Baby, You're Home

Check out the almost entirely positive story on home birth in today's New York Times, accompanied by a lovely slideshow online (including the above photos). The article notes a growing home birth surge taking place:

...in 2006 home births accounted for only one-half of 1 percent of the city’s 125,506 reported births. But local midwives say they have been swamped with calls and requests in recent months, in some cases increasing their workload from two, three or four deliveries a month to as many as 10.

Of course, I would have loved if the reporter hadn't used loaded words like "grueling ordeal" and "traumatic" and lots of other fear-based language when the families involved seemed not to experience their births like that at all (note to the reporter: check your own preconceptions at the door & just observe/report, please). I wish the cover picture were a more joyful one - it's possible to mistakenly conclude that everyone in the picture is worried. I wish it hit harder on cesarean rates (and the fact that some hospitals hover around or above 50% instead of the already-deplorable national average of 33%) - and by the way, a cesarean is far more than a "procedure", it's major abdominal surgery. I wish the last part, about the AMA's stance, were not entitled "Playing It Safe". But overall, aside from the incongruity of the reporter's editorializing as compared to the facts and stories reported, it's good...

Blessings to all the families who shared their births for this article and to all those who read it and consider their options. When people see the beauty and simplicity that birth can be, especially at home, it is hard to go back to that place of fear and judgment. I hope that is true for many who read the NY Times piece.

help save birth center funding

OK - super bad timing, what with the economic bailout and all, but nonetheless...

TheBigPushForMidwives.org is asking people to help respond to a birth center Medicaid payment crisis...read on & help out by calling your Congress folks please.

American Association of Birth Centers
Legislative Alert


Payment Crisis Looming ~ Action Needed Immediately

We must get our message about the payment crisis out to Congress immediately and we need everyone to help!

Over the past few years, CMS (the federal agency that runs Medicaid/Medicare) has begun disallowing federal matching funds for state Medicaid payments for freestanding birth centers services. Birth centers have been recognized by CMS (and earlier, by HCFA) as a Medicaid provider type in State Medicaid Plans since 1987. Recently, however, CMS has disallowed such payment by several state Medicaid Agencies, including Alaska, South Carolina, Texas, and Washington State, claiming that it lacks clear statutory authority and direction to do so. CMS has directed its regional offices to stop federal payments to any state for birth center services.

This is not a Medicaid crisis but a payment crisis for birth centers. Historically all payers follow the lead of Medicaid. If Medicaid stops paying the birth center facility fee so will other insurers. We remind you of what happened to the chiropractors in the 1990s. They spent millions to reinstate their coverage.

Make Your Voice Heard - Act Now! 1. Find out who your Congressional Representatives and Senators are. Use these links
Find your Senators - http://www.senate.gov/general/contact_information/senators_cfm.cfm

Find your Representatives - http://www.house.gov/ - use the tool in the upper left hand corner

The American College of Nurse-Midwives also has a tool on their website - http://capwiz.com/acnm/dbq/officials/?lvl=C

2. Make contact - by phone is best (email boxes are clogged with email about the federal bailout of the banks).

Ask to speak to the legislative aide who works on health care issues.

Tell him/her you are a birth center ________ (midwife, owner, consumer, staff person) that provides care to women on Medicaid.

Use the linked flyer ("Pregnant Women's Access to Care Threatened") as a reference. http://www.birthcenters.org/files/file.php?id=13&file=file&file_type=file_type

Talking Points

1) CMS has stopped paying the facility fee/charges for birth centers in four states and will disallow it in all state plans that come up for review.

2) The federal government has been paying these fees to the states since 1987.

3) The only way to solve this problem is to seek legislation amending Medicaid.

4) Birth centers are part of the vital safety net, especially in rural and urban areas where obstetrical services are closing due to high costs--and many serve a high percentage of women on Medicaid.

5) Birth centers provide innovative approaches to maternity care that reduce disparities for low income and minority women, lower cesarean rates, and reduce health care costs, while increasing access to women on Medicaid.

6) Discuss how your birth center meets some of these needs in your area.

7) Follow the list on the flyer and discuss as many of those points as you want to cover.

8) For a bill, we need sponsors and co-sponsors. Ask if your Senator or Representative is willing to sponsor or co-sponsor the needed legislation to direct CMS to pay facility fees.
a. If they say YES, thank them and direct them to Karen Fennell,
our lobbyist at 301-830-3910 or karenfennell50@yahoo.com
b. If they say NO, ask them why not and give them Karen's contact
information.

9) Ask for their email so you can send a copy of the flyer "Pregnant Women's Access to Care Threatened". Let them know you will stay in touch with them about this issue, and that you will let them know once our bill has been introduced.

10) If they ask questions you cannot answer, tell them you will have Karen Fennell, our lobbyist contact them.
Follow-Up

1) Notify AABC's lobbyist - Karen Fennell - who you have contacted and where they stand on sponsorship. Also relay any questions from your visit so that Karen can follow-up. Cc: Jill Alliman, AABC's Legislative Chair, on your correspondence.
Karen Fennell's contact information:
Phone: 301-830-3910 ~ Email: kfennell50@yahoo.com

Jill Alliman's contact information:
Phone: 423-442-6624 ~ Email: jkalliman@yahoo.com

2) Send a thank you note, with the flyer "Pregnant Women's Access to Care Threatened". Let them know you will stay in touch with them about this issue, and that you will let them know once the bill has been introduced.



Do not delay. Take action today. It will be hard to be heard with the economic crisis in Congress this week. If enough of us call, they will hear us.

If you have questions about how to make these calls, please let me know.

Please forward this email to your lists.


Sincerely,

Jill Alliman, CNM, MSN

Legislative Chair
American Association of Birth Centers

white privilege

Two looks at race in America...different but related...again, I submit that birth & politics are intertwined. Well worth checking out.

from Empowering Birth Blog, & another post

And what if the transporting midwife is a woman of color and thus more likely to receive harassment in a hostile climate? Let's be real, it is easier for us white women to work within the system, even when faced with a sticky situation.

and

This Is Your Nation On White Privilege