crowded near downtown, and I had a large man with headphones at my left and an older woman on my right. The older woman had already smiled at Marcus when we entered and he was on my back, and then again when I took him down and sat him on my lap. Then, Marcus was nursing with his head toward her, but I was wearing a nursing top with empire-style openings so there really wasn’t any skin showing. She kind of looked over at him at that point, and then looked closer, and said, “Ah!” when she figured out what he was doing.

“How old?” she asked me.

“Almost two,” I said.

Very good,” she said, “very good!”

We went on to have a nice conversation–she told me she’s from Eithiopia, she nursed all her babies as long as she could, until they stopped on their own or she got pregnant again, or both, but that her daughter, living here, only used bottles and she didn’t think anyone did things “the old way” anymore.

That was absolutely the encounter I needed this week!

–Christina

26 July 2010 at 9:41 am 4 comments

On more positive notes–rinse with carbs for extra energy in labor??

After Monday’s NYTimes article about the flawed home birth study, I leave you with more positive news: This article, about using a carbohydrate-based mouthwash as a rinse (not swallowed) to provide athletes with an added boost of energy seems potentially huge to me. The study looked at athletes “in intense bouts of exercise, lasting an hour or so,” which sounds a lot like the pushing phase of labor. Though many home birth midwives encourage women to eat and drink during labor, some feel nauseated and unable to keep anything down; furthermore, the article explains, “when blood is diverted from the stomach to working muscles during intense exercise, drinks or foods cause stomach cramps,” which is the last thing you want during hard labor.

“‘You can get an advantage from tricking your brain,’ said a discoverer of the effect, Matt Bridge, a senior lecturer in coaching and sports science at the University of Birmingham in England. ‘Your brain tells your body, “Carbohydrates are on the way.”  And with that message, muscles and nerves are prompted to work harder and longer.’

“It’s a relatively small effect, said George A. Brooks, an exercise researcher at the University of California, Berkeley, who was not involved with the research. But a small difference, he added, ‘can make a big difference. . . .’”

Wow!

–Christina

24 July 2010 at 5:24 pm Leave a comment

“His methodology is deeply flawed”–new study on home birth

The New York Times, under the headline “Home Birth May Add a Wrinkle,” today describes a new study on home birth that claims it’s more dangerous for babies.

Despite that terrifying lead-in, the article notes that even “the lead author, urged caution in interpreting the results. ‘Since this comes primarily from non-U.S. data sources, particularly from places that have a very different midwifery model than we do, it’s limited,’ he said.”

That alone should be cause for concern; midwives quoted in the article raise further skepticism about its conclusions, however:

“Mary Lawlor, president of the National Association of Certified Professional Midwives, found the study defective. ‘His methodology is deeply flawed,’ she wrote in an e-mail message, accusing the authors of ‘obscuring important information about the safety of home birth and neonatal outcomes.’”

–Christina

19 July 2010 at 5:11 pm Leave a comment

Slowly, slowly, slowly weaning a toddler

My son is twenty-three months old and still nurses a lot–before bed and naps, in the morning, 2-6+ times a night, and 2-10+ times a day. It’s so funny trying to even come up with these numbers, because his nursing is so dependent on a number of variables–the only constant, again, is that he does nurse a lot: if he only nurses twice in the day because we’re out and about and he’s busy, then he nurses all night long, and vice versa. If he sees me in the bathtub, he climbs in with me and nurses there (he usually holds a naked baby doll in the tub, so we’re this happy confusion of mama and baby and baby and milk and water). If he sees me sitting at my computer in the dining room in the afternoon, he climbs on my lap and nurses there.

I know a number of women who have nursed past age two, but many say they only breastfeed morning and night. Others say they told their child that the milk stays in the house–in other words, they stopped breastfeeding in public. It’s true that societal pressure to stop ramps up wildly at this age, but I feel like breastfeeding–now that my son really knows what it is–is all the sweeter, and neither he nor I want to stop anytime soon.

In May, though, I stoppped pumping at work–I was down to just one pump a day, and I slowly weaned myself off that. Now, when I work (three days a week) I can make it through the day without being uncomfortable or engorged.

This month, in response to my husband’s perpetual “how long are you going to do that for?” exasperated comments, I decided I would adopt a “don’t-offer-don’t-refuse” technique when out of the house, so, barring scraped knees or tantrums, I’ve been trying not to offer the breast. At home, sure, but out, I figure I won’t refuse if he asks, but I won’t offer it.

Here’s the humorous part: Up until now, my son has never had a word or a sign for nursing. In retrospect, I realize that’s because he never needed one–even when we were out, I always just popped out a breast at a whimper or peep or even a frown. In the last week, though, my creative son developed a way to ask, quite clearly, for the breast: He opens his mouth into the nursing position and lets his lower jaw drop as though he’s swallowing, and vocalizes, so what comes out is a (not quiet) “wuh-wuh-wuh-wuh-wuh-wuh-wuh-wuh.” He continues the sound until he’s actually latched on, and he does this while sitting on my lap (climbing up if necessary) and facing the breast.

So yeah, so much for the first tentative tiny steps toward weaning my toddler. I’m pretty pleased with the way this has worked out, actually–it’s pretty cute, and makes me laugh every time. Plus, it’s so much more obvious that we’re nursing in public that my husband now rolls his eyes at us and has stopped making comments!

–Christina

17 July 2010 at 12:58 pm 2 comments

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