The Mommy Blawg

Do Home Schoolers Deserve a Tax Break?

2011-01-07T00:01:00.002-07:00

Do Home Schoolers Deserve a Tax Break? Should they even want one? The New York Times explores this debate with seven different opinion pieces.

Healthcare Providers and Social Media

2010-11-29T23:59:00.001-07:00

The American Medical Association has issued a new policy on the use of social media (AMA Issues New Policy To Guide Physicians’ Use of Social Media on the Health Care Law Blog). The new policy "aims at helping physicians to maintain a positive online presence and preserve the integrity of the patient-physician relationship."

Do you think that the AMA guidelines would be helpful for other types of healthcare providers, such as midwives, doulas, chiropractors, and so on? Although these types of providers often have a much closer, personal relationship with their clients than do medical doctors, it is always a good idea to protect client's privacy (whether or not the provider is a HIPAA-covered entity) and to separate personal and professional online content.

Informed Consent

2010-10-19T22:08:00.000-06:00

Midwife Thinking sums up informed consent, according to Australian law.

Legal Rights and VBAC

2010-09-10T16:21:00.000-06:00

The Giving Birth With Confidence blog has a new series titled A Woman’s Guide to VBAC: Navigating the NIH Consensus Recommendations. It includes a section on Legal Rights and Protections for VBAC [Vaginal Birth After Cesarean].

Midwives in Australia

2010-06-30T09:10:00.000-06:00

Private Midwife Melissa Maimann explains the current legal situation in Australia in Homebirth is not illegal!

Midwifery Legal/Legislative Updates

2010-06-17T19:51:00.000-06:00

I do mean to post these more often...

In Florida, an appeals court confirmed the conviction of Tanya and Linda McGlade for practicing midwifery without a license. The two were charged after the 2004 childbirth death of a family member. Both women have been sentenced to a year in prison, but had been released pending appeal ("Two women lose appeals in midwifery convictions").

North Carolina's effort to pass licensing legislation is reportedly dead ("Midwife Supporters Will Push Again Next Session").

Pumping at Work

2010-05-13T11:16:00.003-06:00

Lawyer Jake Aryeh Marcus asks you to Curb Your Enthusiasm about the new Federal workplace pumping law on her blog, Sustainable Mothering. Also check out, for comparison's sake, The risks of noncompliance with Oregon's milk expression law by Marion Rice of Nursing Mothers Counsel.

Pumping at Work

2010-05-08T12:32:00.003-06:00

The Washington Business Journal reports on the workplace-pumping provisions of the new health care package, focusing on the business aspects. Check out these facts about why businesses should support lactating women in the workplace:

In 2008, the Department of Health and Human Services outlined the bottom-line business benefits of accommodating breast-feeding mothers. They include:

○ Breast-feeding employees miss work less often. Mothers of formula-fed infants take more than twice as many days off to care for sick children. Maternal milk boosts an infant’s immune system and helps protect the baby from common childhood illnesses and infections — a particularly high risk for children in day care. Health insurer Cigna Corp. conducted a two-year study of 343 employees who participated in their lactation support program. Among other things, the program saved $600,000 by reducing absenteeism rates.

○ Breast-feeding lowers health care costs. Cigna’s program resulted in annual savings of $240,000 in health care expenses and 62 percent fewer prescriptions. The reduced health care costs for breast-fed infants translate into lower medical insurance claims for businesses. Mutual of Omaha Insurance Co. had a similar program and found that health care costs for its working mother employees who did not breast-feed were $2,146 higher per person.

○ Workplace lactation support programs can improve employee retention rates. One study of several companies with lactation support programs showed that 94.2 percent of working mothers returned to their employers after maternity leave when lactation support programs were in place. That compares to the national average retention rate of just 59 percent. Another study estimates that companies save $75,000 for each employee who returns to the workplace after childbirth.

Vegetable purees can not be copyrighted

2010-04-30T13:39:00.004-06:00

Says a New York federal appeals court (AP via law.com). Jessica Seinfeld was sued for trademark and copyright violations after her book, Deceptively Delicious (reviewed here) was published about the same time as Missy Chase Lapine's The Sneaky Chef. Both cookbooks involve sneaking vegetable purees into kid's foods. Lapine also sued Jessica's husband, commedian Jerry Seinfeld, for defamation based on comments he made on The Late Show with David Letterman.

Jury Duty

2010-04-27T17:00:00.001-06:00

Kellymom has a nice collection of resources regarding jury duty for breastfeeding moms.

Legal warning over umbilical cord blood collection

2010-03-13T23:20:00.004-07:00

Interesting article about cord blood collection in the UK - Legal warning over umbilical cord blood collection. The article implies that is illegal to collect cord blood without a license; however, a lack of uniformity among hospital policies, with some hospitals not allowing collection, leads some parents to take matters into their own hands:

The Human Tissue Authority (HTA) has written to more than 150 organisations following concerns that parents, including new fathers, are collecting the blood themselves using kits delivered to their homes.

Some midwives have said they are being put under pressure to collect the blood illegally and there are fears this could be compromising patient care.

The Royal College of Midwives supports the HTA's actions, saying, "[t]he time during the birth when cord blood is collected is one of the riskiest times, in terms of safety. Therefore, it is essential that midwives are able to concentrate on the birth and are not put under pressure to carry out unregulated and unlawful cord blood collections."

Pregnant and Shackled

2010-02-26T15:22:00.001-07:00

RH Reality Check's Aimee Newman examines Washington state's proposed legislation which would ban on the shackling of pregnant incarcerated women or youth in almost all circumstances. Newman points out that the majority of women in prison are first-time, non-violent offenders. And a startling 5% of incarcerated women in the US are pregnant.

New America Media reports on the shackling of pregnant undocumented immigrants in Arizona; and check out Boulder Weekly's Pregnant in Prison.

Lawyer Moms

2010-02-08T11:19:00.006-07:00

I've added a few more blog links to my side bar. A Lawyer Mom's Musings has been caustically blogging since 2008. The Unnecesarian, one of my favorite daily reads, has recently gone to a group-blog format, introducing Mysteria a/k/a ANaturalAdvocate, who is a recent law school graduate and future bar-taker. And Sara has been blogging lightly, yet insightfully, for about a year at D is for Doula. The last two join the small sorority of what I term "birthy lawyers".

ETA: You may notice that I've added a list of Delicious Bookmarks. These are not bookmarks that taste good; it's merely interesting article that I've come across that I want to share, but don't necessarily want to blog about.

Pit Police

2010-01-17T14:22:00.004-07:00

What will it take for me to break my 10-month-long blogging silence (more on that later)? This situation out of Australia (HT The Unnecesarian). Although the health service has since apologized, it is things like this make me truly afraid for the direction our civilization is heading.

Grand Rounds

2009-04-01T23:40:00.002-06:00

Paul Levy is hosting this week's Grand Rounds at his blog Running a Hospital ('cause that's what he does). The topic is "when things go awry".

Is VBAC illegal? Is homebirth illegal?

2009-03-01T13:42:00.004-07:00

The VBAC Facts blog has a great explanation of the legalities of VBACs and homebirth. To summarize, VBAC is legal everywhere in the US. Homebirth (whether VBAC or not) is legal everywhere in the US. The only legal restrictions are placed on providers, what they may do and where they may do it.

You may also be interested in my previous blog post, Is it legal for Florida midwives to do VBACs?

Oh, and if you haven't read it yet, don't miss Time magazine's article The Trouble With Repeat Cesarians in conjunction with ICAN's recently-released report on the organization's hospital survey. I especially liked this quote from the Time article:

But while many obstetricians say fewer patients are requesting VBACs, others counter that the medical profession has been too discouraging of them. Dr. Stuart Fischbein, an ob-gyn whose Camarillo, Calif., hospital won't allow the procedure, is concerned that women are getting "skewed" information about the risks of a VBAC "that leads them down the path that the doctor or hospital wants them to follow, as opposed to medical information that helps them make the best decision." According to a nationwide survey by Childbirth Connection, a 91-year-old maternal-care advocacy group based in New York City, 57% of C-section veterans who gave birth in 2005 were interested in a VBAC but were denied the option of having one.

Hm. Why give patients information about a "procedure" that is not offered by you or allowed by your hospital?

Midwifery Care in Canada

2009-02-19T21:26:00.003-07:00

Mazely writes about A Midwife Crisis: Maternity Care in Canada:

The practice of midwifery in Canada is regulated by provincial and territorial authorities. Midwives can only legally practice their profession if they are registered with these authorities, but only seven provinces and territories have regulatory systems in place. This means that midwifery is essentially illegal in the rest of Canada. Further compounding the problem is the fact that even where midwifery is legal, it isn’t always funded or covered by health care. A two-tier system of care has been established, where the standard of maternal care changes depending on your geographic location. Midwives are only available to some women, in some parts of the country, and only some of those women can afford their services.

In addition to giving a brief history of midwifery in Canada, Mazley links to the Canadian Midwifery Regulators Consortium's chart of the legal status of midwives in Canadian territories and provinces.

Traveling mothers still "face hurdles"

2009-02-10T12:13:00.004-07:00

Traveling mothers still face hurdles in pumping breastmilk, reports the New York Times' business section, despite updated TSA rules regarding the carrying of expressed milk on airplanes. There is encouraging news, though:

Ernst & Young, the New York City financial services company, provides free travel kits so that women on business trips can ship milk home to their babies. And the Boston Consulting Group, a management consulting firm based in Boston, helps women bring their babies on business trips by covering travel expenses for the infant and a baby sitter.
Ms. [Suzanne] Riss [editor-in-chief of Working Mother magazine] called such programs “very cutting edge” and noted that they “go a long way” toward creating loyal employees. “But they’re still the exception, not the rule,” she added.

Top 'Lawyer Mom' Blogs

2009-01-11T13:39:00.004-07:00

I recently discovered that in December Darling Hill (a blog which I had never heard of but plan to keep an eye on!) named The Mommy Blawg one of the Top 'Lawyer Mom' Blogs of 2008.

Check out the other blogs on the list - there are some good ones. And you can find a wealth of information at Darling Hill, which is "the blog that’s devoted to that place where life and flexible lawyering meet. A 100% lawyer-parent friendly legal niche."

FDA raids Miami birth center; Placentas, medical records confiscated

2009-01-03T11:30:00.001-07:00

On Christmas Eve, federal, state, and local authorities executed a search warrant on the Miami Maternity Center following a 10-month joint investigation by the Florida Department of Health, the US Food and Drug Administration, and Miami Dade Police Department’s Medical Crimes Unit. Birth center staff were allegedly dehydrating and encapsulating placentas in a process that resulted in placentas from various birth mothers becoming commingled. Midwife Shari Daniels denies the allegations, according to news reports:

"They charged in here as if I were making crack cocaine," Daniels complained. "They could have sent one person and we should have shown them everything." She suggested that the raid might have been caused by angry obstetricians, who charge several times what she does to deliver a baby. "The local docs are screaming their heads off.''

Jodi Selander, owner of Placenta Benefits, a placenta encapsulation service, writes on her blog:

I am (obviously) a huge proponent of placenta encapsulation. However, I can not in any way condone this type of activity. I created the Training & Certification program specifically to avoid these types of situations.

As an advocate for the movement toward legitimizing the use of placenta for its natural purpose, this story is absolutely outrageous. People who operate with such a total lack of regard for the gravity of the process and who apparently do not realize that the FDA is not on our side, set the movement back and make it harder for the rest of us who are being safe and working toward legitimacy.

Please, people - don’t think that you can find free instructions for drying placentas on the internet and just set up shop. This is serious. You need to comply with government standards and regulations. Get some training. Work with us. Together we can do it. But not when people like this are operating out there.

White Collar Crime News blogger Jef Henninger has a lawyer's take on the situation:

I hate to see good people get caught up in criminal cases when the entire problem could have been easily avoided if a good attorney got in there and essentially performed an audit on the entire business....I don’t know enough about the facts of this case to really figure out what the situation is here, but I see no indication that anyone was harmed. At the most, it seems like they had sloppy business practices while they performed a service that the people wanted; but the FDA does not agree with. This seems like it would be a good case for a lawyer to argue that this is a technical violation of civil law and not a criminal violation as no one was actually harmed.

And, as I have mentioned before, I would love to have an expert's opinion about the HIPAA implications of confiscation of medical records. What happens to a person's right to his or her own medical records when those records become evidence? I assume that HIPAA exempts healthcare providers from liability when complying with a legitimate court order or other legal process, but do the police, prosecutors, and court personnel have the same duty as healthcare providers do to keep protected health information confidential? What if the health of a woman and her baby are compromised because her prenatal records are unavailable? Is there liability? Is anyone but me asking these questions?

Update 1/08/2008: For more information and continuing updates, please visit The Placenta Blog.

Midwife Sued

2008-12-28T21:43:00.003-07:00

Midwife in the Clouds discusses being sued here and here - for allegedly misrepresenting the fact that she was an "in-network" provider:

Obstetrics in America is filled with stories of birth workers who can no longer have loving relationships with their patients because they are scared to death of lawsuits. The only people who suffer from these lawsuits are the mothers and babies because it becomes harder and harder to get the care you want when your caregiver is scared or limited by malpractice insurance.

Thankfully, this case was not about my ability as a midwife or my care of the mother and baby but a question of contracts, insurance, and money. I am so grateful to have learned what I did without anyone being seriously hurt - my heart goes out to midwives who are charged with an unwarrented medical lawsuit.

