State House Testimony

You might remember that I said yesterday's efforts at the State House were really GREAT. Today, I'd like to share with you just a teeny morsel of why it was so awesome!

I wish I could post all of the AMAZING advocacy given by the SENATORS for our bill but the notes are just entirely too long. Instead, I will post this. The following is the testimony given in favor of SB 240 :

(I doubt the Moms giving these testimonies would mind their names being attached online but since I've always been funny about it myself, I have removed their last names.)

TESTIMONY 1
Good morning, my name is Cristy _____ and I am a mother of 4 with our 5th blessing on the way, set to arrive in May. My husband and I have been married 9 years and reside in Birmingham.

We are the typical middle class family. We have a house near downtown Bham, two cars, too many toys for the kids to play with, a swing set in the back yard and of course a dog.

Recently, my husband, who has his masters in divinity from Baylor University and who pastors our church downtown was approached by the state to create a non-profit program to help men transition from prison back into society. We accepted their request and thus had to change insurance carriers to eliminate add’l cash outflow, as we started the non-profit with our savings account.

Well, along came our 5th little one and to our surprise our new insurance policy does not cover maternity services for 365 days, and as you can see we can’t wait that long!

We are not quite sure what to do at this point;
1) We can birth unmedicated at the hospital and expect to pay $8-$10,000 out of pocket.

2) We could drive to TN to hire a midwife who is state licensed, but with 4 hour labors we do not feel that is a wise option to spend 2-3 hours of it on the road.

3) We could hire a Certified Professional Midwife who *might* be willing attend us at home, while risking the chance of being arrested and thrown in jail.

4) Or we can have this baby at home with no professional assistance--not an option my husband is thrilled about.

And we are a middle class, well-educated, conservative family. Our family has access to 5 hospitals within a 2-mile radius of our home, yet we can't afford to birth with any of them.

Restricted access to maternity care in Alabama has many faces. The personal one I just shared-- the family who lives in one of the 31 counties with NO hospital maternity services-- the family who is one of the 650,000 Alabamians with NO health insurance-- the family who can’t attend birth classes or prenatal appts. b/c they have limited or no transportation…the list goes on…

The opposition would like to squash this legislation and they would like to incite fear in you all that the risk of homebirth is simply too great. That midwifery care is simply too outdated or not professional enough. Yet they have given you no evidence-based research …just fear-driven opinion.

Senators, there is NO scientific evidence to suggest that planned home births with a qualified attendant is any more dangerous that a low-risk hospital birth. You can refer to tab 3 in your Reference Guide that provides pages upon pages of documented research. The scientific evidence suggest that midwives who possess the CPM credential provide excellent and professional care AND is demonstrated by their national infant mortality rate. (Hold-up and Read the rates from hand-out).

Families in Alabama deserve access to maternity care. Hospitals are closing their doors in rural counties and physicians are flooding the more lucrative, metropolitan areas.

There is a great passage in the Bible from Proverbs 31 that says, "8 Speak up for those who cannot speak for themselves, for the rights of all who are destitute. 9 Speak up and judge fairly; defend the rights of the poor and needy.”

Today, I am humbly asking you to see the fear tactics for what they are and to choose instead to consider the scientific evidence and be a powerful voice for those who are looking to you for help.
Thank you!


Testimony 2
Good Morning. Thank you all for the opportunity to address you today regarding SB240. My name is Jennifer Moore. I am a Certified Professional Midwife living in Birmingham and licensed in Tennessee. I hold an MA and a Master’s of Public Health in Maternal and Child Health. I am also the President of the Alabama Birth Coalition and as such, am here today representing hundreds of Alabama families who are demanding access to state regulated Certified Professional Midwives.

I’d like to take just a minute to address one point with you. Our opposition refers to us as “lay” midwives. I’ve checked every dictionary in my home, and we have a lot of them because my husband is a professor. And they all say that “lay” means untrained, unskilled, unprofessional. I take exception to that because I trained for five years to obtain the CPM credential. I am not untrained or unskilled.

