A Sad Day for Home Birth and Human Rights

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My heart cries as I write this.  Today, in North Carolina, (which is a state where only Certified Nurse Midwives (CNMs) are legally allowed to attend home births) the right for some CNMs to attend home births has been revoked.  The Board of Medicine has deemed that one physician in eastern North Carolina that was signing the licenses of CNMs, can no longer do so.  This is a sad day, because families (not just women), should have the right to choose where and with whom they give birth.  With this determination by the Board of Medicine, many families are left without legal care providers to attend their births.  The births that these families have envisioned and planned for, are now being encroached upon by a governing board that should have no right to revoke such a right of these families without just cause (evidence based reasons).  Home birth is a safe and viable option for low risk women, and CNMs are highly trained birth professionals who have the right to practice.  This affects many people.

While this issue may not be near and dear to your heart, as it is to mine, I would like to request that you, as my blog followers, and those who may be new to my blog, take some form of action.  I will post several suggestions of what can be done, along with a petition that I have signed.  Please at least sign and share the petition.

Petition (Please sign and share):  http://www.change.org/petitions/north-carolina-medical-board-allow-physicians-to-continue-supervising-homebirth-cnms-in-nc

Several points of contacts can be made:

Business of Being Born (BOBB)

lynn@mybestbirth.com

North Carolina Board of Medicine

1203 Front St.

Raleigh, NC 27609

Telephone: (919) 326.1100 or (919) 326.1109 | Free Long Distance: (800) 253.9653

Licensing Department:  Joy Cooke, Director (Contact web address follows)

Public Affairs Department:  Jean Fisher Brinkley, Director (Contact web address follows)

http://www.ncmedboard.org/contact_us/department/

WRAL News:  http://www.wral.com/apps/feedback/feedback/?d_id_person=207

NC Governor Bev Purdue

Office of the Governor
Constituent Services Office
116 West Jones Street
Raleigh, North Carolina 27603
Phone: (800) 662-7952 or (919) 733-2391
Fax: (919) 733-2120
governor.office@nc.gov

Senator Richard Burr:

217 RUSSELL SENATE OFFICE BUILDING WASHINGTON DC 20510
(202) 224-3154

http://www.burr.senate.gov/public/index.cfm?FuseAction=Contact.ContactForm

Senator Kay Hagan:

521 DIRKSEN SENATE OFFICE BUILDING WASHINGTON DC 20510
(202) 224-6342

http://www.hagan.senate.gov/contact/

Contacting national news agencies to make them aware of what is going on in North Carolina’s families in the way of limiting their rights to choose where and with whom they give birth, is another great option.  The idea here is the put the pressure on the North Carolina Board of Medicine to re-evaluate their decision, and to consult evidence based research and data concerning the safety of home births attended by CNMs.

I thank you in advance for your help.  Any other suggestions may be posted in a comment.

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36 responses »

    • Julie,
      Thank you so much for your support. I’m sorry the link didn’t work for you. Please go like Normal Mama on Facebook, and the link is also posted on there. You may sign the petition and share from there.

      Birth awareness and rights are huge issues, because they not only affect mothers, but entire families and the providers that serve them. North Carolina seems to be behind in many ways. I recently moved from there to Alaska, and in Alaska, not only do midwives have licensure, but they also have tons of support. And not just CNMs, but Direct Entry, and Certified Professional Midwives. It’s refreshing to be here, but heartbreaking to know that North Carolina is struggling so much with what should be a basic human right. Political involvement need not play a role in this, and I am sure this is purely political in nature.

  1. I can’t connect either. But I would say that CNM’s shouldn’t be overseen by physicians. Either their trained and capable or their not. They shouldn’t need a doctor to back them up. Midwives should be monitored by midwives. Not the Health Dept. a group of doctors, or the government.

    • I cannot agree more, and thank you so much for posting your comment. As I said above, I would bet that this all boils down to politics (either that or money), it’s always one or the other. Please like Normal Mama on Facebook, and from there, you can access the link to sign the petition. I appreciate your support in this!

    • I agree! Which is why the government is not encroaching on home births, rather they are abandoning them which is what you ladies want isn’t it? The government has basically ruled health care professionals should stay focused on health care as pertains to, as you stated, “low risk” relatively non-issue stuff.

      • Also, ALL nurses, except for Nurse Practitioners are overseen by Doctors. It’s not just this field. We don’t have nearly the education they do. (we = RN’s)

      • I am a nurse practitioner and all advanced practice nurses have supervising physicians. This is devistating as (in NC) without a physcian, you don’t have a license.

        Families need to have birth options. This is an attack on nurse midwives and reproductive rights

    • There is so much going on right now with all of this. It is pertaining to one particular physician that signed off on the licenses of some midwives in Eastern North Carolina. My understanding, through following Facebook very closely this morning, is that a news crew is showing up at one particular midwifery office to do a story. I am not sure how much the media knows, but I do know that the families who are being affected, as well as prior clients of midwives are lighting fires everywhere to get this reversed. I will certainly post more as I know more. 🙂 Thank you. Please like Normal Mama or follow my blog for more updates. I will update as necessary.

