It was a big day

Phew, 7pm and I’m exhausted.  Here’s a summary of my activities today:

The twins – yes, I said twins, look good.  I’m not quite as far along (only by a couple of days) as I would have thought, and this is an agonizing alteration to my pregnancy “schedule.”  What I mean is that as a loss momma, that last thing I want to be doing is backing up in time… adding MORE time into the 1st trimester.

Both babies are measuring about the same size.  Both babies’ heartbeats were easily detected and measured right around 130 which is good for 6 weeks 4 days or so.  We were so thankful to see those sweet flickers again.

My husband and I found out definitively about the twins about a week ago.  A nurse at the RE’s office recommended a scan because my HCG numbers doubled too quickly.  At about 5-1/2 or 6 weeks we were able to see two sacs and even visualize the heartbeats for both babies.  I call them my little flickers.

Health Reform:  I was thrilled to have been invited to attend a local health reform meeting to represent consumer concerns.  I introduced myself as an University professor and a professional opera singer which of course got a couple of laughs.  Then, I continued by saying that I’m a consumer advocate and come to this gathering as a woman with a scarred uterus.  The main concerns I articulated as a cesarean mom were:

  1. A high local cesarean rate (around 31%); a low VBAC rate (about 1%) at the hospital
  2. A lack of support for the local birth center
  3. Decrease in numbers of CNMs locally
  4. Insurance and health care costs
  5. Insurance company driven health “care”

Additionally, it alarms me that even with my supposed “good” health coverage, I am struggling to pay last year’s medical bills.  The bills are overwhelming, so they pile up, and my credit score is suffering as well.

Arts Advocacy:  I am one of the educations outreach directors for a new opera company.  We had a meeting today to help prepare for the next board meeting and our upcoming educational outreach program.

I even managed to mop the floors.  I’d say it was a pretty darned productive day.

Midwifery legislation called for in Idaho

Homebirth midwives in Idaho have asked for legislation that would put in place a licensing mechanism and give homebirth midwives the ability to offer broader services. 

According to the recent Times-News article (2/22/08):

Proponents say midwives have provided safe birthing assistance for centuries and that expanding their privileges when it comes to dispensing medications, including intravenous fluids, antibiotics, painkillers and emergency oxygen, will boost the value of their services. They say this will especially help people in less-populated areas around the state.

The debate, [Connie Wolcott, CNM] said, is especially important given that 40 percent [sic.]* of births in the U.S. are done by cesarean section. Licensing, she said, would make it easier for people to become midwives and ease what she described as a huge backlog of patients.

“As a woman, that terrifies me,” Wolcott said of the cesarean rate. “As a scientist, I am appalled.”

I agree with Wolcott.  It is terrifying to know how easily a woman can end up with a cesarean section even when she thinks she’s done all of the preparation necessary to avoid an unnecessary cesarean.  As a researcher (qualitative) and educator it is appalling to witness it happening every day in my community and across the United frickin’ States. 

And this is what the opponents had to say, according to the article:

Idaho medical doctors and nurses who testified against the bill said creating a licensing system that still allowed uncertified birth assistants to practice could confuse unsuspecting members of the public who wouldn’t know the level of training of their care provider.

Confuse the public?  Because expectant parents aren’t smart enough to check a midwife’s credentials and history of experience?  Moooooooo?

They also said that the rules would allow midwives to do things that registered nurses aren’t allowed to do on their own.

Ah, here we go.  The nurses are mad because they don’t get the same priviledges that would be extended to midwives serving a small portion of the birthing population?  They’re jealous because they’re governed by doctors whereas homebirth midwives operate independently unless obstetric back-up is needed.

I’ll be interested to see how things progress in nearby Idaho.

* The national cesarean rate (projected, 2006) is 31.1% though certain areas of the country have cesarean rates more than double the national rate.  The cesarean rate is not expected to decline any time soon.

Contrast these homebirth news stories!

I have followed homebirth legislation news in Utah and South Dakota with interest and concern.  I don’t want Montana getting any stupid ideas. 

UtahI blogged about their nonsense recently.  Yesterday, the Utah Senate voted to restrict homebirth practices.  The bill was supposed to have been a compromise, but what resulted was something restrictive and punitive.  Women will be forced to attempt VBACs in hospitals or on their own.  Were this the case in my state, I would have an overwhelminly large chance at “failure” since my hospital’s VBAC rate is a pitiful <1%.  They only had 16 successful VBACs at the hospital in 2006.  Utah legislators have chosen a path that makes homebirth less safe.  To search for Senate Bill 93, click here.

South DakotaI also blogged about their homebirth “situation,” and it appears that both the SD House and Senate have approved a homebirth bill. 

The bill would require midwives to become registered nurses, get master’s degrees in nursing, and pass additional tests. Certified nurse midwives wanting to attend home births would need approval of both the Nursing board and the Board of Medical Examiners.

Allowing certified nurse midwives to attend home births in South Dakota would be allowed on a trial basis until 2013.  (click here for source article)

My concern is that CNMs were previously required to have OB back-up, and evidently no OBs were agreeing to provide back-up services.  What will be different?  And I’m not sure that having a Masters Degree makes anyone particularly qualified to attend labor.  Shouldn’t these homebirth midwives have assisted on “x” number of births before they become licensed?  Why is it always about the piece of paper??

Also, the bill states that CNMs will be able to attend homebirths “under certain circumstances” but doesn’t clarify what those circumstances may be.  I suppose we must find the Board guidelines to find more clear language.  To read the bill, click here.