Are LMs Paying Attention? We Should Be!
Wandering mapless through the Legislation Land can be intimidating. It can be confusing. It's hard to know exactly what you should be doing at any given moment and you think, as many of us have, "What exactly am I supposed to be doing here?"
So, I'll be very frank: What all of us should be doing is two-fold--pay close attention and pay our lobbyists.
While for us in Florida, the legislative conversation has popped up after many years (decades, almost) of relative quiet, the national conversation about the LM/CPM "problem" has not really touched us. This is despite the presence of the 2014 ACOG CPM Toolkit which suggests legislative activity related to LMs/CPMs to include such things as
"Consider requiring home birth patients to preregister at the nearest
hospital and have a transfer agreement."
"Require midwives to keep and file client summary reports; consider
quarterly, biannual or yearly filing requirements."*
"Require midwives to report, within a specified time period, any death
or morbidity including stillbirths."*
"Require midwives to file with the state a notice of intent to home deliver." (ACOG Toolkit)
While we, as autonomous health care providers, deeply value the safety of all clients/patients, and we do support the reporting of adverse events (starred above), we must be part of this legislative activity.
Why? Because we understand the landscape of out-of-hospital birth; we understand the challenges and successes. We are the experts in what's working with our law and rule and what's not.
We ABSOLUTELY MUST show up and stay present when these changes happen. Which is right now with SB 510 and the House Bill (as yet un-filed).
I will not sugarcoat this for you, reader. The conversation about LM practice has been an ongoing one. The language that follows was sent to legislators as suggestions to the "LM Problem." This is quoted directly from a correspondence from a Florida-based OB to ACOG regarding the practice of LMs:
"There are many issues that need to be addressed by the state.
1. Training requirements need to be reviewed if the state is going to continue to sanction and recognize this group as providers of health care.
2. Licensed Midwives should be required to have physician supervision. That physician should be required to accept their patients for treatment at a hospital when needed. Finding a physician, one with hospital privileges will be very difficult.
3. The scope of practice of this group needs to be closely scrutinized and reviewed on a regular basis."
So, Midwives of Florida, there actually is a map for Legislative Land. It's a map that takes us through dangerous territory, and it's a map that was written by ACOG in 2014.
And, it's a map that we may not wish to just willingly follow blindly, without being an integral part of the conversations. We need to agree to forge ahead together, work hard to meet in the middle with ACOG when possible, and have supporters who know the landscape to make sure that we know where we're going to land.
Those supporters and advocates are our lobbyists, Ron Watson and Louis Rotundo. The Legislative Committee also is working hard for all licensed midwives throughout the state.
But we CANNOT DO IT WITHOUT YOUR SUPPORT. If each midwife with a an active license paid $155/year our lobbyists fees of $30,000 would be paid for immediately.
We have about a $3500 deficit at the moment with December 1 payment to the lobbyists (that's about 22 of you!).
For those of you who have paid the Foundation or Midwives Association of Florida, thank you a million times over.
For those who haven't but can, please do so soon.
For those who can't pay the full amount, sign up for recurring $20 payments because those add up.
For those who can't pay $20/month, fundraise with your clients. The average number of births per midwife (according to our annual report) is 14.26 deliveries per year. If each of your clients who delivered donated $11, you'd raise your $155.
You can also give directly to Midwives Association of Florida by donating through their PayPal, MAFloridaTreasurer@gmail.com.
Please join the cause and help protect licensed midwifery by donating to fund the lobbyist today.