  2. Another way we can effect change is to have all residents of NC contact their Sen and Rep and urge them to support H522/S882 and encourage Speaker Tillis to hear this bill in the short session. If this bill passes it will provide a pathway for CPMs and CNMs to attend homebirths. It will take the NC Board of Medicine out of the equation. Stand together NC! If we get this overturned they Med Soc will just find another way to attack. We need to get this bill through. http://www.ncfom.org is a sight to get all your Rep and Sen info and stay up to date on the issue.

  3. Another way we can effect change is to have all residents of NC contact their Sen and Rep and urge them to support H522/S882 and encourage Speaker Tillis to hear this bill in the short session. If this bill passes it will provide a pathway for CPMs and CNMs to attend homebirths. It will take the NC Board of Medicine out of the equation. Stand together NC! If we get this overturned they Med Soc will just find another way to attack. We need to get this bill through. http://www.ncfom.org is a sight to get all your Rep and Sen info and stay up to date on the issue.

  4. This proves a point for those pushing for licensure for midwives who are NOT nurses or CNMs. Licenses do not protect midwifery or parents. Parents need to make it know to the powers that be in their states…..Mothers have sovereignty over their biology and birth is a private family matter. Mothers own birth and it is a matter of parents’ rights where and with whom they birth their children.

    • It depends on what the law says, Carla. The CNM law in North Carolina is one of the most restrictive in the US. It requires CNMs and other advanced practice nurses to be supervised by a physician. They can’t even get a license without proof of that supervision. The kind of laws we need, the kind that the consumers of North Carolina are working for in H522/S882, would grant licenses to midwives for independent autonomous practice, without having to ask a physician to supervise or collaborate with you. Even if the CNM law got changed to “collaborate,” it would still be nearly impossible for the CNMs to find physicians who would agree to that. North Carolina parents shouldn’t have their parental rights taken away by some government agency like this medical board.

    • As I commented above, there is so much happening so fast, that I’m not sure what is out and what is not. A news station has gotten word of this, and they are at a midwifery practice as we speak, doing a story that should air this evening. I will post that link, and any other information that becomes available. Thank you!

  5. This is outrageous and even unconstitutional contrary to the constitution or the basic laws of a state or country…. let me a very damaging to family and all midwives. WHAT HAPPENED to FREEDOM OF CHOICE?
    Midwifing since 1972 i have seen us all grow, release the fears and now i fear i will see us regress?I personally will fight back….and it will be in a very loud voice!.

  6. This is an issue that is dear to me as well. This is why I was denied my home birth after cesarean an hour and a half before I went into labor on 5/14. While I still had an unmedicated VBAC, I was forced into a hospital setting at the last minute with no doula or written birth plan. I labored feeling angry and betrayed…definitely not ideal.

    • Mary, I knew about your situation, and I wonder, that since this is in that same region, if this is all stemming from what happened prior to your birth. It is sad that women are denied such. I agree that regulations should absolutely be in place, and they should be really stringent regulations to protect families, but to do so without just cause seems unjust to me. Families deserve to birth their babies in a manner in which they choose, especially when it is in their own home environment, with a highly trained medical professional such as a CNM. I thank you for sharing this with us on my blog, Mary. And you’re in my thoughts as your mental/emotional healing journey takes place. You’re amazing.

  7. How backwards! We had a homebirth with our second child and one main reason was for comfort and wondering why it had to be in a hospital. No one was sick… I’ll sign the petition too.

  8. Two summers ago, here in NY the legislative bodies revised midwifery licensure requirements and removed the physician backup requirement, instead requiring that midwives have a backup plan in place. Thank goodness. Time to make that happen in NC by focusing on the fact that midwives offer safe, cost-effective, low-intervention care for low-risk populations, and often to those who have poor health care access!! Let’s emancipate the midwives again. Physicians should not be required to sign off on midwifery practice. Current legislation results in a lack of access to safe and effective care, rather than protecting the very people whom the requirements were theoretically intended to safeguard. This requirement simply puts midwives and families in the hands and control of ACOG, who would like to protect the interests of obstetricians.

  9. What needs to be fixed will take time and that is that CNM’s should not have an archaic supervisory law in the state. And of course, there should be a direct entry midwifery law.
    The residents of NC have to make their voices heard by talking to their legislators and making changes at that level. I know it is daunting because medicine has power and money (and a lot of nerve!) which unfortunately gets you what you want unless the people really get determined and really loud.
    Good luck!

    • I know that for years, NCFOM (North Carolina Friends of Midwives) have been trying their damnedest to get laws passed for CPMs to be legal. There is no legalization of such, or regulation, and of course, with legalization would come regulation. It saddens me, truly that now, many midwives are without a supervising physician to sign off on their licenses, and that so many families are without the care they deserve.
      The voices will have to be louder, for sure, and in huge numbers, on a continuous basis, until things change.

  10. Pingback: Sad Day for Midwifery in NC… Video « Normal Mama

  11. The AMA strikes again. The AMA and the drug companies will do what ever they can to maintain and increase their profits. That is why USA medical care is only rated 30-something in the world. They try to tell us we have the best, but of course that is an out right lie. Look it up for yourself. It’s easy to google it.

