Wednesday, February 23, 2011

Legislative Alert from AABC

Passing along a legislative alert from the American Association of Birth Centers:

Women and Children Lose in Budget Cuts: We need your help!

It always is a shock to me that Women and Children's Programs are at the top of Federal and State budget cuts. Republicans in the U.S. House of Representatives have passed large cuts in health services to women, infants, and children (H.R.1):

Hundreds of millions from WIC (Women, Infants, and Children):
WIC provides Federal grants to States for supplemental food, health care referrals, and nutrition education for low-income pregnant, breastfeeding, and non-breastfeeding postpartum women, and to infants and children up to age five who are found to be at nutritional risk.

Hundreds of millions from Maternal and Child Health Block Grants:
This Block Grant referred to as Title V is a public health program that reaches across economic lines to improve the health of all mothers and children, train providers and support services for children with special healthcare needs, offers newborn screening and genetic services, lead poisoning and injury prevention, and health and safety promotion in child care settings.

More than a billion from Community Health Centers:
Community Health Centers are key partners for many Birth Centers. They exist to fill the void in underserved communities and vulnerable populations by assuring access to comprehensive, culturally competent, quality primary care services.

This federal quandary is shared by many states: Demand for health services is growing and states are cutting Medicaid budgets for the poor and disabled. Medicaid accounts for approximately 25 percent of state spending when federal matching dollars are included according to the National Association of State Budget Officers.

PLEASE DO NOT SIT BACK AND DO NOTHING. WOMAN AND CHILDREN NEED OUR HELP NOW. This is not a Republican, Democrat, or Independent position. This is the moral and ethical action to take now.
1. Call your U.S. Senators -( U.S. Capitol Switchboard: 202-224-3121).
Ask to speak to your Senator's health legislative aide.
2. Call your State Governor, Senators and Representatives
3. Tell them you are NOT in support of cuts to women and children's health! The deficit can be reduced by cutting waste in other areas.
4. Please let Karen Fennell (AABC's lobbyist) know of your contacts with legislators.
Tell her who you talked with and any comments or additional information requested. Call Karen at 301-830-3910; Send email to

Suggested Talking Points

WIC Program: This is one of the most efficient programs to improve child nutrition. The program gives expectant mothers with very small children important education on how to eat healthy during their pregnancy and how to feed their children healthy meals. And it provides them with coupons to incentivize them to purchase the best foods for their children. Research shows that without this intervention the nutritional intake of these children would be higher in fats, salts and sugars, according to a recent U.S. Food and Nutrition Services study. Instead if spending $1,400 a month in extra medical care for an obese child, for just $41 per month this program shifts these mothers and children into healthy eating patterns, says the Centers for Disease Control and Prevention. Clearly, the WIC approach is a useful and relatively cheap way to stem the rising tide of childhood obesity and a healthy pregnancy.

Maternal and Child Health Block Program: The program has been cut by 30%. This program is the safety-net care for women and children. The block grant pays for child immunizations and prenatal care for tens of thousands women and children. It is obvious that without access to immunizations more dollars will have to be spent to care for kids sick with easily preventable illnesses. Reducing access to prenatal care is both life-threatening and costly. A preemie baby's health costs are 10 times higher than a full-term, healthy-weight child, according to the March of Dimes. It makes no sense to cut a program that has a proven track record of delivering health to babies and driving down America's health care costs.

Community Health Centers: Funding for community health centers will be cut in half. Senator Orrin Hatch (R-UT), who was a cosponsor of the legislation responding to President George W. Bush's call to expand funding for these centers in 2008, says that "since 2001, additional funding has allowed health centers in more than 750 communities nationwide to provide care to about four million new patients. These centers provide affordable and quality care to at-risk Americans who otherwise might have to might have to do without." As state by the Center for American Progress, "No health care costs will be avoided by cutting this $1 billion out of the budget because the absence of care doesn't stop you from getting sick. It simply means you get sicker and you turn up at the emergency room or hospitals when your illness has progressed to the point that you care needs are exorbitantly expensive.

State Medicaid Cuts: Most States have budget proposals to cut funding for Medicaid. Talk to staff about what you know best - health and costs implications of a lack of prenatal and newborn care. A useful resource is the article Ten Myths About Medicaid published by The Kaiser Commission on Medicaid and the Uninsured.

Jill Alliman, CNM, MSN

Chair, Legislative Committee

American Association of Birth Centers

Friday, February 18, 2011

Snow Baby

Guest article by Katie Tonarely

When Kara Kay started feeling crampy contractions on a Tuesday, she didn’t call a hospital or obstetrician. She didn’t have one. Instead, around 11 a.m. on Tuesday, February 1, Kara called her husband, Mike Benedict, and her Certified Professional Midwife, Deborah Smithey. Then, she sat back, enjoying the early feelings that she knew would eventually bring her her baby. While she waited comfortably inside, the worst blizzard in 100 years raged outside, and Deborah and Mike worked to make their way to Kara.

