Tuesday, March 4, 2008

Update from Missouri

Missouri advocates have posted a press release, excerpted below (read the full text on their website). The case will be heard in the MO State Supreme Court on Wednesday, March 5! (For background about current efforts to have legal CPMs in MO, see Grassroots Network Message 706014 (you can find all messages under Messages in the yahoogroup).

The American Medical Association filed an Amicus Brief in this case, and as noted below, midwifery advocates filed an Amicus Brief in response, addressing the points the AMA brought up basically the same tired old refrain we have been hearing for quite a long time. (If you are interested, you can read the case documents, including all of the various briefs (the AMA amicus brief and the “Citizens for Midwifery” amicus brief are the last two) here.
Just scroll down a bit to see the links.) The CfM amicus brief did not address the legal arguments (about whether or not the sentence in the Insurance Bill violated the single topic rule) as these issues were addressed in other briefs, but focused on the specious AMA arguments regarding safety. The writing and filing of this brief was an amazing effort by a collection of people in various parts of the country, all done by phone and e-mail!

Susan Hodges, “gatekeeper”

Excerpts from the press release:

Missouri Supreme Court to hear Midwives Law Appeal

Court grants motion by coalition of midwife advocates to file a ‘friend of the court’ brief for Mar. 5 hearing

(Jefferson City, MO) The Missouri Supreme Court will hear arguments to reconsider the permanent injunction on the state’s new midwifery law at 9:30 a.m. on Wednesday, March 5 at the Cole County Courthouse, 301 E High Street. A coalition of state and national midwife supporters, midwives and home birth families, led by Friends of Missouri Midwives (FOMM) and mobilized for the appeals process, has learned that the Court has granted their motion to file an amicus curiae (friend of the court) brief, submitted by:

* Citizens for Midwifery (CfM)
* Midwives Alliance of North America (MANA)
* National Association of Certified Professional Midwives (NACPM)
* Our Bodies Ourselves
* The National Birth Policy Coalition (NBPC)

The amicus brief submitted by the coalition supports the lifting of the midwives law injunction and makes the case that increasing access to trained and qualified Certified Professional Midwives (CPMs) and out-of-hospital birth is beneficial to Missouri citizens. In seeking to provide such access, Missouri is following the wisdom of a growing number of states recognizing the benefit of authorizing CPMs, who provide safe and high quality care, to practice.

“If the Supreme Court lifts the injunction, this law will permit CPMs to provide high quality, cost-effective care that will benefit Missouri’s citizens and fill some significant gaps in the state health care system,” said Susan Jenkins, legal counsel to the midwives coalition and steering committee member of National Birth Policy Coalition. “Home birth among low-risk women attended by CPMs does not jeopardize the health of mothers or infants, is authorized in 22 states, and is supported by many highly regarded international and professional organizations.”

Mary Ueland, Grassroots Coordinator for Friends of Missouri Midwives, says she hopes the Court will rule to decriminalize Certified Professional Midwives and remove the threat of prosecution to professional midwives who assist families who choose out-of-hospital birth. "Missouri shouldn't drag it's feet when it comes to allowing mothers to have safer and healthier births options."

The new Missouri Midwifery law was supposed to take effect Aug. 28, 2007, but the Missouri State Medical Association (MSMA) organized a well-financed challenge to the new law and was granted a temporary restraining order on July 3. Then on Aug. 8, Circuit Court Judge Patricia Joyce, who serves on the Board of Directors for St. Mary’s Health Center in Jefferson City, disallowed the Certified Professional Midwives provision contained within HB818 regarding portability and accessibility of health insurance.

Judge Joyce ruled the provision was unconstitutional and unrelated to health insurance, despite hearing from Assistant Attorney General John K. McManus and Midwifery Coalition attorney Jim Deutsch that decriminalizing midwifery does indeed relate to health insurance as they recalled that the Missouri Supreme Court has already ruled health insurance is interdependent on health services, and the two subjects are related.

During the Circuit Court appeal to Judge Joyce on Aug. 2, Deutsch cited nine other states where Medicaid covers home births attended by Certified Professional Midwives and many others where CPMs receive private insurance reimbursement. Both McManus and Deutsch argued that families obviously cannot get health insurance reimbursement for their midwives if their providers are considered felons by the state. They agreed that legalizing Certified Professional Midwives is a first step to home birth families being able to have their maternity care providers covered by insurance. They also cited the lower cost of midwifery care, which in turn could encourage insurance companies to lower their rates for healthy women.

“We’re seeing a strong shift in support of professional midwives as families become more aware of the benefits of CPMs, as well as more alert to skyrocketing c-section rates,” Laurel Smith, President of Friends of Missouri Midwives, said. “Beyond the additional risks for mothers and babies that c-sections create, what effect does a c-section rate of more than 30 percent have on our insurance premiums, and how reliant are doctors and hospitals on these increasing revenues?”

Missouri is part of The Big Push for Midwives Campaign, a nationally coordinated campaign to advocate for regulation and licensure of Certified Professional Midwives (CPMs) in all 50 states, the District of Columbia and Puerto Rico, and to push back against the attempts of the American Medical Association Scope of Practice Partnership to deny American families access to legal midwifery care.

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