This morning I would like to draw your attention to two documents that should answer the majority of questions you have about SB240. The first is the Legislator’s Reference Guide. In it you will find answers to most issues regarding the licensure of Certified Professional Midwives. For example, you’ll find answers to questions of safety at tab 3, education at tab 5, and malpractice at tab 6. Members of the Alabama Birth Coalition are eager to discuss with you any questions you may have that are not fully addressed in this guide.

The other document, SB240 Discussion Points, is intended to answer your questions about the bill itself. In this overview of the bill, you will find an outline of every section and provision of the bill, and an interpretation, where needed, of specific provisions. SB240 has been over 5 years in the making, and is the result of many meetings with midwives, parents, and our opposition. Italicized text indicates our response to concerns or objections that have been raised.

If you’d please look at the section explaining the definitions, there is one final point I’d like to make. Under the definition of Licensed Midwife, you will find an explanation of the Certified Professional Midwife credential. We selected this credential as the single qualification for a Licensed Midwife for several reasons.

1. The CPM is the only credential that requires training in the knowledge and skills unique to out-of-hospital birth. Twenty-two of the 24 states which regulate out-of-hospital midwives also use this credential. No state has ever rescinded their midwifery program.

2. The credential is legally defensible and psychometrically sound, which reduces the costs of the regulatory process for the state.

3. Using the CPM as the basis for licensure eliminates the state’s responsibility and liability for all aspects of certification, including the ongoing psychometric evaluation of the written examination.

Thank you for your time and your willingness to consider this important piece of legislation.

Testimony 3
My name is Lisa _____. I am a mother of four and I live in Huntsville.

In 2006, AL’s infant mortality rate was 9.0. The Department of Public Health has identified five factors contributing to Alabama’s rising infant mortality rate: low birth weight; teen pregnancies; mother's health status; high rates of smoking, especially among young women; and lack of health insurance. Senator Coleman recommended last week that we find a mother on Medicaid who used a midwife to testify today. We were unable to do so. But I hope to convey to you some of the obstacles poor mothers face in receiving maternity care, and ways midwives could positively address those barriers.

My third pregnancy was covered by Medicaid. At the time, I was living with my in-laws. To get to a prenatal appointment I had to load up my one- and two-year old children and take my mother-in-law to work so that I had a way to get to the clinic. At the health clinic, we waited an average of 2 hours before I was seen. At every visit, nurses questioned why I was having my children so close together. It was clear they didn’t believe my answer that I was using birth control every time I became pregnant. That was one of many things I felt judged for. Why was I living with my in-laws? Why didn’t I get a job? Why did I care so much about natural childbirth? I hated prenatal appointments. I always left feeling like dirt.

Compared to some mothers, however, I was lucky. At least I had a car, and didn’t have to drive a long distance to the appointments. I spoke English, and so did the nurses. I was allowed to bring my children, and didn’t have to find child care I couldn’t afford. All of these issues can be huge hurdles to a mother receiving prenatal care. If a woman has to work so hard to get to the appointment, only to be treated with disrespect, it’s easy to see why our percentage of less than adequate prenatal care is highest in poor counties. And this is where midwifery care could make a real difference. I give my time to this cause because my midwives shared with me their time, their skill and their wisdom. Above all else, they respected me and their respect motivated me to care for myself better during pregnancy than any other time in my life.

I don’t intend to suggest that midwives are the solution to our high infant mortality rate. It would be difficult to overcome the perception that midwives equal racism and poverty. Furthermore, the number of women who will ever choose home birth with a midwife is very low. Just .3% of Alabama births in 2006 occurred outside a hospital. Nationwide the rate is about 1%. Given the low numbers of out-of-hospital births, and the very different kind of care midwives provide, I contend that Dr. Williamson’s claim midwives at home births will increase our infant mortality rate is not based on evidence. In fact, under tab 8 of your reference guide, you can see that in licensed states which track out-of-hospital perinatal and neonatal mortality rates, they are 45 to 85% lower than overall state rates.