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Grassroots Network Message 706014
Missouri Medical Association suing state over new midwifery law
june 19, 2007

Dear Friends,

Missouri midwifery advocates have been working long and hard for many years to achieve legal status for direct entry midwives; Missouri is one of the few states where the practice of midwifery is specifically a felony. After opposition filibustered a good licensing bill this spring, successfully keeping it from a vote, the courageous sponsor inserted a single sentence into a related bill (on health insurance) that made CPMs legal but not regulated. This bill passed, in part because almost no one was aware of the inserted sentence.

Missouri Friends of Midwives has just issued a press release responding to the state medical association's announcement that they are going to court in an attempt to get the midwifery sentence ruled unconstitutional! Read the press release below or at www.friendsofmomidwives.org /www.friendsofmomidwives.org/>

The midwifery provision used the word "tocological," a little known synonym for "obstetrical and midwifery", so it went under the radar. Needless to say, the opposition was furious. The critical sentence in HB818 reads: "Notwithstanding any law to the contrary, any person who holds current ministerial or tocological certification by an organization accredited by the National Organization for Competency Assurance (NOCA) may provide services as defined in 42 U.S.C. 1396 f-6(b) (4) (E) (ii) (I)." This means that midwives certified by certifying bodies accredited by NOCA, which includes the North American Registry of Midwives, can practice legally in MO.

Of course the state medical association opposed the licensing bill (and helped stop it), and is furious about the passage of HB818 with the "stealth" midwifery provision, and now they are going to court to get the midwifery sentence ruled unconstitutional. You can read their announcement featured on their home page at www.msma.org /www.msma.org/> . Not unexpectedly, it includes gross misstatements (to be polite) about the actual meaning of the critical sentence.

To be continued%u2026. And kudos to all those active advocates and midwives in Missouri!!

Sincerely,

Susan Hodges, "gatekeeper"

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MIDWIVES: YOUR BEST BET

History

In 1900 half of all Americans were born into the hands of a midwife, at home. Early studies comparing the birth outcomes of physicians versus midwives showed that midwives had fewer maternal and infant loses than the doctors. The United States had a very high percentage of maternal deaths compared to other countries.

Reports done by the White House Conference on Child Health and Protection, the national Committee on the Costs of Medical Care, and the New York Academy of Medicine in the 1930's all concluded that midwives were safer than physicians. These reports chastised doctors for their frequency of interventions which led to problems. Many physicians, in response to the findings of the reports, placed the blame on the midwives claiming that midwives were "ignorant", "dirty", untrained and a threat to the safety of childbearing women. Medical journals and popular magazines contained many articles bashing midwives and blaming them for the nations appalling maternal mortality and infant mortality rates.

Many physicians and public health advocates spoke up for the midwives and their excellent statistics, but the prestige of the anti-midwife physicians and the strong push to move births into the hospitals far over-shadowed their voices. This barrage of anti-midwife articles and propaganda continues today despite the lack of any studies or statistics to prove claims that physicians guarantee the safest outcomes or healthier babies or mothers.

Press Release - June 16, 2007
FOR IMMEDIATE RELEASE:

MSMA Announces Preparations to Take New Midwifery Law to Court

Contact:Mary Ueland
Email: LegislativeChair@MissouriMidwivesAssociation.org
Cell Phone: 417-543-4258
Fax: 314-721-1149

Homebirth families around the state are appalled at the Missouri State Medical Association's plans to try to overturn the new law legalizing Certified Professional Midwives.

Homebirth families have all been celebrating a victory since Governor Blunt signed HB 818 several weeks ago. The bill legalized Certified Professional Midwives and ended 48 years of the practice of midwifery being a felony in Missouri.

Despite broad bi-partisan support in the Missouri legislature for the legalization of midwives and the passage of HB818, MSMA's tyrannical insistence on the felony status of midwifery in Missouri has now turned its efforts to the court system. The announcement of the planned law suit against the state of Missouri has claimed the top banner on the MSMA website.

Those lobbying for the midwifery bill say that they were always willing to sit down and work out a midwifery law agreeable to all parties if the medical associations would have agreed to withdraw their intense opposition. However, they only intensified the opposition as time went on. The midwifery supporters say that the goal of the medical associations seemed to be making sure that no midwives would be available for mothers who choose to give birth at home in Missouri.

"The Missouri State Medical Association has never had any need to work with us, because they intended to maintain a complete monopoly on birth," explained Dr. Keith Nisbett, Ph.D., a professor and homebirth father who has tried to change Missouri's midwife law for nearly twenty years.

"The Missouri State Medical Association does not speak for me as a physician, nor do they speak for many of my physician colleagues who respect midwives and want to see them join us at the table as experts in healthy pregnancy and birth," said Dr. Elizabeth Allemann, MD, a physician from Columbia. "The MSMA has spent twenty years of time and energy fighting the legalization of midwifery in Missouri. You would think the sky is falling and terrible things are going to happen to doctors! That's the farthest thing from the truth. Midwives are well trained professionals and work well together with doctors."

The midwifery supporters say that they are encouraged that other medical groups such as the Missouri Hospital Association are refusing to join the MSMA in the lawsuit. "It shows that the Missouri Hospital Association knows that there are more important things to focus on, like increasing access to healthcare for all of Missouri's citizens," commented Dr. Allemann. "For that, I applaud them."

"There are so many other healthcare issues that need attention in Missouri. Why does the medical association spend so much time trying to criminalize my midwife and limit my access to the birthing service of my choice?" questioned Samanda Rossi, St. Louis Friends of Missouri Midwives area coordinator.

Missouri women who choose home birth are more qualified to determine who should assist them than the MSMA. It is both demeaning and an insult to the intelligence of women to suggest that they would choose anyone other than a qualified professional to deliver their children.

Midwifery is about access to healthcare. Some women do not have the choice whether or not to use a physician. The MSMA, if successful, is actually endangering the lives of women and their babies by denying access to trained professional midwives to attend homebirths. Every pregnant woman deserves to have a professional attend her birth who has been trained to recognize fetal distress, resuscitate a baby, and stop a hemorrhage.

Mary Ueland, legislative chair for the Missouri Midwives Association, contends that MSMA is giving false information to its members and the public. "Anyone can look up the definition of tocology and see that bricklayers and professional golfers are obviously not certified in tocology. Because the truth will not cause concern among physicians or the public, MSMA is telling them lies about what the new law does. We had hoped that we could at least have a candid discussion of the facts with obstetricians."

The law says that those certified in tocology under the National Organization for Competency Assurance can provide prenatal, birth, and postpartum care. The two tocological certification processes certified by NOCA are the Certified Professional Midwives and the Certified Nurse Midwives.

Midwives