Wednesday, April 25, 2007

Article inThe Daily Star-Journal, Warrensburg, MO

Following is an article written after I did an interview with the local paper. It even made the front page!
-deanna


Permission granted from Skye Cobb of The Daily Star-Journal to post in its entirety.
Local Woman Lobbies For Midwife Bill In Senate And House

By SKYE COBB
Star-Journal Staff Writer
A local woman is working hard to get a midwifery bill passed in the
Missouri State Senate and House.
Missouri Senate Bill 303 and House Bill 503 would create a Board of
Direct-Entry Midwives within the Division of Professional Registration.
This board would consist of three Certified Professional Midwives, one
physician, and one public member. Senate Bill 303 would allow the state to
regulate who is practicing with the power to issue licenses and to suspend,
revoke or deny the license of a direct-entry midwife.
Currently in Missouri it is a felony for a midwife to deliver a baby at
home and there are organizations, such as Friends of Missouri Midwives,
Missouri Midwives Association and the Show Me Freedom in Health Care
Political Action Committee who are attempting to give the choice of where a
baby is born back to the mother.
Deanna Jurkowski is lobbying at the capitol for the passage of this
bill, which would allow mothers in Missouri the choice of where their baby
is born.
Jurkowski said that midwifery is legal, or not illegal, in 40 states and
that by making it illegal and unavailable, it is increasing the number of
unattended home births that occur, often with no one there who knows how to
stop a hemorrhage or resuscitate a baby.
She said she has been working for three years to get this bill passed.
According to Jurkowski, the Missouri Medical Association is coming out
strongly against this bill.
"It's all volunteers," said Jurkowski. "We do not have a paid lobbyist.
We're a grassroots movement. We've been working diligently for the last
three years."
The bill has passed the House twice before and was blocked in the Senate
both times. This time Jurkowski said she believes it's getting farther in
the Senate because legislators know more about the midwife profession.
"We've gotten farther than we've ever gotten before," said Jurkowski.
"We've perfected the bill; now we're waiting on the roll call vote. Sens.
(Chuck) Graham and (Yvonne) Wilson have said they're going to filibuster so
we're just not sure what's going to happen from this point on."
She said that she has talked with Sen. Chris Koster and that in the past
he's been supportive, but this year he's been much more supportive.
"We're not sure but with enough work, we're pretty sure we could pass
the House again," said Jurkowski.
She is somewhat worried about a lot of new people in the House. She said
that getting this bill passed is not only about getting information out
there, but combating the misconceptions of what a midwife does.
"There are people who think that midwives will perform abortions and
that's not true," said Jurkowski. "All a midwife is there for is to provide
care during a normal pregnancy. They do prenatal care and the child birth,
check on the mother afterwards, but if anything comes up that is outside of
normal, they will transfer that patient to the hospital."
Jurkowski said that she has had an illegal home birth, but in Illinois,
not in Missouri.
"That child died," said Jurkowski. "But that child died because she had
a heart defect, she had surgery and something happened during the surgery."
In the subsequent investigation the doctor reported to the coroner's
report that the child had had a home birth and that it was a lack of
prenatal care.
"Well we could produce prenatal records, but we had to cross off all
identifying information about our midwife because they actually hunt down
and prosecute midwives in Illinois," said Jurkowski.
She said that right now if a mom chooses to have a home birth and
something goes wrong she has to call 911 and the midwife has to leave
because she'll be arrested and prosecuted.
"Women are choosing to take that risk anyway," said Jurkowski. "If this
bill passes it's going to license and regulate these midwives. We're going
to have a standard of care. They're going to be licensed. If something comes
up where there is a transport needed the midwife can go to the hospital with
the mother and she can relay all the information...It'll be safer for
mothers and babies."
She said that research shows that in a low-risk, healthy, normal
pregnancy a home birth is just as safe if not safer than a hospital birth.
Jurkowski stated that a midwife would be required to make a decision
whether a mother is healthy enough for a home birth; and that if they are
not, the midwife would not provide them with health care but send them to a
medical professional.
She said the other part of this bill regards collaborative practice
agreements, and that is where a midwife would have to have a doctor sign off
that he's going to be responsible for her actions and that is not going to
work.
This bill really focuses on Certified Professional Midwives, a
nationally recognized title and profession.
Midwives Continued from Page 1
"Certified Nurse Midwives are legal in the State of Missouri," said
Jurkowski. "They can do home births if they have a collaborative practice
agreement. There's only one doctor in the state willing to sign
collaborative practice agreements and he's not going to do it anymore. So
that means there's only one midwife doing home births in the State of
Missouri, legally."
She said that it sounds good in theory but that the doctor is putting
his license on the line for the actions of someone else.
"This bill says everybody's actions should stand alone," said Jurkowski.
"The midwives should stand alone, the doctors should stand alone, they're
only responsible for something they do."
If the bill passes, Certified Professional Midwives will be required to
go through the same training as in other states, with differences according
to the state.
The CPM credential is the only one that requires the midwife to have
training in out-of-hospital births.
Certified Professional Midwives are required to have 1,350 clinical
hours of one-on-one training with their preceptor plus their academic work,
which takes years of full-time study to complete, said Jurkowski.
They are also required to take the North American Registry of Midwives
(NARM) exam -- an eight hour written exam and demonstrate proficiency at 750
hands-on skills, before receiving their certification.
The CPM credential process is overseen by the National Organization for
Competency Assurance - the very same one that oversees nurses, nurse
practitioners and nurse midwives credential process.
She said that another issue that comes up with this bill is insurance
and the fact that midwives are not required to carry malpractice coverage.
"No insurance group is going to cover them because it would be
astronomical," said Jurkowski. "Currently in the State of Missouri a
physician is not required to carry malpractice insurance. Hospitals may
require them to, but Missouri State Law does not require them to carry
malpractice insurance."
She said that physicians are not required to disclose to their patients
whether or not they carry malpractice insurance. They don't have to inform
the patient of their history, background, education or insurance.
"A midwife, according to this bill, has to disclose all of these things:
the risks, the benefits, her training, how many births she's attended and
whether or not she carries insurance, which is a good thing. That means the
mom is getting all the information and is able to make a well reasoned
decision."
She said that sometimes it feels like they're (legislators) saying that
women in Missouri aren't smart enough to make a good choice.
"If you're going to complain about something you've got to be willing to
make a stand to fix it," said Jurkowski. "That's why I do what I do. ...
We're not going away. We'll keep pounding the pavement until we get there.
... We need the support. I know there are a lot of medical professionals who
disagree, but my opinion is that by not having midwives legal in the state
and regulated by the state that it's harming mothers and babies. I think it
would be much safer for both mothers and babies and families in general, to
have this option in the State of Missouri."
On April 15 Jurkowski received an e-mail which included a link to a
petition asking Missouri Legislators to allow Certified Professional
Midwives to practice in Missouri.
After posting the link on her blog, and as of April 24, there were 787
signatures on it.
For more information or to help the cause please call Deanna at (660)
530-4310 or visit her Web site at www.deannajurkowski.blogspot.com.
The petition is located at
http://www.petitiononline.com/MOMW/petition.html.

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