ABA Journal Blawg 100

2008-12-06T11:12:00.000-07:00

The American Bar Association Journal has published a list of this year's 100 best legal blogs. I didn't make the list. Neither did Blawg Review, though, so I'm in good company.

NaBloPoMo

2008-11-30T23:07:00.002-07:00

Poland debates paying for childbirth pain meds

2008-11-30T22:49:00.001-07:00

From Anna Wilkowska-Landowska ("Poland Says No to Pain-Free Childbirth"), the Polish health system no longer plans to pay for childbirth drugs. The Ministry of Health Director suggested (in an article in a Polish newspaper) that not only can the state budget not afford to ensure free anesthetization during childbirth to all Polish women, but that there are not enough anesthesiologists in Poland. Says Wilkowska-Landowska:

In Western European countries, as well as in Poland's neighboring countries, childbirth anesthetization is considered a standard service provided to women. The question becomes, then, why do Polish women have to pay for it? This situation divides the Polish women into two groups: those who can afford to pay for anesthetization and those who cannot afford to pay for something to which they are entitled.

The article also mentions that since the Polish government is encouraging families to have more children, the Minister's statements only make the decision to have a baby more difficult for women.

Well, I guess it's another strike against socialized medicine.

NaBloPoMo - almost there!

2008-11-29T22:59:00.000-07:00

Well, twenty-nine straight days of blogging, and I've run out of steam. Tomorrow we'll celebrate (it's also my birthday), but for now I'm going to get some sleep.

Thanksgiving

2008-11-27T03:18:00.002-07:00

Happy Thanksgiving, everyone! I'm thankful for the fact that it's NaBloPoMo and I'm still technically in the game.

From Thanksgivings past, I bring you What To Do With Leftover Turkey and Leftovers (or, a Tale of two grandmas). Don't forget to watch the Thanksgiving Day Parade!

Birth Center Grand Opening - Cleburne, Texas

2008-11-22T23:01:00.001-07:00

If you live near the Dallas/Ft. Worth metroplex - particularly the southwesternmost portion - you might want to check out the newest birth center:

We are thrilled to announce the Grand Opening Celebration of Edenway's Cleburne Birthing Center on Saturday, December 6, 2008 from 11am to 4 pm at 805 N Main, Cleburne, Texas 76033. Come see how we can help you achieve the birth you desire. Meet our staff! Tour our facility! Bring the whole family for FREE refreshments! FREE pregnancy testing! FREE chair massages! Door prizes! Kids' jump house! Free info about natural childbirth, waterbirth, fertility health, baby slings, massage, herbs, birth photography, and chiropractic care in pregnancy… This will be a fun event for the entire family! Visit us at www.cleburnebirthingcenter.com or call 817-558-BABY for more information.

New ABA Poll on the job market and the economy

2008-11-21T01:01:00.000-07:00

The ABA Journal is surveying lawyers about the job market and the current state of the economy. Results will be published in the January edition of the Journal.

Links for Midwives and others

2008-11-17T22:57:00.000-07:00

Thanks to Citizens for Midwifery for posting a link to USPharmD.com's list of 100+ Essential Online Resources for Midwives.

Homeschooling and Vaccinations under the Obama administration

2008-11-16T13:01:00.013-07:00

I guess this is the sort of question that everyone is asking these days. Yesterday I received a flyer in the mail advertising a seminar for estate planning professionals on how to advise their clients in light of the incoming administration. Of particular interest to my readers is how the Obama presidency will impact home schoolers and "mandatory" immunization programs. (If you have any input or links regarding midwifery, homebirth, or breastfeeding, please feel free to post in the comments; however, they tend to be state issues and I haven't heard any buzz about these topics).

Homeschooling - The Home School Legal Defense Association (HSLDA) recently sent out an e-lert on the subject of what to expect under an Obama administration. It states, "Despite HSLDA's efforts prior to the election to get an official statement from the Obama campaign regarding their position on homeschooling, we received no response." It goes on to mention the Democratic Party's support of the National Education Association (NEA) and public education in general, but asserts that the Federal government has no constitutional authority over home education. Of greater concern, perhaps, is the possibility that the United States under Obama will ratify the United Nations Convention on the Rights of the Child, a move which HSLDA opposes.

The blogger at Obama States of America has done quite a bit of research. Rational Jenn critiques the HSLDA position. And then there are Homeschoolers for Obama ("because there is no such thing as 'the homeschool vote'").

Vaccinations - Before the election, Autism activist Becky Estepp contacted the Obama and McCain campaigns regarding the candidates' positions on the issue of vaccine safety. The McCain campaign responded with a statement that "John McCain believes in the right for individuals and in the case of children, parents, to make informed health care decisions, and does not support pre-empting these prerogatives." Obama, however, responded only with a general letter about autism which did not address the issue of vaccine safety or parental choice. However, according to New Jersey mom Claudine Liss who asked Obama point-blank about his stance, Obama replied, "I am not for selective vaccination. I believe it will bring back deadly diseases, like polio." More details are available from Age of Autism (McCain Addresses Vaccine Safety, Obama Silent, McCain Senior Policy Advisor Responds To Autism Questionnaire, and McCain or Obama: Who Will Reform Vaccine Safety?); Inside Autism (The autism election and McCain supports vaccine choice) and the Oct. 23, 2008 press release.

While the issue of mandatory immunizations and exemptions are currently a matter of state law, the federal government does have a role to play in funding vaccine safety research, enacting legislation exempting vaccine manufacturers from tort liability, the availability of military exemptions, and so forth. In addition, there are Constitutional issues involved in religious exemptions (the Equal Protection clause) and the reach of state vaccination requirements, for example to private schools which do not receive government funding, which could be decided by presidentially-appointed federal judges.

For my part, just because we have elected a president who does not appear to share my views on issues that I am passionate about (namely, the right of citizens to make healthcare and educational decisions on behalf of themselves and their children without government interference) does not mean that The End is upon us. Of course, we must be eternaly vigilant in guarding our precious rights and liberties. Fortunately - in this case at least - government is a slow-moving beast, and I have come to the conclusion that one man cannot screw things up so bad that we cannot get it fixed four or even two years from now.

Baby, You're Home

2008-11-14T23:01:00.002-07:00

The New York Times published a piece on homebirth this week ("Baby, You're Home") which is getting good reviews in my normal-birth circles, though it was inexplicably placed in the "Home & Garden" section of the paper. It seems that while homebirths are up all over the country, the biggest surge seems to be in New York, according to local midwives and sellers of birth tubs. according to the article, this may be due, in part, to the impact of last year's documentary The Business of Being Born, which was filmed in New York City. Actual statistics on this won't be available for several more years, though.

Doctors 'in denial' about safe home births

2008-11-11T23:01:00.000-07:00

Australian doctors are "in denial"about safe home births, according to an article in the Australia and New Zealand Journal of Obstetrics and Gynaecology:

And in the absence of publicly funded homebirthing programs, women who cannot afford private midwives are increasingly opting for unassisted homebirths, says Lareen Newman, a researcher in the department of public health at Flinders in Adelaide... When obstetricians point out the real risks of this trend, women may believe they are ‘crying wolf’ because of their unfounded opposition to safe homebirths, she writes.

She calls on RANZCOG [the Royal Australian and New Zealand College of Obstetrics and Gynaecology] to acknowledge the evidence for homebirths and support public homebirth programs in its revised statement expected next month.

Good luck with that.

Midwives who Blog

2008-11-07T23:01:00.002-07:00

Infomidwife discusses legal considerations for Australian midwife-bloggers in Cyber Talk and Midwives.

Farm-to-Consumer Legal Defense Fund

2008-11-03T23:01:00.002-07:00

If you are interested in topics such as consumers' access to raw milk and other farm-fresh products, and the regulation of small farms in general, check out the Farm-to-Consumer Legal Defense Fund and related organizations, the Farm-to-Consumer Foundation and the Farm and Ranch Freedom Alliance.

Minimum Length of Hospital Stays

2008-11-01T23:01:00.000-06:00

The Raising Women's Voices blog notes that new federal regulations take effect January 1, 2009 for group health plans and health issuers concerning minimum length of hospital stays for mothers and newborns following childbirth. The regulations can be found here: 73 FR 62410 (.pdf).

NaBloPoMo

2008-10-31T23:01:00.002-06:00

I am, once again, making an attempt at National Blog Posting Month. As before, since I have three blogs, I intend to post to only one of the three every day:

The Mommy Blawg
The Baby Blawg
The Book Blawg

I may or may not mirror posts on the NaBloPoMo website; I have in the past but it is a bit time-consuming.

Happy Reformation Day

2008-10-31T22:00:00.002-06:00

My husband found the Reformation Day Symposium, sort of a blog carnival of reformation day posts.

Midwifery and the Law

2008-10-26T12:00:00.002-06:00

This week's Midwifery Today E-news is on the topic of Midwifery and the Law.

Guess what! I have an email address!

2008-09-24T23:59:00.002-06:00

If you will kindly turn your attention to the right-hand sidebar, you will see the word "Email". Directly under that word is something that looks like this: mommyblawger AT gmail DOT com. It is, in fact, my email address. It is in a format which obscures it from the view of evil email address-gathering spambots. If you simply replace the word "AT" with the "@" sign and the word "DOT" with a period, and close up the empty spaces, you will have my email address. You can send me an email and I will get it. I might even write you back - eventually.

International "Talk Like a Pirate" Day

2008-09-19T01:52:00.007-06:00

September 19th is International Talk Like a Pirate Day. Be sure to visit the official website.

And for my lawyer friends, check out the Pirate-themed ~~Blawg~~ Blarrgh Review #153 at Declarations and Exclusions.

Some news, and a break

2008-07-20T18:00:00.002-06:00

Hello, faithful readers.

I'm going to be taking an extended blogging break - probably 4-6 weeks - and then I will be back with an announcement and a renewed commitment to my blogs. Until then, here are a couple headlines that have popped up recently:

An Arkansas court of appeals says that shackling prisoners during labor is not unconstitutional.

After a six-year absence, nurse-midwives are returning to Austin hospitals.

Midwife-signed birth certificates along the Texas-Mexico border questioned.

If you haven't heard, the AMA has joined ACOG in opposing homebirths. For more on this flap, check out these responses from ICAN, MANA (pdf), Citizens for Midwifery, and Ricki Lake, Jennifer Block & Abby Epstein on the HuffintonPost. Feel free to leave a link to your favorite blog post in the comments.

When Faith and Health Care Clash

2008-06-13T10:24:00.003-06:00

When faith and health care clash for French Muslims:

The law in French state hospitals is clear. Women can request women doctors and probably get them most of the time. But if the attending doctor that night is a man, as happened in this case, the woman — and in this case, her husband — have to accept that. When this woman went into labour in November 1998, the couple rushed to a hospital in Bourg-en-Bresse and a midwife examined her. She recognised a complication and called the doctor, but the husband physically blocked him for half an hour because he did not want a strange man touching his wife. By the time he gave in, it was too late for a caeserian and the baby had to be delivered by foreceps. Little Mohammed is now 100% handicapped.

The father sued the hospital for €100,000 in damages and €10,000 in personal compensation. The court rejected this and blamed the father, saying: “The child’s state is totally attributable to the attitude of Mr. Radouane Ijjou.”

The court additionally fined the father for court costs.

Podcast: Jake Marcus on nursing in public and the law

2008-06-08T14:54:00.002-06:00

The Motherwear Breastfeeding Blog has posted a podcast interview with attorney Jake Marcus on the subject of nursing in public and the law:

Jake discusses the different types of breastfeeding laws, what to do if you're harassed for nursing in public, and where to get information on the law in your state.

Also, don't miss her article on Lactation and the Law at Mothering.com.

Midwifery Legal News - Pennsylvania

2008-05-25T12:22:00.002-06:00

The big news this week is that a Pennsylvania appeals court has overturned the State Board of Medicine's decision against Diane Goslin, who was charged with practicing medicine without a license and practicing midwifery without a license. In the decision, the Commonwealth Court of Pennsylvania made the crucial distinction between Midwifery and Nurse-midwifery:

Thus, section 1 of the 1929 Law regulates, by the issuance of certificates, persons who are not registered nurses with nurse-midwife licenses, but who make a practice of attending women in childbirth gratuitously or for hire.11

Given the different purposes of the two statutes, we conclude that the nurse-midwife charges against Goslin under the 1985 Act did not give Goslin adequate notice to defend against the midwife offenses described in the 1929 Law.12

11 We recognize that statutes in pari materia shall be construed together, if possible, as one statute. Section 1932(b) of the Statutory Construction Act of 1972, 1 Pa. C.S. §1932(b). However, the 1985 Act and the 1929 Law do not relate to the same class of persons. Although both relate to midwifery, the 1985 Act relates to the licensing of registered nurses as nurse-midwives and the 1929 Law relates to the granting of certificates to other persons who attend women in childbirth.

12 Moreover, we note that, although the Board concluded that Goslin violated section 1 of the 1929 Law by holding herself out to the public as a midwife, section 1 does not make such conduct unlawful. It is section 5 of the 1929 Law that prohibits a person from “advertising herself as a midwife” without a certificate or a license. 63 P.S. §175.

The ruling apparently means that Ms. Goslin will be able to resume attending births.

Links:
Text of the decision (pdf)
Story from the Philadelphia Inquirer
SaveHomebirth.com
Midwives Alliance of Pennsylvania
PA Pundits has commentary here and here.
Commentary and video from Independent Childbirth.