    • We should look into a Canadian style healthcare plan. They have private care, in other words everyone picks their own providers, but there is a single payer. So everyone gets the care they want and it is paid for 100% by the government. They get much more comprehensive, same quality care as we have for a MUCH lower over all cost! Single payer. Let’s do it in the US!

  12. Link to the news story:
    http://abclocal.go.com/wtvd/story?section=news/local&id=8685857

    Currently the NC Medical Board has not issued an official disciplinary action against the doctor and therefore is unable to talk about what is happening. So far what I know is that the board went on a fishing expedition for tales of “catastrophic home birth transfers” and an hour later the seven midwives under this physician’s supervision received this email :
    “I have just been informed that the board has advised that I will not be able to supervise nurse midwives outside my practice for a minimum of 2 years. Although the official documents have not been sent to me for signature yet, I would consider this effective immediately.
    You should inform your licensing boards of this change and arrange for another physician to act as your backup immediately. I am sorry as I know what an impact this will have on your practices, however it is out of my control at this point.
    I wish you all the best in the future.
    Let me know if you have any questions”

    I’ve had two amazing home births, attended all four of my mother’s home births, and now in my third trimester have found myself without care overnight. There is absolutely no reason why CNMs need to have a supervising physician. They are competent care providers and trained to know when a situation is outside of their abilities and can transfer care as needed on their own.

  13. This is absolutely outrageous. They are taking away our rights as women to choose who we want to attend the birth of our babies and they are not looking at statistics for it. It is clearly not about safety anymore, but about democracy and control… probably in part because pharma is afraid of losing money as more people turn toward homebirths again.

  14. It is long past time to change the law in North Carolina so that the medical board can no longer erect barriers against families that want home births. If you live in NC, please join North Carolina Friends of Midwives and work with them to demand passage of this bill, which will regulate midwives to protect North Carolina moms and babies, but will remove the harmful element of physician control. The Medical Board would lose jurisdiction over out-of-hospital birth if this bill passes. My heart breaks also for the women and families who are clients of these midwives — and all the other women and families in North Carolina who have been denied access to out-of-hospital birth with a midwife in attendance. The medical board is not going to care what you say, no matter how many people call or write them, however. They aren’t elected, and don’t care what the public says or thinks. The best and MOST EFFECTIVE thing you can do to help the women of North Carolina claim their right to birth where and with whom they choose, is to support the NCFOM legislation. If you live in NC, join NCFOM and help them work for this cause. If you don’t live in NC, consider sending NCFOM a small (or large) contribution so they can continue their work. NCFOM is battling against organized medicine, in the form of the North Carolina Medical Society, which wants to prevent independent midwife practice by either CNMs or CPMs. THIS is how you can fight back and fight back effectively. HELP the families of North Carolina change the law.

  15. Hold the vision sweet sister… Change is in the air! And the truth shall set us FREE… The real truth about how all this happened can be found in the history of The Medical, Pharmaceutical, Insurance Machine created by money from the Rockefeller Foundation, both in the USA, in China, and in parts of Europe. It begins in 1913..I will be telling the story for the next few days over at my facebook page..and maybe, I will fire up the old blog too at femininechange, or go to http://www.femininechange.com . Please keep talking. it is all about the $$$ really!!!

  16. I understand that feelings run high on this issue but it is important to recognize that the NCMB while it is no friend to home birth, did not compel this MD to abandon his coverage of these midwifery practices. He did so voluntarily. It really worries me that he was allowed to supervise so many mid-levels in the first place. I was a PA for a long time and am now an MD. For years, a doc could only supervise 2 PAs at a go but essentially unlimited numbers of NPs and CNMs. This simply did not seem like a safe situation.

    I also question the belief that CNMs are as a group more humane/in touch with the needs of mothers. As a PA student years ago I really wanted to be involved in women’s healthcare (and eventually was in both a county health department and at Planned Parenthood) and so chose to do my OB rotation with a midwifery group then based in Chatham Co. What I saw did not encourage me to run out and contact a midwife when I got pregnant with my second child. They were ok, but not terribly smart or nice or empathetic. One of them treated me like dirt because I didn’t have a nursing background. Since that time I have met other CNMs and have a good friend who is one that I thought were fabulous. But I also think that the OB-Gyns (both men BTW) who delivered my 18 years apart girls were fabulous as were the OB-Gyns who got me through 3 miscarriages.

    I like the idea of home birth. I think hospital based childbirth education programs are caca and basically teach women to be passive. I think VBAC is a viable option for most women. But pregnancy and childbirth while natural are not risk free and while the medical model may be going backwards in how it manages childbearing, largely due to the risk aversion of both patients and physicians, I think it is crucial to remember that graveyards are no longer full of young women and their infants who died in childbirth. Anyone, no matter whether they are a CNM or direct-entry midwife or an MD needs to recognize that things can go bad very quickly and you better have access to a back-up. Sorry- -but sometimes you need the much demonized hospitals and someone with surgical skills and a couple pints of blood on hand and yes, competent oversight is necessary.

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