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Supporting Pregnant Women During COVID-19: A Call To Action

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“During a pandemic, out-of-hospital birth is essential to minimizing transmission, maintaining health, and efficiently utilizing medical resources. Midwives who specialize in out-of-hospital birth should be involved in emergency planning for maternity care during a pandemic.” 

Foundation for Advancement of Midwifery
Supporting Pregnant Women During COVID-19: A Call To Action
Supporting Pregnant Women During COVID-19: A Call To Action

Rome (and the state of Georgia) needs to step up in the care and options for our moms-to-be. During this COVID-19 pandemic, I’ve heard fear stories that pregnant women would rather have babies unassisted in their car in the hospital parking lot (so they are close if there is a problem) than risk going inside.  I am calling on all of YOU to help support these women by legalizing Certified Professional Midwives in Georgia (if only temporarily) to allow for safer out-of-hospital options by emailing our pandemic leaders.

A Few Facts:

  • CPM’s are Certified Professional Midwives and are highly trained and specialized, similar to Certified Nurse Midwives. CPM’s are licensed in 34 states plus Washington DC, but Georgia is not one of them.
  • CPM’s specialize in out-of-hospital births and can provide proper, safe care to low-risk women.
  •  Bill HB910 was up for voting in the Georgia legislature recently allowing CPMs to become licensed. The legislative team thought it would pass. The vote was never called.
  • New York by executive order, just allowed any midwife licensed in another state to legally practice for the next month.
  • By writing to our Pandemic Task Force, you can help make Certified Professional Midwives Legal (at least temporarily) to allow women more safe out-of-hospital options for childbirth during this pandemic.*

What YOU can do to help:

1. Read this newsletter about out of hospital births during this pandemic. Select a few points that stick out to you.

2. Draft a respectful email to the Coronavirus Task Force Committee members asking that they make Certified Professional Midwives legal immediately, at least for the current time. Include the few points from the letter above. Tell committee members how women are choosing unassisted births right now instead of going to the hospital. Mention Bill HB910* if possible.

3. Include and attach this statement.

4.Send the email to the following leaders:

Candice.Broce@georgia.gov, Director of Communications for the Georgia Coronavirus Task Force
Ben.Watson@senate.ga.gov, Chair of the Primary Care Subcommittee on the Task Force
Kay.Kirkpatrick@senate.ga.gov, MD and Legislators on the Committee
Mark.Newton@house.ga.gov, MD and Legislators on the Committee
Emily.Jones1@dph.ga.gov, Dept of Public Health

5. One more thing: Insurance companies are recognizing the risk of in-hospital births during this pandemic. Some are offering to cover out-of-hospital births. Please sign this petition to help support this coverage. (Note: many midwives do not accept insurance, so you will need to be educated about your options.)

*Note: I 100% support hospitals and medical care. This is not written to persuade women to have home births. It is simply about increasing resources and options for our women in the case that they may be interested in a home or birth center birth. I would rather safe alternatives to opting to unsupported births if women are nervous to go into hospitals.

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How Midwives can be Beneficial for Low-Risk Women

Studies have repeatedly shown that, for low-risk women, planned midwife-attended out-of-hospital birth has excellent outcomes with very low rates of intervention. This type of care has been proven to provide high quality, safe care with

  • low cesarean rates
  • less unnecessary interventions
  • reduced costs
  • expanded access
  • higher maternal satisfaction

According to this statement addressing the pandemic from the Foundation for the Advancement of Midwifery, legalizing Certified Professional Midwives (those with official training and education) can serve our population as a whole. Here’s how:

…Low-risk, healthy pregnant people who do not need to birth in the hospital will have nowhere else to go and medical providers who could otherwise treat sick people will be needed to care for pregnant women.

Barriers to out-of-hospital birth should be eliminated during a pandemic to meet the demand and relieve pressure on hospitals.

With increased demand for out-of-hospital birth and increasing strain on our hospitals, policy makers and institutions must act quickly to involve out-of-hospital midwives in pandemic planning and response

GA has the highest maternal mortality rate in US.  Having had three children in three different hospitals and two different states, and training with Nashville’s premier Birth Network Doula trainer, I understand that Rome is behind the times in options for women.

What is a Certified Professional Midwife?

Enter my friend Maria, a Certified Professional Midwife (CPM). Maria holds a Masters Degree just like a Certified Nurse Midwife, which ARE legal in Georgia. She has years of experience owning and running her TWO birth centers in Utah, and was an approved Medicaid provider. A CPM is the only credentialed midwife in the United States whose evidence-based training is specific to community-based (out-of-hospital) maternity care.

Care from a Certified Professional Midwife includes:

  • monitoring the physical, psychological and social well-being of the mother throughout the childbearing cycle
  • providing the mother with individualized education, counseling, and prenatal care (relationships with mom)
  • providing continuous hands-on assistance during labor and delivery
  • providing extensive postpartum support

Maria recently moved to Rome. Here, her profession is illegal.

The national credentials are for CNMs and CPMs, but GA only licenses CNMs. Therefore, CPMs in GA hold licenses in other states, but could get in trouble for practicing unlicensed in GA.

CNM is a Certified Nurse Midwife, which is licensed as an Advanced Practice Registered Nurse with a Masters in Nursing and may attend birth in any setting. All midwives in GA hospitals and accredited birth centers are CNMs. They work under or collaboratively with physicians. They must have a delegating physician to prescribe medications. CNM scope of practice includes primary care, GYN care and newborns. A few practice in Birth Centers and home births.

CPM is a Certified Professional Midwife. She is trained specifically for homebirth, and has met NARM standards for certification. She may choose to be a member of the state midwifery association, GMA, who has practice standards for risk and transfer criteria, and hosts peer review. CPMs are not licensed, but have a legislative bill (HB910) that needs support to pass for licensure. Through licensure there is regulation and a grievance processes.

There is hope: *Bill HB910 was up for a vote a month ago in the legislature which would have given licensure to Certified Professional Midwives who had been through an accredited educational program. Maria was there. Our legislative team was fairly confident they had the votes to get it out of subcommittee, but the vote was never called. The subcommittee chair closed the hearing without allowing a vote. Unless the governor chooses to take action, it’ll be at least another year before the vote can be made.

If you are interested in more information and support for mamas-to-be or being in contact with Maria (CPM, once legal), please contact me at romegawithkids@gmail.com

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Sources

New Studies Confirm Safety of Home Birth With Midwives in the U.S. by Geradine Simkins, CNM, MSN, Executive Director, Midwives Alliance of North America Outcomes of planned home births with certified professional midwives: large prospective study in North America BMJ 2005; 330:1416

Outcomes of Care for 16,924 Planned Home Births in the United States: The Midwives Alliance of North America Statistics Project, 2004 to 2009. Cheyney, M., Bovbjerg, M., Everson, C., Gordon, W., Hannibal, D. and Vedam, S. (2014), Journal of Midwifery & Women’s Health, 59: 17–27.

Find more information on CPMs at georgiacpm.org

Details on Legality and Homebirth in Georgia by Moonlight Midwifery

Pregnant Moms Scared of COVID-19 in Hospitals Need Home Birth Options