US Air Force Pays Record Settlement for Injured Baby

2008-05-18T22:49:00.000-06:00

U.S. Air Force Pays Record Amount for Baby Injured in Government Hospital

What is the take-away here? That VBACs are dangerous? That VBACs shouldn't be augmented with Pitocin? Or something else?

Placenta Victory

2008-05-08T11:29:00.002-06:00

Sunrise Hospital, threatened with a second lawsuit, reversed their policy to allow the release of healthy placentas to women upon request, reports The Placenta Blog.

Blawg Review #158

2008-05-04T23:01:00.045-06:00

Welcome to Blawg Review #158! Today is International Midwives' Day (sometimes called "International Day of the Midwife"), when traditionally I remind my readers to call, write, or email their midwives and thank them. Accordingly, the theme of today's Blawg Review is "Midwives and the Law":

But the midwives feared God, and did not do as the king of Egypt commanded them, but saved the male children alive... Therefore God dealt well with the midwives, and the people multiplied and grew very mighty. And so it was, because the midwives feared God, that He provided households for them.
-Exodus 1: 17, 21 (NKJV)

For those of you who are wondering, "What's a Midwife? Are they still around?", I would invite you to visit the Wikipedia on the subject before reading any further. Also, for a look at modern, urban midwifery, rent or buy Ricki Lake's (yes, that Ricki Lake's) movie The Business of Being Born. By the way, Ms. Lake is scheduled to discuss her movie today on The View.

Why Does the World Need Midwives?, you may well ask. In most industrialized countries in the world, midwives attend 70% to 80% of all births and are the primary providers of maternity care. The U.S., where hospital- and home-based midwives attend less than 8% of all births (and despite spending the most per-capita on health care), ranks near the bottom of developed countries in terms of infant and maternal mortality rates.

A few quick definitions. There exists in the U.S. a class of midwives which is unique to this country, the Certified Nurse-Midwife (CNM). In every state, CNMs are licensed to practice with varying degrees of autonomy. CNMs have their own legal issues; however, they are not usually subject to being arrested, sued, or otherwise prosecuted merely for practicing midwifery, and I will not deal with those issues today.

Rather, when I use the term "midwife", I am referring to direct-entry midwives (DEMs); those who have completed a course of study and an apprenticeship in midwifery, but who are not also nurses; and who are licensed by the North American Registry of Midwives as Certified Professional Midwives (CPMs), and/or licensed under a particular state's regulatory requirements for direct-entry midwives (variously termed "Licensed Midwife", "Certified Midwife", and so forth). They are almost never hospital-based.

The term "lay midwife" is, increasingly, only used for uncertified or unlicensed midwives who are educated through informal routes. They may also be called "traditional birth attendants", "community midwives", "traditional midwives", etc.

Although planned homebirths with CPMs have been shown to be just as safe (with fewer complications) as hospital births, only 22 states specifically authorize the practice of direct-entry midwifery. Ten states prohibit the practice of midwifery outright (in Missouri it is a felony), while in the remaining states the status is a little less clear:

[M]any midwives have long operated under the assumption that states without a [Direct Entry Midwifery] statute are "alegal," a word that doesn't officially exist but has been understood to mean neither authorized nor forbidden by law, or "unregulated." But the problem with this concept, as more midwives are beginning to realize, is that the practice of midwifery - that is, the act of attending women in childbirth - is defined and regulated in all fifty states, through the medical and/or nursing practice acts, all of which contain broadly worded language that defines various acts associated with the practice of midwifery as either medicine or nursing.
-Katherine Prown, Ph.D., "Understanding the Legal Status of Direct-Entry Midwives: an Introduction" , From Calling to Courtroom

Currently, a midwife can be licensed & regulated in one state, but in a neighboring state with the exact same credentials she is subject to charges ranging from practicing medicine, nursing, or nurse-midwifery without a license, to manslaughter, child endangerment, and possession or use of controlled substances. Moreover, it is not always clear what the legal status of midwifery in a state is; some states, such as Pennsylvania, in which the practice of midwifery was long considered "legal", have suddenly begun to prosecute midwives. Many direct-entry midwives are under the mistaken impression that they are practicing legally, when they are in fact at risk.

And you thought that multijurisdictional practice of law issues were complicated.

I was going to include a list of midwifery-related legal resources, but it was getting a bit long, so I've published it as a separate post.

One more quote and then on to "This Week in the Blawgosphere":

We who live in the United States are fully aware how different our country is from most others when it comes to midwifery and the way the state looks at childbirth. If we try to list every variety of midwife that has come into existence during the last half-century, we have to write a very long sentence with lots of adjectives and commas. We lead the world in the number of criminal trials for the practice of midwifery or the practice of medicine, or even manslaughter or second-degree murder charges brought against unlicensed midwives. In this dubious sweepstakes, we have the company of our neighbor to the north, Canada, which got itself into a similar societal mess a century ago by neglecting to create a way for midwives to continue to exist by following the example of the rest of the industrialized world.
— Ina May Gaskin, "Unity: An Elusive but Necessary Goal for US Midwives and Their Advocates," Midwifery Today Issue 64.

Blogging and Blawging

Midwives tend to be a little (ok, a lot) less tech-savvy than, say, lawyers; although I've noticed the younger generation is changing that somewhat. On the sidebar of The Baby Blawg, you will find a list of "birth biz blogs", many of them written by midwives. There's some great stuff there. Besides me, the only blogs I can think of right now that write specifically about midwifery legal issues are Midwifery World, Jennifer Block (Pushed Birth), and possibly the Citizens for Midwifery blog.

Real Lawyers Have Blogs, but does your employer have a Law firm blog policy?

Bag and Baggage's Denise M. Howell discusses Blawgs In (Magazine) Space.

Nick Holmes of Binary Law explains what makes a good blawg; Anne Reed of Deliberations suggests that Alltop offers a great way to find them (Finding Good Blogs), and Scott Greenfield concurs, but thinks that

It also is going to give an odd impression to the person who doesn't know much about the blawgosphere, since there doesn't seem to be any particular rhyme or reason to why blawgs are listed in any particular order . . . . This page makes no distinction for the looker who doesn't know what he's looking at.

There seemed to be a great deal of discussion regarding the creation of law.alltop.com ("Blawgs Get Kawasakied"), including at Jim Calloway's Law Practice Tips Blog, Brett Trout's BlawgIT, and Sheryl Sisk Schelin's The Inspired Solo; but NY Personal Injury Lawyer Eric Turkewitz feels Personal Injury blogs were Dissed Again.

Coming and Going

Check out this new blog, The Legal Antiquarian. And say goodbye to Decision of the Day's Robert Loblaw who is calling it quits and hanging up his keyboard.

Social Media

John Phillips presents Young Teachers Gone Wild posted at The Word On Employment Law. And learn about Social Media's Impact on Health Care at Bob Coffield's Health Care Law Blog.

Would you turn down a job offer from a firm that did not allow you to access social networking sites such as Facebook or MySpace? No Facebook? No thanks!

Searches and Seizures

In another turn, [Midwife Marcia Kay McCulley] was arrested in March at her birthing center in front of two couples and their babies. A witness said about a half-dozen Medical Board officers came to the center, and one of them had his gun drawn.

"It seemed like the kind of conduct you would use on a drug house or on a dangerous criminal," said Jett Whitworth, who was in the waiting room with his wife and their 6-day-old girl.

- "Midwife disputes health allegations", Ventura County Star, May 12, 2007

From The Faculty Lounge, Dan Filler informs us Canada Supreme Court Nixes Suspicionless Dog Sniffs. And EFF's Jennifer Granick helps out with Protecting Yourself From Suspicionless Searches While Traveling.

Hiring a Lawyer

From Calling to Courtroom: A Survival Guide For Midwives has a wonderful chapter entitled Looking For a Lawyer (And Why You Should Do it Sooner, Not Later).

Austin Criminal Defense Lawyer Jamie Spencer presents Hiring a Jerk to be Your Lawyer. And watch out - Eliot Spitzer Enters Private Practice.

After my first son was born, and until about six months after my second was born, I practiced law from home, as did my husband for a time. Do you care if your lawyer has an office? Susan Cartier Liebel of Build a Solo Practice, LLC, writes When Going Home To Go To Work Benefits The Client.

Legal Drafting

Mark Liberman of Language Log parses Closer, my ex, of you; Ken Adams discusses "Survival" Provisions; and Conglomerate's Christine Hurt asks Who Wants in on the Nineteenth Edition of the Bluebook?

Trial Preparation

Tom O'Connor of Law Technology News claims Bates Stamps' Days May Be Numbered. Lean and Mean blogger Stewart Weltman makes easy work of taking expert depositions. South Carolina Trial Law Blog's guest blogger Brian Ford gives advice on Using Multi-Media at Trial.

Trials and Class Actions

Occasionally I will hear rumors of an effort by midwives and midwifery consumers to bring a class action suit against insurance companies for denying coverage of their services; or aginst someone (obstetricians?) for restraint of trade. The Class Action Blawg provides a most helpful Partial Glossary of Representative Actions and Terms.

Drug and Device Law has a long but worth-it post ("New Decisions Raise Old Issues") that refers to Bendectin which, as a three-time HG sufferer, I sure wish was still available.

Judges & Juries

Picking a Jury? Anne Reed writes "Your Honor, I Move To Strike Your Mother For Cause".

JD Hull opposes the elected judiciary at What About Paris? (a/k/a "What About Clients?")

Law Ingenue loved her Civil Procedure professor (Law Ingenue: Civil Procedure... Or Is It?) and so did I. In fact, Prof. Mayo not only blogs on health law, but writes poetry columns.

Speaking of poetry, and because no Blawg Review is complete without either Limerick or Haiku, recovering lawyer Madeleine Begun Kane (Mad Kane's Humor Blog) presents Ode To A Grudge-Holding Judge:

There once was a federal judge
Who was famous for holding a grudge.
But his clerk found a way
To get him to say,
“I forgive you.”
She bribed him with fudge.

Perhaps this Oklahoma judge needed some fudge as well - Publish or Perish: Lawyer Sanctioned With Order to Write Bar Journal Article by Alan Childressat at Legal Profession Blog:

She ordered the offending attorney "to submit to the Oklahoma Bar Journal for publication an article pertaining to civility and professionalism as they relate to adversary proceedings." He has six months to write it.

Consider yourself warned.

Family Law

Midwives' conferences often contain one session on family law basics. Usually these are conducted by other midwives; but sounds like a good marketing opportunity to me.

There was lots of blogging this week on the raid on the Texas FLDS compound. My major interest in the case was the allegation that nursing babies were being separated from their mothers.

Austin blogger Scott Henson (Grits for Breakfast) says More law blawggers need to weigh in on West Texas polygamy case. Robert J. Ambrogi talks about An Army of Lawyers in West Texas. Eugene Volokh had several posts concerning facets of the case arising from the raid on the FLDS' Texas compound. Audree Heath at World on the Web addresses Polygamy and religious rights. And J. Craig Williams (May It Please the Court) pens Who's On First? The Polygamous Mess In A Texas Courtroom.

Speaking of J. Craig Williams, my blogging about Placentophagy does not hold a candle to his Blood Sausage post.

Birth Certificates, Social Security, and Taxes. Oh My.

One issue that parents living in, and midwives practicing in, "illegal" states face is, how to file for a birth certificate. Should a midwife sign the birth certificate, or will this bring her to the attention of local authorities? And if she doesn't, what additional documentation must the parents provide in order to register the birth?

Without a birth certificate, you cannot get a social security card, a driver's license, or pretty much any job for which you are not paid in cash. Although I have known parents who delayed obtaining social security numbers for their children, without one you cannot claim them as dependents on your tax return (unless you are Amish, by the way. Hint, hint.). I recently filed an amended tax return because I neglected to include my most recent ~~tax deduction~~ child one year, and discovered that, while my children may be priceless to me, to the IRS they are worth $1000 per year. Each.

Why is My Rebate So Small? Tax Girl's got the lowdown on The Incredible Shrinking Tax Rebate. Nick Cowen asks Should Inheritance Tax Be Defended? (Civitas Blog), and Pundit Mom wants to see your I.D.

Women's Bodies, Women's Wisdom?

Having given birth to three babies, I sometimes think about having "a little work done". But then I realize that I am a mother, and my body looks like the body of a mother, and to try to look as if I have not had three babies would be an insult to mothers everywhere. Besides, how would I explain the surgery to my children without Encouraging Vanity and Misogyny? (Frank Pasquale of Concurring Opinions). And though I cringe to mention it, my body is not Just like open-source software! (Ann Bartow, Feminist Law Professors).

On that topic, among birth-related (non-legal) blogs, Birth Rape (see also More Than a Traumatic Birth) is being widely discussed. The legal implications are obvious - I have heard stories of women, even in my own community, who have been given unwanted (and unconsented-to) episiotomies, even while kicking and screaming "No!". Unfortunately, attorneys (prosecutors or plaintiff's) seem reluctant to pursue litigation. But I wish more lawyers would join this conversation. The situation is so bad that those in the birth biz are discussing, writing about, and conferencing on post-traumatic stress disorder. No wonder women are rejecting hospitals and doctors and birthing at home with midwives.

Green Things

This week I ran across Bamboo Diapers. I'm skeptical. David Yaussy at WV Environmental Law discusses Bamboo as Environmentally Sustainable Crop. And AgLawyer Susan Schneider reflects on Recent Perspectives on Meat Production.

