M.A.M.A. – The Midwives and Mothers in Action Campaign has been working diligently for sometime for federal recognition of certified professional midwives (CPM) both so women’s access to the care they provide can be increased, and so that CPMs can be reimbursed for the care they give through Medicaid and other federal health insurance programs. In January 2011, a bill proposing such recognition will be introduced in the House of Representatives. This is great news for women nationwide, and is especially good for those of us living in rural areas that have been traditionally served by midwives.
Why is this news so good for us? A certified professional midwife is a fully trained, independent practitioner certifed by the North American Registry of Midwives. They have met the certification requirements and professional standards needed to provide high quality maternal care in the setting that the mother chooses. This means that mother can give birth in her home, in a birth center, or in a hospital and be cared for by a CPM. This is great for areas such as southeastern Kentucky where choices in birth location are limited and if you would like to give birth at home it could be difficult to find a midwife who will attend. Having low-risk women being attended by a CPM in their homes or in established birth centers and hospitals around the region would mean more convenient access to high quality prenatal care, less time for travel to both prenatal visits and the location where you will give birth, and more choices in where and how you will give birth. It is awesome news for low-income women as well, if the bill is passed through Congress and made into law, because it would increase their access to this option for their care and save them out of pocket expenses of travel, missing entire days of work, and the hassle of finding childcare for your firstborns or having them tag along to visits with you far distances for appointments. It saves money!
If Congress passes this bill into law, CPMs could then have the possibility of being licensed to practice in states that don’t already do so. This will mean easier relationships between the midwives and obstetricians who would give them back-up in case of emergencies. Developed partnerships makes the transfer process from home or birth center to the hospital less stressful for both mother and the midwife if the need should arise. This working relationship would also mean that women would have the option of visiting the back-up obstetrician during prenatal appointments should the midwife have any concerns without having to completely transfer care to the doctor. The doctor and the midwife can work together then to assure that the mother is a good candidate for homebirth or birth center. This kind of opportunity makes birth safer for everyone. It could also result in decreased costs in maternity care overall for midwives and obstetricians alike, who currently pay outrageous amounts for malpractice insurance, which translates into higher costs for us.
Studies have shown that under midwifery care women tend to experience fewer medical interventions than those who give birth in the hospital attended by a physician. By decreasing the use of “routine” medical interventions the risk of poor outcomes for mother and baby is also decreased. Not only this, but it equates in decreased cost to the mother, insurance providers, and the government/taxpayer in Medicaid payouts. Better overall outcomes and fewer interventions could also result in decreased costs in maternity care overall for midwives and obstetricians alike, who currently pay outrageous amounts for malpractice insurance, which translates into higher costs for us. A study published in the British Medical Journal verifies the safety of homebirth and midwifery care and states that only 1.7% of the mothers in the study would choose a different type of caregiver for future births. This means not only did the mothers and their babies reap all the benefits of midwifery care, but they did not have to sacrifice any of their satisfaction.
Southeastern Kentucky would greatly benefit from the increased presence of certified professional midwives. It is not uncommon for women to travel and hour or more to prenatal visits and the hospital where they will give birth. CPMs could open birth centers in the communities where there isn’t a hospital as well as attending homebirths. It is obvious that in making prenatal care more convenient it will increase the number of mothers who are able to obtain quality prenatal care. With an increase of mothers receiving this care, we will also see decreases in health risks to mothers and babies that are not uncommon in our state today – prematurity, smoking in pregnancy, low birth weight babies, pre-eclampsia (read about Kentucky at the bottom of this report), and drug addiction. Midwives achieve these results through diligent attention given to the whole health of the mother – physical, mental/emotional, and environmental. They pay close attention to detail recognizing red flags that would alert them to problems with the pregnancy or birth many times long before test results are in. If a midwife recognizes that the mother requires the care of an obstetric physician, care is transfered. It is not uncommon for a visit with a certified professional midwife to last 45 minutes to one hour. There is no question that there isn’t time for. The average visit with an obstetric physician lasts 6 minutes.
I am one mother who will make sure that my voice is heard when this bill reaches Congress in January. I chose to have my prenatal care and birth with a certified professional midwife during my second pregnancy, and was more than happy with the care I received. I know that there are awesome caregivers of all types in this country, but because of my personal experience with CPMs and the reasons I mentioned above, I feel like we need to see more of their presence for the increased health of mothers and babies across the United States. Please, make your voice heard as well. Sign up at the M.A.M.A website to receive updates on the progress via email, and contact your legislators when time comes. You may also donate to the cause that the website as well.
Many happy days to you and yours,