Birth Action Coalition Our Bodies, Our Babies, Our Births

Community activist organization to bring together members of community who are concerned and outraged to protest a recent policy approved at by St. John’s Hospital (St. John’s is part of Catholic Healthcare West).

On Friday, February 12 from 11:00am until 1:00pm members and supporters of the Birth Action Coalition (BAC) will gather in front of St. John’s Hospital & Corporate Offices (at the corner of Rose & Gonzalez) in Oxnard to protest the policy banning nurse-midwives from attending births at Pleasant Valley Hospital in Camarillo. The policy was approved by the Medical Executive Committee at St. John’s and was supported by the Board of Directors. BAC is holding this protest to further our mission of creating a supportive birth environment for all birthing women in our area by demanding that St. Johns’ reinstate the privileges of all nurse-midwives at Pleasant Valley Hospital.

It is the position of BAC that certified and licensed midwives are an integral part of our community. In Ventura County, professional midwives have been working with doctors in providing a choice to birthing families for over 30 years, as certified nurse midwives (CNM) in our local hospitals, and as licensed midwives (LM) since 1996, when the state began licensing midwives for births in women’s homes and independent birth centers.

St. John’s states that the ban on midwives is to ensure “patient safety.” Yet studies continue to show that low risk births attended by certified and licensed midwives have better outcomes overall than low-risk births attended by obstetricians (see studies in attachment).

St. John’s also has policies restricting the practices of those obstetricians who choose to work with and back up licensed midwives who attend births out of the hospital. This relationship between obstetricians and licensed midwives exists to ensure continuity of care in the event that specialized hospital care is required in the course of a home birth or birth in a birth center. Licensed midwives, along with obstetricians, desire the best care for the women they serve and seek to have a safe, supportive option should the need for a hospital transfer occur. BAC feels that St. John’s has worked to reduce the availability of physician backup for licensed midwives, thus working to create an unsafe and unsupportive environment for a population in Ventura County. St. John’s is not the only hospital to have instituted such policies against physicians who support licensed midwives. The members and supporters of BAC seek to expose these practices of anti-competition which ultimately reduce birthing options for families in Ventura County.

Attachment:

1) Cragin L, & Kennedy HP (2006). Linking obstetric and midwifery practice with optimal outcomes. Journal of obstetric, gynecologic, and neonatal nursing : JOGNN / NAACOG, 35 (6), 779-85 PMID: 17105644

http://www.acnm.org/siteFiles/education/Quality_&_Effectiveness_12.05.pd…
(underlined emphasis added)
Abstract:Linking obstetric and midwifery practice with optimal outcomes. Cragin L, Kennedy HP. Department of Obstetrics, Gynecology & Reproductive Sciences, University of California, San Francisco, CA 94110, USA. craginl@obgyn.ucsf.e du OBJECTIVE: To compare midwifery and medical care practices and measure optimal perinatal outcomes using a new clinimetric instrument. DESIGN: Prospective descriptive cohort design. SETTING: A large, inner city obstetric service with medical and midwifery services. PARTICIPANTS: Three hundred seventy-five of 400 consecutively enrolled patients were participated (25 excluded due to extreme risk status or missing data); 92% were of minority race/ethnicity and 54% had less than a high school education. Of the 375 patients, 179 received physician care and 196 received nurse-midwife care. MAIN OUTCOME MEASURES: The Optimality Index-US was measured. Health record data were extracted and scored using the Optimality Index-US to summarize the optimality of processes and outcomes of care as well as the woman’s preexisting health status. RESULTS: Midwifery patients had more optimal care processes (less use of technology and intervention) with no difference in neonatal outcomes, even when preexisting risk was taken into account. CONCLUSION: Even among moderate-risk patients, the midwifery model of care with its limited use of interventions can produce outcomes equivalent to or better than those of the biomedical model. PMID: 17105644 [PubMed - indexed for MEDLINE]

2) 2008 Millbank Study on Evidence Based Maternity Care" available online: http://www.thebigpushformidwives.org

Summary of implications for practice:

Midwife-led care confers benefits and shows no adverse outcomes. It should be the norm for women classified at low and high risk of complications. Policy makers and healthcare providers should be aware that such benefits are conferred whether midwives provide antenatal care in hospital or community settings. Not all areas of the world have health systems where midwives are able to provide midwife-led models of care (De Vries 2001 ) and health system financing is a potential barrier to implementation. Policy makers who wish to achieve clinically important improvements in maternity care, particularly around normalising and humanising birth, should consider midwife-led models of care and consider how financing of midwife-led services can be reviewed to support this.