Well, that's a wrap for Blawg Review #158! Thank you, everyone, for you submissions. A special award goes to Anne Reed of Deliberations as the "Most Suggested" blawger.

Blawg Review has information about next week's host, and instructions on how to get your blawg posts reviewed in upcoming issues.

Midwifery-related Legal Resources

2008-05-04T22:59:00.000-06:00

This is something of a work-in-progress, so if you know of others, please email me or leave a comment.

From Calling To Courtroom: A Survival Guide for Midwives, an online book. Although some of the state-by-state resources are out of date, it remains the only legal guide of its kind.

Midwives Alliance of North America's list of state laws and chart.
Citizens for Midwifery's State by State Guide to Midwifery in the United States.

Articles:
CfM's Midwifery and the Constitution
What to Do When Your Midwife Has Been Charged by Katherine Prown, Ph.D.
Suzanne Hope Suarez, Midwifery is Not the Practice of Medicine, 5 Yale JL & Feminism 315 (Spring 1993).
Eric Jansson, In childbirth, the new makes way for the old.

For cases where the courts ruled that midwifery does not constitute the practice of medicine or nursing for purposes of statutes regulating the practice of medicine, see the NARM Position Paper on the Practice of Midwifery.

Websites:
Legal Aspects of Midwifery from Ronnie Falcao's Gentle Birth Archives.
Midwifery Related Law from Motherstuff.com
The Big Push for Midwives

Books:
Jennifer Block, Pushed: The Painful Truth About Childbirth and Modern Maternity Care (Chapters 6 & 7).
Raymond DeVries, Making Midwives Legal: Childbirth, Medicine, and the Law.

Blawg Reviews & Other Bloggy Goodness

2008-04-28T22:59:00.003-06:00

Hello Faithful Readers!

Next week's Blawg Review will be hosted right here, by Yours Truly. Not coincidentally, May 5th is also International Midwives' Day, so of course the theme of Number 158 will be "Midwifery and the Law". But posts on a wide variety of legal topics will be included as well. If you would like to submit a post for consideration, instructions are available at Blawg Review.

This week's Blawg Review has been posted at Thoughts From a Management Lawyer, a Canadian labor & employment law blog. Also of note: Carnival of Moms in The Law is a monthly law-moms roundup hosted by Power of Attorney. Moms In Lawschool is a weekly carnival which rotates between PT-LawMom and A Little Fish in Law School. And the law-student author of the intriguing The Art of Manliness is starting The Manival, a blog carnival "for posts dedicated to man stuff."

Enjoy, and please come visit next Monday for Blawg Review!

Breastfeeding in Moscow

2008-04-27T01:15:00.006-06:00

Muscovites, amid a baby boom and changing attitudes towards children, wrestle with public breastfeeding:

Sheer lack of an alternative may ultimately have an effect on general attitudes and official handling of the issue of breast-feeding in public.

Britain, for example, introduced anti-discrimination legislation mandating that mothers be allowed to breast-feed babies wherever they like. Under the law, restaurants, stores and other public establishments preventing women from breast-feeding would face fines of up to ?2,500, or $5,000.

An incident last year in London, in which an exhibit attendant at the National Gallery told a woman to either stop feeding her 11-month-old daughter or to take her to the museum's mother-and-baby room, focused attention on the issue in Britain.

Similar incidents in the United States at shopping malls, restaurants and other public places over the last two decades have prompted many states to prohibit bans on public breast-feeding.

There are also countries, including Italy, Israel and many in Africa where legislation has never become an issue because there is no cultural bias against the practice.

It would appear to be an issue in Moscow.

A highly random and even more unscientific survey of employee attitudes at Independent Media, which publishes The Moscow Times, provided insight into how Muscovites feel about the issue. Of the respondents, who were divided almost evenly between men and women, about 80 percent said they did not think that breast-feeding should be done in public unless in an emergency, and then only discreetly.

This is the same traditional Russian approach that led to the creation of special "mother and child" rooms in Soviet times that are still found in airports, railway stations and some metro stations.

Outside of the transport milieu, however, things are tougher.

Finding herself in the city center with a screaming baby and no plans to travel by plane or train, Charlotte Baring said she had no other option than to feed her infant son on the nearest park bench.

"I was terrified I would get shouted at by a babushka for subjecting my baby to the germs of a public place," said Baring, an interior designer from Britain. "Nobody actually said anything to me, but I definitely got a few stares and funny looks."

Having been on the receiving end of a scolding by a babushka once or twice in my life, I should say that "terrified" is an apt word to describe the feeling.

Midwifery in the News

2008-04-26T22:42:00.005-06:00

In the news this week...

California - Midwife surrenders licenses to regulatory boards.

Florida - Linda McGlade and her daughter-in-law, Tanya McGlade, will get a new trial after being convicted in 2006 of practicing midwifery without a license, a third-degree felony:

Under the law, there are three components to midwifery: supervising labor and childbirth; advising as to the progress of the childbirth; and rendering prenatal and postpartal care. Also, there is no standard instruction for the crime of midwifery, according to the 4-page ruling written by Chief Judge Stevan Northcutt.
Judge Nicholas may have misled jurors to believe they could use only one of the three elements of the charge to determine if the McGlades were guilty, according to the higher court's ruling.
"In the absence of a standard jury instruction, the trial court clearly attempted to craft a proper instruction by employing the statutory language," Northcutt wrote in his opinion. "A defendant is entitled to have the jury correctly and intelligently instructed on the essential and material elements of the crime with which she is charged."

(Link)

The court "rejected the McGlades’ claim that they were entitled to a jury instruction on the defense they were engaged in the free exercise of religion" (Link). The full court opinion is available here (pdf).

Missouri - Midwife legislation still stalled in Senate; Fierce Debate Over Midwifery Licensure; Midwifery bill runs into issues in Senate.

Pennsylvania - Diane Goslin's case in the news. Midwives Alliance of Pennsylvania has more information.

Also check out Midwifery World's Legal Cases in the News.

Breastfeeding and FLDS Mothers

2008-04-22T00:42:00.004-06:00

I'm taking a bit of a blogging break this week while we have houseguests, but I wanted to pop in and mention this new blog, FLDS Babies Have Right To Breastmilk:

I am saddened to say that many Texan breastfeeding mothers may be separated from their nursing infants immediately, if not already... While we may not agree or understand the circumstances, I think we need to fight for the right of the children to have the best care and nutrition, which includes breastmilk.

The blog also contains information on breastfeeding and family law/custody issues.

NaBloPoMo - March

2008-04-07T22:05:00.002-06:00

Well, March is over, and with it the little experiment that was List Month. I did better this time - a total of 17 posts over 3 blogs.

See you next November, NaBloPoMo!

NY Hospital Bans Vaginal Births

2008-04-01T11:19:00.002-06:00

Women's Health News reports today's alarming announcement:
Nation’s Largest Hospital to Ban Vaginal Birth, NY State Likely to Follow

Breastmilk as a Human Right

2008-03-20T17:32:00.005-06:00

It's always interesting to read news articles from other countries. The perspective is just... different. Take this one from India, for example:

Can fashionable young women who do not breast feed be pulled up for violation of human rights of the child? Alleging that many young women influenced by television ads on bras are not breastfeeding to maintain their breasts, CPI(M) member in Lok Sabha Varkala Radhakrishnan on Wednesday said: "It (denial of breast milk) is human rights violation."
Maintaining that "breast milk is not just the only wholesome food, but also the child's right", Radhakrishnan said that "breastfeeding must be strictly enforced".

Link: Breast milk denial is human rights violation.

Childbirth Classes as a Tax-Deductible Expense

2008-03-11T00:38:00.001-06:00

ABC News reports a list of Tax Deductions You Should Know About, including the fact that:

You can deduct a number of medical expenses as they pertain to the expansion, or even delay, of your family. Deductions include fees paid for childbirth preparation classes, certain fertility enhancement procedures, birth control pills and/or legal operations to prevent having children.

Wonder if Doula services would be permitted, too.

NaBloPoMo - Redux

2008-03-01T09:31:00.005-07:00

You might recall that back in November, I signed on to National Blog Posting Month (NaBloPoMo). The idea is, you write at least one blog post each day for the entire month. In one sense, NaBloPoMo was a failure for me - I posted a total of 15 times on my 3 blogs before running out of steam. In another sense, however, I was very successful in getting out of my blogging slump and just getting stuff out there.

So, I was really interested to hear that NaBloPoMo is going monthly ("This is not the same as Blog365. Those [crazy -ed.] folks are blogging every day FOR A YEAR."). Each month they will have a theme, and this month's theme is: Lists. Now, anyone who knows me knows that I am a list-kind-of gal. I am totally about lists. I can do this. So to kick off the month, here's an easy one: Movies I Want to See.

All the President's Men
American Dreamz
Analyze This/That
Anchorman
Anger Management
Around the World in 80 Days (Disney 2004)
Batman Begins
Bourne Supremacy/Identity/Ultimatum
Catch Me if You Can
Cheaper by the Dozen (modern)
Cinderella Man
Devil Wears Prada
Dodgeball
Facing the Giants
Groundhog Day: The Weight of Time
Hamlet (Brannaugh)
Hamlet (Gibson)
Jurassic Park 2
Legally Blond
Legend of Zorro
Little Miss Sunshine
LOTR: Return of the King
Love Actually
Man of the Year
Manchurian Candidate
Master and Commander
Matrix 1, 2, & 3
Music & Lyrics
National Treasure I & II
Ocean's 12/13
Office Space
Pee Wee Herman's Big Adventure
Pride & Prejudice (Kiera Knightly)
Prince of Egypt
The Prize Winner of Defiance, Ohio
Rocky
RV
Serenity
The Seige
Surf's Up
Three Musketeers (Mickey Mouse)
Topsy-Turvy (1999)
Two Weeks' Notice
War of the Worlds (Cruise)
What a Girl Wants
Yentl

There ya' go. As a mom of 3, I don't see many current movies, and some of these I've seen and just want to see again.

Midwifery Legislative Updates

2008-02-26T21:48:00.001-07:00

The Big Push For Midwives, launched on January 24, is a coordinated campaign to advocate for regulation and licensure of Certified Professional Midwives (CPMs) in all 50 states and the District of Columbia. The website includes a page with links to news articles related to midwifery-related legislative efforts, and a map of states where licensure is available or where legislation is pending. Licensure is currently available to CPMs in 22 states.

Here's what's going on - at least, what's been in the news lately. Not a comprehensive list, but hopefully I'll get these updates out more often.

Alabama - SB240 and HB 314 establish a State Board of Midwifery. Link: Bill would allow home childbirth, a healthy option.

Idaho - HB 488 would provide for voluntary licensure for CPMs. Link: Idaho midwives want licensing option, ability to offer meds.

Maryland - HB 1407 would end the requirement that nurse-midwives practicing in Maryland have a written agreement with a doctor. Get the info from VBACFacts.com.

Missouri - Home birth supporters return with new midwifery measure:

Last year, lawmakers unwittingly approved a lay midwifery law after [Senator John] Loudon inserted an obscure medical term into a broader health insurance bill during the legislative session's frantic final days. The measure was signed by Gov. Matt Blunt but has since been overturned by a Cole County judge. An appeal to the state Supreme Court is pending.

Senate President Pro Tem Michael Gibbons responded to Loudon's tactics by removing him as chairman of the Small Business, Insurance and Industrial Relations Committee. He earned the job back by promising to push a bill repealing the law allowing those with private "tocological certification" to offer pregnancy-related care.

Tocology is a synonym for obstetrics, coming from the Greek root word of childbirth.

On Wednesday, the Senate Pension, Veterans' Affairs and General Laws Committee considered two Loudon bills - one to repeal the midwifery law, and the other to create a state licensing board to monitor midwives - but took no action.

The Missouri bills are HB 1600, SB 1021 and SB 870.

New Hampshire - The NH legislature has passed a bill, SB131, which requires insurance companies to cover midwife-attended home births in that state:

The bill builds on New Hampshire's long history of supporting alternatives to hospital birth. For more than 20 years, the state has permitted "lay midwives" who do not have medical or nursing degrees to practice in the state once they obtain proper training. Two years ago, it approved a measure that required health insurers to pay for deliveries in birthing centers run by midwives.

The newest bill does not change much other than the range of places where a woman can deliver her baby, but that choice is critical, many of the bill's advocates said.

"This gives women a real choice," said Rep. Jim Martin of Sanbornville, a Republican who was one of the bill's sponsors.

link: Backing at-home births.

North Carolina - Midwives seek state sanction:

Rep. Charles Thomas, R-Buncombe, submitted language to legislative bill drafters last year but never turned it into a bill. He said the supporters didn’t meet with doctors and trial lawyers seeking common ground, as he had encouraged.
So Rep. Ty Harrell, D-Wake, won legislative leaders’ agreement to form a commission to study the issue. The panel includes medical professionals as well as Thomas, Harrell and other lawmakers, and is co-chaired by Rep. Bobby England, a doctor and Democrat from Rutherford County.
After the panel’s first meeting, Thomas was skeptical of the proposal he called “an end run around medical school” but said a compromise might be reached if concerns about safety and liability are met.

Ohio - Legalizing Birth: Ohio criminalizes midwives wanting to help women deliver at home:

Ohio law only recognizes nurse midwives, who are registered nurses with a master's degree in midwifery, according to Stephanie Beck Borden, chair of Ohio Families for Safe Birth.
"In Ohio, nurse midwives are not independent practitioners" but rather have a "written collaborative agreement with an obstetrician to practice," she says.
But CPMs or direct-entry midwives like Helwig, who care for women giving birth in their homes, lack official approval.
"Direct-entry midwives are at risk of legal prosecution for practicing medicine," Beck Borden says. "In Ohio there is no protection, no regulatory body for direct-entry midwives. (They can be) prosecuted for practicing advanced-practice nursing without a license or practicing medicine without a license, which is a felony."

South Dakota - Senate Bill 34, which allows Certified Nurse-midwives to attend home births, passed both the House and the Senate by wide margins. House Bill 1155 which would license and regulate Certified Professional Midwives, is struggling. See also Home Birth Midwifery "Smoke Out".

Babies at Work

2008-02-20T12:20:00.005-07:00

Time Magazine had a piece in January, Bringing Babies to Work. It reminded me of a website I stumbled across a while back, Babies in the Workplace (www.babiesatwork.org), which details the why-tos and how-tos of developing a truly family-friendly workplace.

The Latest from ACOG

2008-02-06T21:26:00.000-07:00

The American College of Obstetricians and Gynecologists "reiterates its long-standing opposition to home births":

Childbirth decisions should not be dictated or influenced by what's fashionable, trendy, or the latest cause célèbre. Despite the rosy picture painted by home birth advocates, a seemingly normal labor and delivery can quickly become life-threatening for both the mother and baby.

Anyone besides me think that this statement is a response to The Business of Being Born?

Attempting a vaginal birth after cesarean (VBAC) at home is especially dangerous because if the uterus ruptures during labor, both the mother and baby face an emergency situation with potentially catastrophic consequences, including death.

Oh, that's nice. More and more doctors and hospitals won't "do" VBACs, but they're telling you not to do them at home either. I think most HBAC-ing women would rather have been in the hospital, if they thought they would actually have been successful there.

ACOG encourages all pregnant women to get prenatal care and to make a birth plan.

Really??? Then don't ignore our birth plans when we make them. And put pressure on the hospital staff to respect them, as well. How come the L&D nurses think that birth plan = cesarean section? What's up with that?

The main goal should be a healthy and safe outcome for both mother and baby. Choosing to deliver a baby at home, however, is to place the process of giving birth over the goal of having a healthy baby.

But the two aren't mutually exclusive, the "process" and the "goal"! Don't you get it? A healthy process creates a healthy mom and a healthy baby. Disturbing the process adversely affects the outcome.

And I'm sorry, women who are so traumatized by their birth "experiences" that they will not set foot in a hospital again unless they are dying, are not "healthy". Women whose bodies are cut and then stitched back together are not "healthy". Babies who leave the hospital formula-fed when their mother had planned to breastfeed them are not "healthy". Healthy is not the absence of disease or medical condition. Healthy is body, mind, and spirit.

So ACOG, if you don't like out-of-hospital birth, start practicing evidenced-based medicine. Start trusting women's bodies to birth. Stop pretending that you know everything (anything?) about natural (normal, physiological) childbirth. Stop lying to women. Try listening to them instead.

Midwives & Malpractice Insurance

2008-01-25T00:01:00.000-07:00

The Citizens for Midwifery blog discusses malpractice insurance for midwives:

When looking through this lens, it becomes clear that lawyers and insurance companies have more to gain from legislation mandating insurance policies for midwives than do birthing women and their families.

The impetus for CfM's post was an article by Judy Slome Cohain in the Winter 2007 issue of Midwifery Today entitled, "Mandatory Malpractice Insurance—Increases CS Rate & Profitability of Litigation, Decreases Planned Homebirths". I don't subscribe to MT, and the article isn't online yet, but the description in the table of contents is intriguing:

This frequent contributor argues convincingly that making malpractice insurance mandatory for midwives will lead to more profitable lawsuits and decrease the number of homebirth midwives to deliver babies, rather than improving birth outcomes or public health.

California Raw Milk Regulations

2007-12-30T11:15:00.000-07:00

A new law regulating the amount of coliform bacteria allowed to be present in raw milk is angering some California consumers.

Moms in the Military and in Prison

2007-12-13T00:58:00.000-07:00

Interesting blog posts this week; Angela White updates us on U.S. Military Rules for Breastfeeding Mothers at Breastfeeding 123. And Rachel Roth of RH Reality Check asks, "What Do Prisons Have to Do with Reproductive Rights?":

People in prison are the only group in the United States with a constitutional right to medical care. ... In practice, however, securing needed medical care can be daunting, as numerous lawsuits and investigations attest. Women encounter multiple barriers to care - from co-payments they can ill afford to having to convince a guard that they need to see a doctor. Gynecological and obstetric care is often woefully inadequate. In a nationally representative government study, 20 percent of pregnant women in prison reported getting no prenatal care, and 50 percent of pregnant women in jails went without care.

Things You Should Never Have to Say to a Customer Service Agent

2007-11-29T09:29:00.000-07:00

"You've never heard of that? Let me pull up your company's website, and I will read you a description of the service I ordered."

Leftovers (or, a tale of two grandmas)

2007-11-23T15:23:00.000-07:00

In 1950, my Grandma Jo won a Dallas Morning News contest for her leftover turkey recipe. Here you can read "the rest of the story".

My Grandma Pat died this week. I have years and years of Thanksgiving memories of her cooking a turkey and making gravy. One year, not too long ago, she decided she was done cooking. And she quit, just like that. She was like that when she had her mind made up. I'm speaking at the funeral tomorrow and I might post my comments, if I feel like it.

US immigration agency sets new policy after arrest of breast-feeding mother

2007-11-09T19:17:00.000-07:00

Wow. I am just speechless. No so much about the arrest, but that the situation was resolved so quickly, with a policy being put into place:

U.S. immigration officials said they have enacted a new policy to show greater consideration for breast-feeding mothers, days after authorities arrested a Honduran woman in Ohio on an immigration violation and separated her from her crying baby.
Sayda Umanzor, 27, admitted to being in the United States illegally when sheriff's deputies and federal agents knocked on the door of a house in Conneaut, Ohio, on Oct. 26.

Umanzor was breast-feeding her 9-month-old daughter, Brittany, at the time, and the baby cried as her parents were led away.

"It was like a piece of me was torn away," Umanzor said Thursday, speaking through an interpreter.

The baby cried incessantly over the next several days as she went without breast milk and Umanzor suffered soreness from engorged breasts.

Greg Palmore, a spokesman for Immigration and Customs Enforcement, or ICE, said the agency approved Wednesday a new policy to address the needs of breast-feeding mothers.

"It basically ensures that you take humanitarian issues involving nursing moms into consideration," he said Friday. "It also ensures we make contact with state social service agencies to address caregiver issues."

In Umanzor's case, the first jail where she was held did not know it had a nursing mother until Monday, when Lucia Stone, a Spanish-speaking representative of the La Leche League of Ohio, alerted them, said jail commander William Schultz.

Schultz said jail officials then accepted a breast pump and tried to work with local Spanish-speaking mothers to get milk to the baby, but the two sides failed to connect, and the milk had to be thrown out.

Umanzor was transferred to a county jail in Tiffin, Ohio, before immigration lawyer David Leopold secured her release Tuesday night. Leopold argued it was inhumane to hold a nursing mother and unnecessary to jail someone who the ICE knew how to find.

Umanzor was permitted to rejoin her children and was fitted with an ankle bracelet that tracks her whereabouts. She is expected to be deported soon.

Umanzor's husband, Marcus Antonio Bejarano, also an illegal immigrant from Honduras, was taken into custody. A 5-year-old son, David, also has been ordered deported. The couple's 9-month-old baby and a 3-year-old daughter, Alexandra, are U.S. citizens.

Also, see my previous post on the UK addressing this issue last year.

Vaccinations Among Homeschooled Children

2007-11-04T22:59:00.000-07:00

The authors of an article published in The Journal of Law, Medicine & Ethics advocates that state governments require vaccinations for home schooled children:

With the spectacular growth in the number of homeschooled students, it is becoming more difficult to reach these youth to ensure that they are immunized at all. These children are frequently unvaccinated, leaving them open to infection with diseases that are all but stamped out in the United States with immunization requirements. States should encourage parents to get their homeschooled students vaccinated through enacting the same laws as those used for public school students. This could be done by enforcing current laws through neglect petitions or by requiring that children be immunized before participating in school sponsored programs. As most states require some filing to allow parents to homeschool their children, it would be easy to enact laws requiring that homeschooled children be immunized or exempted before completing registration.

Abstract (subscription required to view full article).

This line of thinking - or rather, illogic - is similar to that of the recent push for a mandated HPV vaccine for school children. The state has an interest in seeing that public school students are vaccinated because in the schools, large numbers of children are congregated in conditions which make it easy for diseases to spread quickly. There is a logical nexus between the state's action (requiring vaccinations) and the context of the requirement (enrolling in school). HPV, however, is not spread by casual contact, so there is no reason to require it in order to enroll a child in school. Likewise, homeschooled children are not more likely to spread diseases while "in school" than anyone else is at any other time. If the government has the authority to require homeschooled children to be vaccinated, does it not then have the authority to require anyone and everyone to be vaccinated?

HT: Saying No To Vaccines

And for a related article, Parents Use Religion to Avoid Vaccines.

National Blog Posting Month

2007-11-01T00:00:00.000-06:00

Angela at Breastfeeding 123 has issued a challenge to Breastfeeding and Mothering bloggers to participate with her in National Blog Posting Month (NaBloPoMo). The idea is that you commit to write one blog post per day, for the entire month of November. Why do this? Cause, uh, you started a blog to make yourself write more often?

Anyhow, I'm in! If you haven't noticed, I am currently posting maybe every week or two. It's not that there's a lack of important things going which need to be blogged about, either. On the contrary; sometimes I feel overwhelmed by bad news and the amount of cruddy stuff still going on in the world.

I'm qualifying my participation by saying that since I have three blogs, I only plan to post to one of the three each day. Wish me luck!

Where does your candidate stand on health care?

2007-10-17T15:11:00.001-06:00

This is a neat little tool for comparing the presidential candidates' positions on health care. Choose up to four, and get a side-by-side comparison:

Health08.org

One caveat: looks like the information was compiled from the candidates' websites, speeches, debates, etc. (sources are listed) rather than from questionnaires submitted to the candidates, so one cannot rule out bias on the part of the information-gatherer.

Why we have EMTALA

2007-10-01T16:47:00.000-06:00

Foreign woman rejected 7 times by hospitals in western Japan after childbirth

The incident happened in August 2006, but was reported in Japan on Thursday in the wake of the case of a 38-year-old woman who suffered a miscarriage last month after ten hospitals refused to admit her and her ambulance collided with another car.

The cases have raised concerns about shortcomings in emergency care for pregnant women, an growing worry as Japan grapples with declining birthrates - among the lowest in the world - and a burgeoning elderly population.

...

Last year, a pregnant woman in western Japan died after being refused admission by about 20 hospitals that said they were full.

Ignore Us At Your Peril

2007-09-22T22:27:00.000-06:00

Lawyer Mama writes We Won't Be Ignored:

I just want to remind the media and all of the Presidential candidates not to dismiss us. We "Mommy bloggers" are a force that can't be denied. We are well educated and vocal. We are doctors and lawyers and journalists and political followers. We care deeply about the future of our children and this country. We have checkbooks and blogs and we aren't afraid to use them.

Take heed, candidates. We may be mothers and we may be women, but we will not be ignored.

Planning a Protest

2007-09-08T22:59:00.000-06:00

Well, I'm back from the Applebee's protest. I'm exhausted! We had 30 adults (moms, dads, and grandparents) and over 50 babies and children. But no press :( despite all my efforts at sending out press releases this week. One station (NBC5) did carry a blurb on the six o'clock news, just using the information we provided, but did not have the personnel to send a crew out to the protest itself. Numbers are still coming in, but looks like nationwide we had nearly 2000 people at 101 events in 43 states.

Oh, but the really exciting news (at least to me) is that I finally bought the shirt I have wanted for at least two years. Mine looks just like the photo and has "I Make Milk. What's Your Super Power" embroidered on it. I bought it at Granola Threads, and the owner, Keri, was most helpful in making sure I received it in time for today's event. You can buy shirts with the same slogan at Cafe Press and the like, but they are about as expensive and not nearly such good quality. Plus, it was on sale.

One interesting thing about planning this protest is that I learned a bit more about First Amendment law. Perhaps I should say "re-learned" - I'm pretty sure it was on the bar exam. I interfaced with an assistant city attorney, a police lieutenant, and a patrol officer. I discussed easements. I read through the Arlington Municipal Code and now know how to apply for a parade permit, should I ever wish to organize a parade. I didn't speak to the press, but I learned how to write and send out a press release. And I sharpened my skills at organizing people, by doing it and by watching others do it. I took the lead when no one else was willing. I'm looking at this big picture. I'm adding tools to my toolbox.

Eatin' Good in the Neighborhood?

2007-09-07T12:48:00.000-06:00

Applebee's restaurants are the target of a nationwide protest to take place this Saturday, September 8, 2007, at 12:00 noon (local time), in a response to an incident that took place last June in Kentucky. While discreetly feeding her baby at an Applebee's restaurant, Brooke Ryan was asked to either leave or cover her baby's head with a blanket, in violation of 2006 Ky. Acts, Chap. 80 , which reads in part:

No person shall interfere with a mother breastfeeding her child in any location, public or private, where the mother is otherwise authorized to be.

You can read all the details at Birth Without Boundaries, which is sponsoring the national event. However, I will summarize by saying that Lactivists do not call for nation-wide protests unless the response from corporate representatives has been less than adequate:

Shortly following the incident, Ms. Ryan retained the services of a lawyer who contacted Thomas and King, the company that owns and operates the Lexington Applebee's location. Nearly 2 months later, the company responded with a letter stating "we are considering keeping blankets in the restaurants for use by breastfeeding mothers that may not have them readily available,"...

Here's a list of bloggers covering the event (so far):

Our Applebee's is not nursing friendly... (Azuroo)
Breastfeeding Advocates Sending Nationwide Message to Applebee's (Breastfeeding 123)
Applebees Hates Babies, Try Hooters Instead (Breeders are Eaters Too!)
Applebee's accuses nursing mother of having "an agenda" (Human Lactation Information)
Applebee’s Nurse-In, Nurse-Out (The International Breastfeeding Symbol)
Breastfeeding nurse-out Saturday (Journal of a North American Celtic Bobtail)
August is World Breast-feeding Awareness Month (Kentucky Women)
Applebee's Ticks off Nursing Moms or "I Won't Be Eating Good at THAT Neighboorhood" (The Lactivist)
Applebee's Nurse In (Mama Knows Breast)
Eating not-so-good in the neighborhood (The Mother Tounge)
Nationwide nurse-ins at Applebee's (Motherwear Breastfeeding Blog)
Eatin’ Good In The Neighborhood? (My Little Tribe)
Applebee's Nurse-in (Nursing Your Kids)
Wear Your Burka if You Want to Nurse at Applebees (The Twinkies)
Eatin’ Stupid in the Neighborhood (Women's Health News)

If I missed anything good, leave me a comment.

Law School Moms

2007-08-27T16:38:00.000-06:00

Hello, faithful readers. I've been out of town and then busy getting my 1st grader back-to-school. I'm working on a legal update of things that happened while I was gone.

I see that there is now a carnival of Moms In Law School. MILS #8 is posted at PT-LawMom. I'm a fan! Personally, law school was difficult enough. I can't imagine doing it and being pregnant or a mom to young children. But I see I have some more bloggers to add to my "Lawyer Moms" list.

Speaking of Carnivals, yours truly is hosting Blawg Review on International Midwives' Day which is, oh, sometime next spring. Last time I hosted, I used a reality-tv theme. If anyone has a great idea for a theme, let me know. Obviously I'm going to talk about the legal status of midwives in the US, but I'll also have quite a few legal posts (ok, most of them) that don't have anything to do with midwifery or childbirth. I just need an organizing scheme to tie everything together...

Pregnant Inmates Need Doulas, Too

2007-08-03T10:21:00.000-06:00

In honor of Nicole Richie's newly-announced pregnancy - and the fact that she may soon be spending time behind bars for a DUI conviction - I give you this wonderful article by Amie Newman, Pregnant Behind Bars: The Prison Doula Project. Amie interviews Christy Hall, the co-founder and Development Coordinator for The Birth Attendants, which started the project:

"A lot of the issues that are the general issues for pregnant women are magnified in prison. For instance, which provider will you choose for pregnancy and childbirth? In prison, you don't get to choose your provider - not being able to choose who attends your birth is a big deal. Up until recently, in the prison we work in, there was only a male doctor available for labor and delivery. But for many women in prison - a huge number of whom have experienced sexual and domestic violence - having a male provider between your legs is not exactly ideal. Another issue is lack of informed consent - the lack of information and resources around having a healthy pregnancy for these women is huge. They just aren't given any information on pregnancy, their health, their bodies. The lack of access to proper nutrition during pregnancy is a big problem - the pregnant women in the prison we work with get "extra canteen" which means they get like an extra pack of Fritos. Also, the lack of access to health care in prison means that, in general, a health issue is not dealt with until it turns into a huge problem. It's a high-risk population anyway because, for the most part, these women lacked proper health care before coming to prison and being pregnant in prison doesn't change that. Also, there is a much higher rate of cesarean sections for women in prison as compared to women on the outside - mostly for the convenience of medical and prison staff."

The article mentions another organization, The Rebecca Project, which aims to end the practice of shackling pregnant inmates, particularly during labor and delivery, through the enactment of federal legislation.

Also check out this 1997 article by Sheila Kitzinger on the state of pregnant women and mothers in Great Britain.

Unassisted Childbirth

2007-07-31T12:25:00.000-06:00

The Washington Post has an article today on Do-It-Yourself Delivery. Though I am not a supporter of unassisted childbirth, I do have an interest in the positive - or at least fair and unbiased - portrayal of normal birth in the media. The article contained this gem:

To [Mairi Breen] Rothman, [a nurse-midwife and spokeswoman for the American College of Nurse-Midwives, which does not support unassisted childbirth], Shanley's beliefs underscore a more fundamental problem with maternity care. "To me the really interesting question is, Why would someone go outside the system?" Rothman said. "What is so broken that they don't want to use it?"

[Heather] Jones, the Navy wife, has an answer. Her first delivery in a hospital four years ago was marred by "interventions and interferences based on someone's outside judgment" of how well her labor was progressing, she said. She said she felt pressured to have epidural anesthesia, was not allowed to move around as she wished and was denied access to her baby until he was two hours old because he was being observed by the hospital staff.

Jones said she decided to give birth to her third child unattended after her second was born five minutes after the midwife arrived at her home."

She was like, 'See, you didn't need me,' and I thought, 'You know, maybe I don't,' " she said, as baby Gideon, now 5 months old, cooed in the background.

This Week's Legal News

2007-07-21T15:46:00.000-06:00

Breasts, placentas, midwives, and the TSA -

Woman wins settlement in breastfeeding case:

Watch-maker and clothier Fossil Inc. agreed to pay $3,600 to a woman who was barred from breast-feeding her infant while visiting a company showroom, the New York Civil Liberties Union said on Tuesday.
Lass King, 37, a buyer for a Maine clothing store and a mother of two, said she received a letter of apology and the payment from Fossil after threatening the company with a lawsuit.

In its letter to King, Fossil also said it had issued a policy affirming that breast-feeding was permitted in all Fossil stores and showrooms, said Galen Sherwin, director of the NYCLU's Reproductive Rights Project.

Representatives of Fossil could not immediately confirm details of the settlement.

New York law states that women are permitted to breast-feed "in any location, public or private, where the mother is otherwise authorized to be."

Hospital told to return placenta to mom:

A woman has won a court fight to keep the placenta after her daughter's birth. She had planned to grind it up and ingest it as a way to fight postpartum depression, but now plans to bury it.

Clark County District Court Judge Susan Johnson granted a preliminary injunction Tuesday, ordering Sunrise Hospital and Medical Center in southern Nevada to return the placenta to Anne Swanson. Hospital officials said they will comply.

What is interesting was that the plaintiff was expecting a ruling on a temporary injunction, not a ruling on the merits (see Swanson vs. Sunrise Hospital for the blow-by-blow). Doesn't sound as if the hospital will fight this decision, but they are not changing their policy either:

Amy Stevens, system vice president for Sunrise Health, which operates Sunrise Hospital, described the ruling as specific to Swanson. She said the hospital must comply with strict regulations in handling human biohazardous waste.
There is no Nevada law prohibiting hospitals from returning placentas to mothers. But several Las Vegas area hospitals told the Las Vegas Review-Journal the organ is usually destroyed unless a physician designates it for medical tests or a patient seeks it for specific religious or cultural reasons.

USA Today ran a piece this week on placentophagia (Ingesting the placenta: Is it healthy for new moms?) which mentions the Swanson case.

After numerous complaints, the Transportation Safety Administration (TSA) has changed its policy regarding breastmilk:

TSA is also modifying the rules associated with carrying breast milk through security checkpoints. Mothers flying with, and now without, their child will be permitted to bring breast milk in quantities greater than three ounces as long as it is declared for inspection at the security checkpoint.

Breast milk is in the same category as liquid medications. Now, a mother flying without her child will be able to bring breast milk through the checkpoint, provided it is declared prior to screening.

Birth Without Boundaries lawyer Jake Marcus comments:

Under the old TSA rule, pumped breastmilk had to be packaged in 3 oz containers all of which had to fit into one 12 oz ziplock bag. Birth Without Boundaries has assisted many women whose pumped milk was confiscated and dumped by TSA security officers, either because it was not packaged according to regulation or because the TSA officer did not know what the regulation was. All of our complaints to the TSA have gone unanswered, until now.

Marcus also recommends that women traveling with expressed milk carry a copy of the modified policy, just in case they encounter an employee who has not yet gotten the memo.

Judge dismisses Mendon midwife lawsuit:

A federal judge has dismissed a lawsuit filed earlier this year by a former Mendon midwife in a bid to have her license to practice in Vermont reinstated.

Roberta Devers-Scott claimed in the lawsuit that the state violated her due process rights, leading to the revocation of her midwife license. Secretary of State Deborah Markowitz, whose office oversees professional licensing of midwives in Vermont, was among the defendants named in the lawsuit.

Judge J. Garvan Murtha issued a six-page ruling in U.S. District Court in Brattleboro granting a motion filed on the defendants' behalf dismissing the lawsuit, ruling, in part, Markowitz had immunity from the lawsuit.

Michael Sussman, Devers-Scott's attorney, said Friday he planned to appeal the judge's ruling to the 2nd Circuit Court of Appeals in New York City.

And that's what is making news this week.

Huntington Beach Bans Nudity

2007-07-18T09:17:00.000-06:00

Aren't there state regulations on this?

The [Huntington Beach] City Council unanimously voted to ban public nudity during its Monday meeting after a brief debate that resulted in striking portions of the proposed ordinance.
The council decided to limit the law to being nude where it is visible from a public area. They deleted regulations on a women breastfeeding an infant older than age 2, and restrictions on wearing a costume or device that simulated nudity.

The article goes on to say:

This type of ordinance is not new to cities in Orange County. More than half of the cities in the county have approved similar bans on public nudity, said [Police Chief Kenneth] Small.

Wonder what those ordinances say about breastfeeding?

Is it legal for Florida midwives to do VBACs?

2007-07-13T15:18:00.000-06:00

Occasionally one will hear that it is illegal for licensed midwives in Florida to attend VBACs (vaginal birth after Cesarian). Not so, as Sarasota midwife Heidi Dahlborg, LM, explains:

It is legal for a Florida LM to do a primary VBAC, but it does carry a risk score of 3, which requires a consult from a VBAC friendly doctor. Some midwives who can not get consults have mistakenly told people "its illegal to do VBACs at home" when they mean "it is illegal for me to do VBACs at home because I can not get the proper consult to comply with the law".

So you can legally have a VBAC with a homebirth Licensed Midwife, as long as she obtains a consult from a physician with OB privileges. There is a state risk assessment score for LMs that assigns points for various risk factors, and when your points reach 3 for any reason, you must have a consult with a physician that does obstetrics. A prior c-section scores 3 points for "prior uterine surgery". Prior uterine surgery with a subsequent successful vaginal birth (a secondary VBAC) is only 2 points. So if the mother has no other point scoring risk factors, she will only have a 2, and thus can have a VBAC with out consult. If she smokes, is over/underweight, or has other factors, she will need a consult based on her overall points. The risk assessment is in the rules, which can be viewed online at http://www.doh.state.fl.us/mqa/midwifery/mw_statutes.html under Rules: Chapter 64B24, its a large document and you must scroll down to Chapter 64B24-7, Midwifery until you see the Midwifery Practice Act, which includes the risk assessment. You can also get a risk screening tool from any practicing midwife.

If the midwife also has a birth center, that complicates things further. The birth centers are governed by a separate law, and it says the birth centers can only do VBACS in the birth center if they are participating in the National VBAC study, which has been closed for 7 years. So there has been no way to comply with birth center law, so there is no way to legally do a VBAC in the birth center. But midwives who own birth center will often do VBACs at home, even though they can not do them in the center.

I know an attorney that was drawing up a consent to allow midwives and moms to choose to go outside of the law or rules, as part of the alternative medicine law, but I do not know if anyone actually does that yet.

The American Association of Birthing Centers, the birth center association, is going to open the National VBAC study up again soon, thanks to Charlynn Daughtery a Tampa midwife that own Labor of Love Birth Centers. She has really been a strong VBAC advocate in political circles, working hard to keep VBAC options open at home and birth centers. Once that study open, hopefully in Fall, Florida women will be able to have VBACs in birth centers if the consults are obtained. You can contact them, AABC, to urge them to get the VBAC study opened again.

So, as it stands- in Florida you CAN have a VBAC at home, but not in a birth center, as long as the proper consults are obtained. Many women travel 3 hours or so to get the consult, at around 28 weeks, but you can usually get the consult anytime including preconception. It is generally just a review of your surgical record, and a conversation on risks and benefits.

Thanks, Heidi, for the great explanation!

I'm so behind, I'll never catch up

2007-07-11T10:52:00.001-06:00

Here are a couple things on the radar today:

The Australian parliament is debating whether breastfeeding legislators should be given a proxy vote - that is, to have their vote recorded while they are out of the chamber:

The issue of breastfeeding in Parliament made headlines in 2003 when Victorian Labor MP Kirstie Marshall was thrown out of State Parliament for breastfeeding.

Committee members said the debate had resurfaced in light of an increasing number of new mums in the House of Representatives in the past decade.

The committee found only 10 female MPs had given birth while in office - out of a total of about 130 female MPs.

"Women have faced the difficult choice between prioritising their duties as a member with those of being a mother," members said.

Pennsylvania's governor signed that state's breastfeeding legislation. Although breastfeeding advocates would have preferred a stronger bill, it's better than nothing.

A Missouri judge has issued a temporary restraining order blocking implementation of HB 818 which decriminalizes direct-entry midwifery. This bill has caused a lot of controversy. Apparently, it's a circus over there in the Missouri legislature:

A senator secretly attached the provision to a bill intended to make health insurance more accessible to some Missourians. Gov. Matt Blunt signed the bill into law.
Several physician groups sued last Thursday, claiming the midwife language violates the Missouri Constitution by going beyond the bill’s health insurance title and by changing the bill’s original purpose.
The recently passed legislation says that regardless of the current felony statute, anyone with a “tocological certification” — meaning in obstetrics — from a privately accredited group can provide services related to pregnancy.
The title of the bill that passed described it as “relating to health insurance.”

(link)

Alabama has voted down its midwifery bill. Try again next year?

Nancy Ver Steegh of The Family Law Prof Blog reports Problems at Center Where Mothers Serve Prison Terms With Young Children:

"The authorities in California are investigating accusations that poor health care at a center where mothers serve prison terms with their young children led to the stillbirth of a 7-month-old fetus and endangered the lives of several children.

Staff logs, statements by prisoners and interviews with investigators, staff members and prisoners’ families depict a facility where inmates and their children were denied hospital visits and medications, and where no one kept adequate records of accidents involving injuries that included a skull fracture and a broken collarbone."

Giving Birth With Confidence links childbirth issues to a recently-released government list of hospitals where heart patients are most likely to die in Out of the Dark: Transparency and Birth:

Transparency is suddenly a big deal. This government report follows on the heels of efforts in New York City, and communities across the country, to improve the level of transparency related to childbirth. Giving birth in the dark is an apt metaphor for the current state that women find themselves in when attempting to access information about maternity care. The recent NYC public advocates’ report identified that city hospitals although legally mandated to do so, are still failing to provide maternity information. Public Advocate Betsy Gotbaum is working tirelessly to insure that hospitals do what they are legally mandated to do…including reporting induction and cesarean rates.

Better get this posted before I get distracted by something else...

How a Bill Becomes a Law

2007-06-15T23:11:00.000-06:00

This funny is attributed to W. Bruce Cameron (author of 8 Simple Rules for Dating My Teenage Daughter, basis for the sitcom of a similar name), but I can't locate it on his website:

HOW A BILL BECOMES LAW

The following steps trace the process by which a paternal proclamation becomes law in the Cameron household.

Step One:
The father of the house issues an executive order that all Saturday activities will be suspended until the garage is cleaned up.

Step Two:
The children form a committee and produce a report finding the order totally unconstitutional, because it violates the "Cruel and Unusual" clause.

Step Three:
The committee report is voided by paternal declaration.

Step Four:
The ruling is appealed under the "This is stupid nobody else has to do this kind of stuff" doctrine of the "Equal Protection" clause. Specific examples are cited of other children who are not cleaning their garages.

Step Five:
The "nobody else has to" doctrine is rejected as having no bearing on the case.

Step Six:
Each child petitions separately for the relief under the "why do I have to do it none of it is my junk" theory.

Step Seven:
The father rules that the individuals of the household are a family, that the junk in the garage belongs to the family, and that the family has the responsibility of cleaning it up.

Step Eight:
The children attempt to stay the executive order by evading subpoena.

Step Nine:
The father retrieves the children from their bedrooms and declares notice properly served.

Step 10:
The children plead pre-existing obligations that preempt the paternal proclamation. The oldest is due at the shopping centre, the middle child has to go to a soccer game, and the youngest is yeah me too.

Step 11:
Clarification is sought from the youngest on which of the two lame excuses is yeah me too: soccer game or the mall?

Step12:
The youngest says the soccer game.

Step 13:
The father rules the soccer game cannot preempt the garage cleanup.

Step 14:
The youngest says I meant the mall.

Step 15:
The father rules the mall cannot preempt the garage cleanup.

Step 16:
The children pass a resolution that the father is the meanest man in the world.

Step 17:
The father agrees to accept the "meanest man" amendment and calls for an end to the debate.

Step 18:
The children submit an emergency appeal on the grounds that there might be mice living in the garage.

Step 19:
The father issues an executive decree that he has authority over all rodents and that there are no mice in the garage.

Step 20:
The children move for dismissal, claiming they are exempt because they have homework to do.

Step 21:
The father consults the official Cameron family calendar and determines there is another day left in the weekend in which homework can be done.

Step 22:
The children file a grievance with the Supreme Court of the house: their mother. A restraining order is sought prohibiting enforcement of the father's executive order on the grounds that he never listens, he is ruining our lives, he's mean, and if he really wants the garage cleaned up, why doesn't he do it himself?

Step 23:
A constitutional crisis is averted when the wife hands down a decision supporting the father's right to order the children to clean up the garage.

Step 24:
The children declare themselves no longer members of the family. As stateless persons, they are not subject to parental authority.

Step 25:
The father agrees to expedite the emigration of each child on the date they are of age. Until the parents are released by the laws of the locality from their obligations, however, the family members are stuck with each other. Meanwhile, the father identifies further sanctions to be imposed upon delay of compliance with his order, including suspension of telephone privileges.

Step 26:
The teenagers file a brief equating telephone cut-off with capital punishment.

Step 27:
The father further suspends all use of the family automobile until the garage is cleaned up enough to park the car in it.

Step 28:
The children petition for relief from further sanctions by agreeing to clean up the garage.

Thus, with these simple 28 steps, a bill moves through the checks and balances and becomes law.

It may not be the best system, but it's the only one we've got.

Midwifery Legal Update - Wyoming

2007-06-10T16:12:00.000-06:00

Wyoming news sources are reporting that Midwife Susan Merrill of Cheyenne has been charged with involuntary manslaughter and practicing medicine without a license following the death of a newborn in April of 2006. The articles go on to state:

The practice of lay midwifery has been illegal in Wyoming since 2003. However, Wyoming does allow for the practice of midwifery by Certified Nurse Midwives, CNMs. CNMs are registered nurses who have advanced training and skill in care of women and newborns at birth. CNMs are licensed by the Wyoming State Board of Nursing and practice in homes and hospitals.

Gladys Breeden of the Wyoming State Department of Vital Statistics claims to be aware of 8 lay midwives who practice in the State of Wyoming and one certified nurse midwife who practices legally with a Wyoming License. The Department of Vital Statistics is responsible for the filing of birth certificates in Wyoming.

A 2005 bill to legalize direct-entry midwifery was defeated by the Wyoming legislature.

Although the article states that ms. Merrill was denied a court-appointed attorney, my sources inform me that she has now obtained representation.

Breastfeeding mother given parking ticket

2007-06-05T14:47:00.000-06:00

Breastfeeding mother given parking ticket:

Breastfeeding support groups have condemned the actions of an attendant who fined a mother for parking in a restricted area to feed her child and then took photographs for proof.

The warden employed by a national car park management company confronted Jerricah Watson, 19, after she pulled into a permit holders-only bay in the Candle Lane area of Dundee to breastfeed her 14-week-old son Jaksyn.

Ms Watson pulled into the quiet street to get away from the city-centre traffic and said the warden initially said it was okay to feed her child. She said he then took photos and put a ticket on her car.

When she approached the attendant, from Birmingham-based Central Ticketing, which is responsible for policing the parking in the area, he said it was too late to withdraw the ticket. The penalty was for £85 or £60 if paid within two weeks.

"As I'm breastfeeding and therefore my son is fed on demand, I need to stop right away," she said.

"I feel with the government both locally and nationally trying to encourage mums to breastfeed that it was unfair of the man not to take that into account or even bother to ask me to move or give me a few minutes to feed my child."

The incident has alarmed breastfeeding support groups who believe more should be done by government to allow babies to be fed naturally.

Gillian McWhirter, a Scottish breastfeeding support group adviser, said: "This is a very unfortunate situation. There is enough of a problem getting mothers to breastfeed because they are embarrassed to do it in public. But to not just give this woman a ticket but take pictures of her while she was in the car, is quite shocking.

"These kind of situations encourage ignorance over the importance of breastfeeding, which scientific evidence shows decreases the rate of infant illness.

"It is a basic right for a child to receive nutrition and every mother knows that when baby cries, baby has to be fed."

Thyll Buchanan, a registered Scottish breastfeeding network supporter, added: "Young mothers need all the help and support they can to continue to breastfeed. It is safer to pull over and feed a crying baby than to try and continue driving under stressful conditions."

Central Ticketing said it would cancel the ticket if an investigation into the mother's complaint found her story to be true. Part of the inquiry would involve examining pictures taken by the parking attendant.

"We will see if this woman's story stacks up, because the warden would have taken photographs and she would have been in the vehicle," said the spokesman.

"We issue thousands of parking charges a week. Fifty per cent of people send in an appeal. You have to bear in mind of every 10 letters we receive seven or eight of these members of the public are telling lies. We are not saying this woman is. This will be investigated."

Figures released last month show that fewer Scottish mothers are opting to breastfeed despite numerous government campaigns promoting the health benefits.

Last year, only 44.2% of mothers were breastfeeding at the time of a health worker's first visit when the baby is about 10 days old while 36.6% were doing so after six to eight weeks. That compares with 45.1% and 37.2% respectively in 2005.

This incident occurred in Scotland, where anyone who interferes with breastfeeding can be fined up to £2,500 (nearly $5,000). Since Scotland is the first (known) jurisdiction to impose a fine for interfering with breastfeeding, the language of the law (.pdf) could be a model for other jurisdictions to follow:

1 Offence of preventing or stopping a child 5 from being fed milk
(1)Subject to subsection (2), it is an offence deliberately to prevent or stop a person in charge of a child from feeding milk to that child in a public place or on licensed premises.
(2) Subsection (1) does not apply if the child, at the material time, is not lawfully permitted to be in the public place or on the licensed premises otherwise than for the purpose of being fed milk.
(3) A person guilty of an offence under subsection (1) is liable on summary conviction to a fine not exceeding level 4 on the standard scale.
(4) In this section—
"child" means a person who has not yet attained the age of two years;
"feeding" includes—
(a) breastfeeding; and
(b) feeding from a bottle or other container;
"licensed premises" means premises licensed under—
(a) section 12 of the Theatres Act 1968 (c.54);
(b) Part II of the Licensing (Scotland) Act 1976 (c.66);
(c) Part II of the Civic Government (Scotland) Act 1982 (c.45); or
(d) section 1 of the Cinemas Act 1985 (c.13);
"milk" means breastmilk, cow’s milk or infant formula;
"public place" means any place to which, at the material time, the public or any section of the public has access, on payment or otherwise, as of right or by virtue of express or implied permission.

I'm not implying that the parking attendant violated the Scottish law, it just seemed like a good opportunity to blog about Scotland. I like the fact that the statue defines "public place". Although the definition of "public place" is probably well-defined in the case law of US states, the definition was not incorporated into most breastfeeding statues, leading to some confusion among the general public.

A New Look

2007-05-24T14:24:00.000-06:00

How do you like The Mommy Blawg's new look? Revka at RS Designs created the custom header for me. She and Linda from Mama’s Coffee Corner are running a contest to launch their blogs (ends today - hurry!) , where you can win a free custom header, a $20 Amazon gift certificate, or a box of Brazillian goodies. Revka's headers are beautiful and her service is great and speedy, so if the look of your blog just screams "free Blogger template", head on over and get yourself something new.

I also updated my links on the right side. I pared down the list of legal blogs and added a section called "Lawyer Moms". If you are a mother and a lawyer (including law student or non-practicing attorney) and blog even a little bit about both, let me know and I'll add your blog to my list.

My next project is to update The Baby Blawg. I want to add a link section there for birth biz blogs, and another for my favorite childbirth, breastfeeding, and baby care websites, as well as recommended reading. That's the plan, anyway.

Placentas, Protests, and Property Rights

2007-05-09T14:55:00.000-06:00

Before Anne Swanson gave birth at Sunrise Hospital in Las Vegas, she requested that her placenta be saved so that she could take it home. At the time of discharge, however, the hospital refused to release the placenta to her. According to placenta activist Jodi Selander, "There are no laws in NV that state a hospital can not release a placenta, yet the hospital refused because it 'was not comfortable' doing so." (link)

Swanson is now waging a legal battle against Sunrise for possession of the placenta. The hospital normally keeps placentas in cold storage for three days, then disposes of them. According to Swanson, the hospital has informed her that it will not release the placenta without a court order, and will destroy it on May 15th. A pro-placenta rally was held on Monday, May 7, and supporters are planning a push for legislation, similar to that passed by Hawaii last year, which would require hospitals to release non-infectious placentas to patients on request. The Hawaiian statute states:

§321-30 Human placenta. Upon negative findings of infection or hazard after appropriate testing of the mother, the human placenta may be released by the hospital to the woman from whom it originated or to the woman's designee. The department shall establish a release form which shall stipulate appropriate measures for the safe release of human placenta.

That seems pretty simple and covers all the bases, doesn't it?

I know that stopping the spread of infectious disease is serious business, and proper disposal of hospital waste is an important part of that. We don't want needles and body parts thrown in dumpsters, where they might be discovered by dogs, rats, and homeless people. But look at it this way: Baby comes out of mommy's uterus - baby gets taken home. Placenta comes out of mommy's uterus - placenta gets thrown away. Placenta is infectious waste. Baby isn't. Huh? Yes, I know that the baby is a living, breathing human, and the placenta is an organ. But for some people, placental burial is an important religious or cultural ritual, and for others, it is about having control over one's body and retaining ownership of its products.

Now, to turn to the broader legal question: does a person have a property interest in his or her own cells, organs, or body parts? I'm not going to give this question the full treatment, but the leading case on this issue seems to be Moore v. Regents of University of California, 793 P.2d 479, 51 Cal.3d 120 (1990). In this case, university researchers used tissue taken from Moore's diseased spleen to create a cell line which they later patented. The Supreme Court of California held that Moore did not have property rights to or a financial interest in his cells (Wikipedia). Part of the Court's reasoning was that California statutory law restricts a patient's control over his or her medical waste, citing California Health and Safety Code section 7054.4:

[n]otwithstanding any other provision of law, recognizable anatomical parts, human tissues, anatomical human remains, or infectious waste following conclusion of scientific use shall be disposed of by interment, incineration, or any other method determined by the state department [of health services] to protect the public health and safety."

Of course, each state may come out a little differently on this issue (California Supreme Court decisions not being binding on the rest of us). And even if a person does have an ownership right to their body parts doesn't mean they necessarily have a possessory right to them. As we learn on the first day of property class in law school, property rights are like a bundle of sticks.

If you are finding this fascinating, you may want to read Ownership of Human Tissue: A Proposal for Federal Recognition of Human Research Participants' Property Rights in Their Biological Material, Wash. & Lee L. Rev. (Winter 2004). I didn't - it was too long and I dont' have the time. But I did get out my bluebook for that cite, which I'm hoping makes up for the fact that a cited to a Wiki a couple paragraphs ago.

Anyhow, hope that give you something to - er - chew on.

Links:
Diva/Mamma (the go-to blog for this case)
Placenta Benefits
Placenta befouled, mom told (Las Vegas Review-Journal)
Making pills from placentas (Las Vegas Review-Journal)
Action News 13 Las Vegas (video)

International Midwives Day

2007-05-05T16:24:00.000-06:00

Today is International Midwives Day (also variously called "International Day of the Midwife" or "International Midwifery Day"). Call or write you midwife and thank her!

It's a great day to host an event, such as a picnic, lecture, protest, etc. to help raise awareness of midwifery care. The International Confederation of Midwives has some more ideas (.pdf). So if you are part of a consumer, homebirth, or natural parenting group, you might want to start planning something for next year.

The Seattle Midwifery School has information on how you can help a library or bookstore create a display.

Wisconsin has reason to celebrate. Not only did the governor declare May 5th International Midwives' Day, but this week marked the first home delivery by a licenced midwife since that state's newly-enacted regulatory scheme went into effect. Congratulations to Wisconsin midwives and midwifery supporters for all their hard work.

Louisa at Mama (Mid)Wife Madness answers the question "Why does the world need midwives?".

In The News

2007-04-29T11:12:00.000-06:00

Medical case wins $2.27M: Jury finds midwife guilty of neglect.

Greene Co. sheriff says procedures followed in childbirth death.

Police Taser Man Holding Baby

2007-04-19T00:16:00.000-06:00

Taser used on dad leaving Houston hospital with baby

Apparently, there was some confusion over whether the dad was kidnapping the baby, or just leaving the hospital AMA.

Breastfeeding Legislative Update

2007-04-15T19:24:00.000-06:00

Tanya Lieberman, host of The Motherwear Blog, has done an excellent job of summarizing recent breastfeeding-related legislation. So much so, that I don't feel like I need to do my own, which I was - sort-of - working on. I do have a couple additions to the list, below.

La Leche League maintains a Summary of Proposed Breastfeeding Legislation; however it is not as complete as one would like.

Texas - The September, 2006 issue of ParentWiseAustin covered the state's NIP statute thoroughly:

What’s the big deal about breastfeeding in public? The law, that’s what. Although it protects a woman’s right to breastfeed in Texas, few folks know about it and, even if they do, they don’t necessarily have to follow it. We explain why beginning on page 8.

Excellent reading. I even learned some things, such as the fact that a woman who feels that her right to breastfeed has been interfered with can file a complaint with the Texas Department of State Health Services , which "responds to complaints by sending a letter to the facility where the alleged violation occurred, explaining the law and encouraging the owner or manager to inform employees about it." They get about 2 or 3 complaints a month.

Also, the Texas DSHS has a number of brochures and other breastfeeding information which can be ordered or downloaded, including a "licence to breastfeed in public" card.

Wisconsin - Assembly Bill 104/Senate Bill 30 would guarantee the right to breastfeed in public and put in place a fine not to exceed $200 for interfering with a breastfeeding mother. Also, the city of Madison approved a breastfeeding ordinance in January.

Internationally, Chile passed a law this year giving mothers the right to breastfeed their child at work; and the city of Toronto is hoping to raise public awareness of the protected nature of nursing in public.

Midwifery Legal Update - Iowa, California

2007-04-14T22:14:00.000-06:00

Certified Professional Midwife Melanie Moore of Iowa has been charged with violating Iowa Code Section 147.2, practicing medicine without a license, a class D felony. She has not been arrested, but a court appearance is scheduled for later this month.

Licensed Midwife and Nurse Practitioner Marcia McCulley of Simi Valley, California was arrested on March 14th at her office for practicing medicine without a license. According to eyewitness accounts, agents from the LA County Sheriff's office entered the premesis, where clients with babies were present, with guns drawn. Pursuant to a search warrant, patient charts were seized (anyone know the HIPPA ramifications?). Ms. McCulley seems to be in trouble with both the California state Nursing and Medical boards. You can read about it on the birth center's website.

New Email Address

2007-03-20T22:48:00.000-06:00

Please note that I've changed my email address to (in standard format) mommyblawger at gmail.com. Thanks!

Blawging Moms

2007-03-20T12:10:00.000-06:00

Ooh, I found a new (well, less than 6 months old) blog written by lawyer-moms (3 of them), Mamalaw.

HT: The Porch Light

Doula Liability

2007-03-12T00:25:00.000-06:00

Doulicia (like yours truly, a non-practicing lawyer) covers Doula Liability and Insurance.

Immigration Raids Split Families

2007-03-11T23:00:00.000-06:00

Look, I'm a conservative. I suport enforcement of immigration laws. I'm all for building a big, tall, fence. But this goes too far:

This past week in Massachusetts, most of the 361 workers picked up in a raid at a New Bedford leather-goods factory that made vests and backpacks for the U.S. military were women with children, setting off what Democratic Gov. Deval Patrick called a "humanitarian crisis."

Community activists scrambled to locate the children, offer infant-care tips to fathers unfamiliar with warming formula and changing diapers, and gather donations of baby supplies. One baby who was breast-feeding had to be hospitalized for dehydration because her mother remained in detention, authorities said.

Child-care arrangements had to be made for at least 35 youngsters.

Officials of the U.S. Immigration and Customs Enforcement division released at least 60 of the workers who were sole caregivers to children, but more than 200 were sent to detention centers in Texas and New Mexico.

Midwifery Legislative Update

2007-02-16T22:24:00.000-07:00

A lot going on. Let's get right to it.

Federal (US) - The Midwifery Care Access and Reimbursement Equity Act of 2007 (HR 864/S.507) would "amend title XVIII of the Social Security Act to provide for reimbursement of certified midwife services and to provide for more equitable reimbursement rates for certified nurse-midwife services."

Illinois - SB 385 would provide for the licensure of direct-entry midwives. I'm not hearing a lot of buzz about this one.

Indiana - A Midwifery Licensure Bill, HB 1238, is scheduled to be heard by the Committee on Public Health on Monday morning. Quick! Contact your legislator!

Missouri - SB 303 and HB 503 provide for the licensure of direct-entry midwifery. The bill defines "direct-entry midwife" as one licensed as a Certified Professional Midwife by NARM. Currently, the unlicensed practice of midwifery in Missouri is a felony.

North Dakota - SB 2377 was originally a bill making it a Class B Misdemeanor for a person to provide obstetrical services without a license; however it now appears to be a bill providing for a legislative council study "of the provision of obstetrical services by laypeople."

South Dakota - HB 1207, the bill to regulate direct-entry midwifery seems to be dead. HB 1267 would remove the requirement that Certified Nurse-Midwives have a written collaborative arrangement with a physician, which would in effect allow CNMs to attend homebirths.

Utah - SB 243 would amend Utah's Direct-Entry Midwife Act by defining what constitutes a “normal” pregnancy, labor and delivery; and clarify when consultation or transfer is required. Opponents of the bill say that the language is too restrictive, and would effectively end homebirth in the state for all but a handful of women. The Mommy Blawger thinks that legislators, the vast majority of whom have neither given birth nor delivered a baby, are not qualified to define "normal" birth by any stretch of the imagination.

Know of any legislation that I've missed? Shoot me a comment or an email.

Is EMTALA Unconstitutional?

2007-02-15T17:45:00.000-07:00

Shadowfax asks the question, and Flea says repeal it. Related discussion at Kevin, M.D.

Pork, Trademarks, and The Other White Milk

2007-02-03T23:45:00.000-07:00

I admit I've been in a blogging funk lately. It's been a long, cold, January (o.k., I know I live in Texas but it's cold for here) and we've all been sick with two colds right in a row (except my husband, who escaped the sinus yuck but got himself food poisoning). Not to mention my 3 boys have birthdays 3 weeks apart from mid-January to early February. So I have some excuse. But today it was sunny and over 50 degrees outside, and Spring approaches...

While I was funking, I got scooped on The Lactivist/Pork Board brouhaha by my fellow blawgers. I mean, any story that contains the words "lawyer" and "breastmilk" has Mommy Blawger written all over it, so to speak. Don't ya think?

On to the story... The Lactivist runs a CafePress store where she sells t-shirts and bumper stickers and such with catchy lactivism phrases such as "Eat at Moms" and "The Other White Milk".

Oops.

Seems that the National Pork Board, owner (or not?) of the trademark "The Other White Meat", is concerned about trademark infringement and dilution. They sent a nice long cease and desist letter to the Lactivist, who posts here and updates here. To make a long story short, The Lacitivst got lawyered up, all you bloggers and lactivists out there got really busy (Information Week described it as "National Pork Board Stumbles Into Hornet's Nest Of Bloggers"), Cafe Press pulled the slogan immediately so it was a non-issue anyway, and, most satisfactorily, the CEO of the Pork Board issued an apology. All in just three days. Whew.

Lactivist Amy Philo wrote an absolutely hilarious letter to the Pork people.

In addition to a ton of mommy bloggers (including former lawyer Andi Silverman of Momma Knows Breast), lawyers Denise Howell, Ann Bartow of the Feminist Law Professors, and Ted Frank of Overlawyered, all mentioned the situation, and Marty Schwimmer is responsible for the memorable phrase, "Don't send a demand letter to a blogger if the subject matter is breasts, as they make for good copy."

Kaimipono Wenger of Concuring Opinions summed it up best: "Overall, I can't say that this was a bad legal decision. Just a very bad business decision." No kidding.

Daycare Charges More for Breastmilk

2007-01-20T22:51:00.000-07:00

Although most daycare centers are supportive of breastfeeding, the Motherwear Breastfeeding Blog reports that at least one has been charging parents extra to feed babies the real thing:

Here are just a few of the reasons why charging more for serving breastmilk is absurd:
It's safe and requires no special storage. The Centers on Disease Control (CDC) states that breastmilk is not considered a hazardous bodily fluid (something requiring "universal precautions" in health care-speak). As such, it requires no separate storage, protection, or handling by a child care provider.

It's easy. Breastmilk is no more complicated to serve than formula, and does not require mixing and measuring as formula does.

It saves them money. Babies receiving pumped milk are less likely to be sick, which means less disease spread among children in the center, and less absences for both babies and staff. This reduces a center's cost of operation.

Babies are happier and less messy at day care. Breastmilk is more easily digested than formula, so breastfed babies are less fussy, spit up less frequently, and have less diarrhea - all things you want to avoid if you are a day care provider.

All good points. I had always wondered whether breastmilk was considered a hazardous bodily fluid.

News of the Weird

2007-01-20T22:49:00.000-07:00

You just gotta love headlines like this one:

"3 Pregnant Teens Break Out Of Group Home: Teenagers Whack Director With Frying Pan, Tie Her Up, Steal Her Purse And Flee In Stolen Minivan"

Childbirth in Africa

2007-01-20T22:44:00.000-07:00

Zimbabwe is dismal:

A staggering 42,000 women died in childbirth last year, compared with fewer than 1,000 a decade ago.

And Zambia is not much better:

"Being pregnant in Africa is like having an unknown disease," says Zambian mother Alice Tembo, referring to many of her compatriots' lack of basic knowledge about pregnancy and childbirth.

She has recently given birth without any complications, which is exceptional in a country where the maternal mortality ratio is 728 per 100,000 live births.

However, Zambia's maternal death rate is still lower that the rate for the whole of the sub-Saharan African region, which stood at a shocking 920 per 100,000 live births in 2000 according to the United Nations Statistics Division.

Internationally, sub-Saharan Africa has by far the highest ratio of maternal deaths. It is more than double the rate for the world as a whole, which is 400 deaths per 100,000 live births.