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Lobbying for Midwives

The American College of Nurse Midwives has declared August Midwifery Lobby Month.  That means they want all members and supporters to talk to legislators about policies that improve access to midwifery care. One of the national bills they encourage support for is MOMS for the 21st Century. Take a look at the information and let me know what you think.

I want to draw your attention to one item this bill would address – maternity care shortage areas. Why? Because this is my main research interest.  Currently, we don’t really know where these shortage areas are.  How do I know. I just finished my master’s thesis on the subject and honestly, the information doesn’t exist.

We don’t have an accurate count of what, if any, family practice physicians are still providing maternity care and which perform cesareans.

We don’t have an accurate count of which OB-GYNs are providing maternity care, and which are doing only gynecological work or specialized in areas without providing general maternity care.

We don’t have an accurate count of what midwives are providing maternity care – in fact in some states a direct entry midwife could be legally providing care, but there is no registration so there is no count.

As if the lack of numbers of providers were not enough, the estimates of how many providers are needed is really an estimate.  There has never been validation of the number based on maternity outcomes.

And when you add in the problem that that United States doesn’t actually have a health system, and that in some states 50% or more of births are paid for through Medicaid, having an accurate number of which practitioners are providing services for medicaid recipients becomes important in determining where care is adequate.

There is a lot of work to be done to improve maternity care in the US, and it isn’t all about changing practice protocols. My research is quite timely, but first I need to make it through two years of coursework.

 

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Jennifer Vanderlaan CNM MPH is the author of the BirthingNaturally.net website. She has been working with expectant families since 2000, training doulas, childbirth educators, and midwives. She has worked with midwives in Central America and Sub-Saharan Africa. Her interest in public health grew in 2010, and she is now a PhD student learning to become a producer of knowledge.

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