Choosing a Midwife
A hospital birth was never an option for Kara. “I’ve never been really comfortable with a hospital,” she says. “I never imagined I would have a birth in a hospital.” Mike agrees. After typical hospital experiences with his first two children, he was ready for a change. “It allows the father to be much more involved,” he says of his home birth experience.

A Certified Professional Midwife provides more in-depth care, Deborah says. Prenatal visits usually last an hour or more, and whatever is on the mom’s mind is up for discussion. Of course the CPM also checks how the mother is doing physically: blood pressure, pulse, fetal heart rate and growth. Midwives also focus on a lot on nutrition and overall health during pregnancy.

For Kara and Mike, the safety of home birth was a big factor for them, too. “I feel it’s safer overall, because there aren’t any doctors to force you to take unnecessary drugs or inventions that tend to cause more problems that solve them,” Mike says. Deborah cites a 2009 study that confirms these claims. The study, “Outcomes of Planned Home Births with Certified Professional Midwives: Large Prospective Study in North America” by Kenneth C Johnson and Betty-Anne Daviss, found that birth at home is safer, has better outcomes and fewer interventions.

Getting There
Mike knew the storm was coming and was planning to come home from work early anyway, but when he got the call from Kara, he left so he could get home to be with his wife. Getting there, though, proved to be a challenge, as the snow fell and cars and trucks slid into ditches on either side of the highway. “It was just white; you couldn’t see anything,” he said. After his own car ended up in a ditch, someone picked him up, but that car ended up in a ditch, too. Not really sure what he should do next, Mike started walking and running the mile-and-a-half home. “When I saw the tow-trucks and 18-wheelers stuck in the snow, I started to panic. That’s when I started to get anxious.” The couple of mile journey too him over an hour. “By that time, I was pretty nervous. I was ready to get home,” he says.

The midwife’s journey took even longer. She and her husband left Stockton at about 1 p.m. Normally, her drive to Carthage takes about an hour. They drove a four-wheel-drive truck to maneuver through the 13 inches of snow, with more falling by the minute. In the back seat of the truck, she had her midwifery supplies packed. “The roads became more and more treacherous as we went,” she says. “At one point, we couldn’t see the road at all.” To break through the snow drifts, they had to drive fast, but were also sure to go slow enough, so as not to lose control.

When they finally made it to the highway, they expected to it be clear. Normally, highway 71 is a four-lane highway, but only one lane was moving. “Semi-trucks and pick-ups were stranded on both sides of the road, and some were even stopped in the road,” Deborah says. “I have never seen anything like it.”

Deborah and her husband made it to Kara at 4:30 p.m. The one-hour journey took three hours.

Labor Land
Pregnant with her first, Kara expected a longer labor. Though the world outside was urgent with worries of weather and time, Kara sat comfortably in her home, not worried at all. “I just didn’t realize how bad the weather was,” she says. “I wasn’t concerned.”

As labor progressed through the afternoon and night, Kara used what she had learned in her Bradley Method class. She worked on breathing slowly and had visualizations and mantras ready to help her get through the tough times. “I’m just in labor land; I’m just passing through, “she repeated.

When it was finally time to push the next morning, February 2, Kara worked hard. She says, though, that she never felt the head descend. She counted on Mike and Deborah’s encouraging words. “I didn’t feel like I was getting anywhere,” she says.

Once the baby’s head came out, the midwife helped deliver the baby’s stuck shoulders. Called shoulder dystocia, this complication can be rather painful, yet Kara didn’t know it was happening until later. She continued to rely on her midwife’s encouragement. “Deborah reached up; it wasn’t invasive at all,” Mike says. “At that point, I was really glad that Deborah braved the storm.”

Snow Baby
Mike caught his daughter, Kaliyah Winter, at 7:49 a.m.. She weighed 9 pounds, 12 ounces. “I don’t think this experience will ever leave my mind,” he says.

For her post-partum care, Kara stayed put and was able to enjoy time with Kaliyah. “The midwife came to us,” Mike says. “I didn’t have to lug my baby out in the cold and snow.”

After she realized the snow’s devastation, Kara couldn’t help but be grateful for the midwifery model of care. “This just shows the dedication, loyalty and passion of midwives,” she says. “I’m totally thankful to Deborah and her husband.”

When there’s a natural disaster, Deborah asserts that midwives are best to handle birth. She asserts that it would be ideal for every Missouri county to have a Certified Professional Midwife ready to handle births in an emergency. “Common sense tells us that it would be far safer for a midwife to travel to a birthing mother then have a mother risk delivering along the side of the road in horrible conditions,” she says. In addition, CPMs are trained to handle common complications, such as cord entanglement, shoulder dystocia and post-partum hemorrhage.

For Mike and Kara, the intensity of the storm outside was nothing to compare to the positive feelings associated with bringing a new baby peacefully into the world. “It’s just a miracle, and I’m thankful everything turned out,” Kara says.

In addition to being a wife and mother to two boys with another due in May, Katie Tonarely spends her time writing for several publications, including Springfield, Missouri's "News-Leader" and "Moms Like Me." She also does web content writing for Demand Media Studios.

For more about homebirth and midwifery in Missouri see: