Midwifery Legislative Update - Nebraska

The Nebraska Board of Health is refusing to allow CNMs to attend home births (link - KHAS-TV).

**Update 8/04/2006**
Home birth advocates continue to fight

Lawyer, Wife Livid Over Breastfeeding Incident

Oooh, I love it! Lawyers and breastfeeding!:

A Deerfield Beach lawyer is on a letter-writing campaign after, he says, a restaurant employee asked his breastfeeding wife to "take it outside."

Geil Bilu said that he and his wife and children, ages 19 months and nine weeks, were at Westside Bagels in Coral Springs Saturday morning when his infant daughter began to fuss. Bilu said his wife began to discretely nurse the baby, when a man, who Bilu said he believes was a restaurant manager, came over and asked her to leave.

Bilu said when his wife told the man that she was nearly done feeding the baby and would leave as soon as she was done, the man stood by the table and stared until the family packed up and left.

(link)

And of course:

Since there is no criminal offense involved, Geil Bilu said he may pursue a civil case against the restaurant in order to raise public awareness of mother's rights to nurse.

Alabama Midwives: Going Natural

The Huntsville Times has a really good article, Alabama Midwives: Going natural which proclaims "area women willing to travel to Tennessee to have natural childbirth.":

A 1976 rule change effectively ended planned home births in Alabama by limiting the practice of midwifery to certified nurse midwives - registered nurses with extensive childbirth training. They can deliver babies only at a hospital and must be supervised by a doctor.
...
Because Alabama does not sanction CPMs, they can be charged with practicing certified nurse midwifery without a license if they are caught delivering babies here. That has happened at least twice since 1995.

"For many people, midwifery is a calling, and here's the state saying, 'Oh no, you can't do this,' " said [Chloe] Raum, who is apprenticing at the Ardmore birth house. "They can't recognize that birth can be managed in a dramatically different way (than hospitals) and have just as good or better outcomes.

"We try to be very respectful and nice and quietly educate people."

While state health officials say a hospital is the safest place to have a baby and the vast majority of parents are happy to go that route, midwife births are slowly gaining in popularity. According to government statistics, midwives delivered 328,153 babies in 2003 - about 8 percent of children born in the United States that year. That's up from 7.4 percent of all births in 1998.

The trend is being fueled in part by a study published last year in the British Medical Journal that concluded planned home births are as safe as hospital births for healthy women, with less chance that the labor will end in a Caesarean-section surgical delivery.

No discussion in the article of legislative efforts, however.

My First Nurse-In

Jen is planning to attend her first Nurse-In.

(Related post: Lactivism, Nurse-ins, and Victoria's Secret)

Informed Dissent

The SpunkyHomeSchool blog is keeping up with the Abraham Cherrix case and reports that the appellate judge has set aside the order of the juvenile court requiring Abraham to report for chemotherapy treatments.

(Related post)

Woman to sue after childbirth turns tragic

A South African woman who was left a paraplegic after a childbirth-related epidural is pursuing civil remedies. (link)

Right of Teens to Refuse Cancer Treatments

ABC News explores teens who refuse cancer treatments:

While traditional medicine says that chemotherapy, radiation, and stem cell transplants are the only options available to treat cancer, there are a number of alternative treatments that some say are successful, too.

Some of these methods include diet management, electrode therapy, herbal and plant extracts, supplements, and oxygen treatments.

If an adult were to choose one of these, a physician would acknowledge that decision and uphold it, even if it meant his or her patient could die.

When a teenager wants to do the same, it can quickly become a legal battle between the teen and his doctors.

Is that fair?

And while an adult can refuse medical treatment on his or her own behalf, parents who refuse treatment on behalf of their child can be investigated for medical neglect, or worse:

A month later, Billy returned home with his parents' promise that he would not have to continue the chemo.

Instead, the family came together and chose to turn to alternative therapies. This family decision prompted Billy's physicians to report his parents as unfit to the authorities.

Some medical ethicists, however, believe that some older teens are capable of making informed, life-or-death decisions for themselves. But their parents, who are legally able to make those decisions for themselves, are not able to make those decisions for their children. Sorry if I seem to be repeating myself; I am trying to wrap my brain around this. Instead, it is better for doctors, judges, hospital ethics boards - strangers, essentially - to make these decisions for them.

What Doctors Hate About Hospitals

Courtesy of the Medical Malpractice and Pharmaceutical Liability Law Blog, check out this Time Magazine cover story from May, Q: What Scares Doctors? A: Being the Patient: What Insiders Know About Our Health-Care System That the Rest of Us Need to Learn.

Wow.

Ban the Bags

A new blog, banthebags.org, devoted to stop hospital-based marketing of baby formula.

Breastfeeding Lesislative Update - VT

Council kills breast-feeding initiative:

The City Council [of Burlington, Vermont] decided at its last meeting not to involve the city in encouraging breast-feeding. Some councilors said it is not a "core mission" of the city.

Denise Howell

Blogger and mom Denise Howell, of Bag and Baggage fame, has been fired. And she writes about it so graciously and insightfully.

Ms. Howell is widely credited with coining the term "blawg", a fact for which I and my three blogs are eternally grateful.

P.S. There is no Wiktionary entry for "blawg", and no definition on Wikipedia, either as its own entry or on the "blog" page. Someone want to take care of that?

50 Ways to Protest a VBAC Denial

Barbara Stratton (voted one of the United States' top 30 women's health activists of 2005 by the National Women's Health Network) has a great piece up at Midwifery Today titled 50 Ways to Protest a VBAC Denial:

In 1999, the American College of Obstetrics and Gynecology (ACOG) issued new, restrictive guidelines for physicians and hospitals that handle vaginal birth after cesarean (VBAC). At first small, rural hospitals stopped offering VBAC; then larger, metropolitan ones followed suit. Now over 300 hospitals in our country no longer allow women to choose their method of birth.

Some of her suggestions include the usual; contacting local media, writing your legislator, organizing a protest, etc.; but she has the following legal suggestions:

3. File a complaint with your state medical board against the physician. Again, if the hospital where he/she has privileges meets the ACOG guidelines, then use the standard of care argument. Also point out that your physician is violating your right to refuse treatment. For more information on these rights, see the essay created by Katie Prown based on her research of the illegality of VBAC bans, at www.birthpolicy.org/primer.html.

Katie also covers how denying a patient the right to refuse treatment violates ACOG's own ethics guidelines. Throw that in, too!

In situations where you were literally forced into surgery, use the blue pages of the telephone book to contact your state's attorney general and pursue criminal assault and battery charges against the physician.

4. File a complaint with your state agency that regulates hospitals. In Maryland, this is the Office of Hospital Quality Assurance (comes under of Department of Mental Health and Hygiene). They have an official complaint process for consumers. Again, use the ACOG standard of care argument if your hospital meets the VBAC guidelines and include that you are being denied your right to refusal of treatment. Then, pull a copy of your hospital's patient bill of rights (found on many hospital Web pages) and see if the ban is a direct violation of their own document! In Maryland, all hospitals are required to have a bill of rights.

She later explains:

7. Find a lawyer who will help you sue your banning hospital. Make sure you give him or her the link to Katie's essay because most lawyers don't seem to know the ins and outs of the patient rights issue. Tell them about the violation of standard of care if that pertains. To find a lawyer, write to your state chapter of the ACLU or contact your local law school and ask for someone who deals with health law. Try your state's bar association for referrals as well. In a case from Massachusetts a woman was awarded $1.5 million for the post traumatic stress disorder and medical complications resulting from her coerced cesarean.(Meador v. Stahler and Gheridian (Middlesex Superior Court C.A. No. 88-6450, Mass. 1993)) Many lawyers won't know about that case until you tell them.

Interesting. Any takers?

National Advocates for Pregnant Women

The National Advocates for Pregnant Women (NAPW) website (whose stand on some issues I don't happen to agree with) has a blog which, among other things, tracks the arrests of pregnant women (for instance, women who allegedly used drugs while pregnant and are charged with child endangerment). Another one of their issues of note is coerced or court-ordered c-sections and childbirth interventions.

While of course no one thinks it is a good idea for pregnant women to use illegal drugs, it is quite ironic that society and the medical profession frown on drug use, legal or illegal, during pregnancy, but once labor starts we encourage the use, sometimes without informed consent, of all kinds of drugs which have not been proven safe for the unborn baby.

Spokane, Washington, CPS Case Update

Hawthor the Cow Goddess gives an update on the CPS story I blogged about in April.

Inmate Shackling

As promised, Wisconsin's Department of Corrections is "close" to finalizing a policy on shackling of pregnant inmates during labor.

Lactivism, Nurse-ins, and Victoria's Secret

At last count, 39 states (and a few cities) have enacted legislation protecting the right of mothers to breastfeed in public. Usually this legislation exempts breastfeeding from public indecency laws, with language stating that a woman has the right to breastfeed "anywhere she is legally allowed to be" or something similar. Federal legislation on the topic ensures the right to breastfeed on federal property. None of the legislation, to my knowledge, has any "teeth"; that is, there is no fine (so far) or remedy in tort for a mother who has wrongfully been asked to move, cover up, or stop breastfeeding (but see Scotland, which levies a fine).
One could argue that there is an inherent right to breastfeed in public without legislation, but that is beside the point.

Lactivists, however, have developed their own disincentive for businesses who give nursing moms a hard time: the Nurse-In. Basically, it works like this: You own a business. One of your employees asks a customer to stop breastfeeding in your place of business, otherwise open to the public. Or cover up. Or go to the restroom to nurse. Either on their own whim, or at the request of another customer. Regardless of how the situation is resolved, mom goes back home, and complains of the incident on her blog, on her email and discussion groups, at her La Leche League meeting, etc. And the news will spread like wildfire. Promom will start a letter writing campaign. The incident will be discussed to death on Mothering Magazine's discussion forums. Hawthor the Cow Goddess will write a cartoon about you. Your business will be on the evening news.

If you act quickly, offer an apology, and promise to change your company policy and educate your employees on the law, you may be able to avoid the Nurse-In. Maybe not. What will happen is that on a given day, at a given hour, anywhere from two to a hundred women with nursing infants (and some without) will come to your establishment and nurse their babies. If, by the time of the Nurse-In, you have apologized and made nice, the lactivists will eat at your restaurant, shop in your store, and be friendly. If you are stupid enough to still profess to be in the right by this point, they will stand on the sidewalk, or across the street, carry signs, and eat at your competitor's restaurant.

On June 21st and 22nd, there were two separate incidents (in Boston, MA and Burlington, WI) where women who were shopping at Victoria's Secrets were asked to use a public restroom instead of a changing room or nursing in the store. In case you miss the high irony of the situation, here are some quotes from the Blogging Baby article:

[S]he had been asked "to nurse in the restroom because the sight of her breasts might offend a customer."

Imagine, Victoria's Secret customers offended by the sight of breasts!

When she refused to nurse in the bathroom, she was told that "it was unsanitary for her to nurse in the dressing room because people change in them."

And restrooms are more sanitary?

If this had been the first such incident for Victoria's Secret, it might have been forgivable, but sadly it is not. After you get some bad press on this once, you think you'd get the word out to your managers and employees. Also, Victoria's Secret does not carry nursing bras (although I do own two of their bras and manage to nurse in them quite comfortably), even though sexy fashionable nursing wear is quite hot right now.

Anyhow, these two women started a nationwide protest - yesterday at 1:00 pm Nurse-Ins were taking place at VSs across the US. (I tried to blog about this two days ago but ran out of time. If you wanted to go and were depending on me to give you the heads up, you need to get out more often). They were met with varying degrees of response from the VS employees, from complete ignorance of the Nurse-In, to a pleasant "yes, we have been told to expect you" welcome. A couple minor run-ins with mall security, but no arrests as far as I know. Also clear from the post-Nurse-In debriefing; the problem with scheduling these things is, sometimes babies just don't want to nurse at 1pm on a Saturday in the middle of a mall. It's hard to have a protest when half your participants don't feel like participating.

I hope, by the tone of this post, I don't seem unsympathetic to, or critical of, the Nurse-In as a form of social protest. I actually think it is quite effective and might have joined had my domestic schedule been otherwise. But I am looking at it from the point of view of the business owner, for whom it is a major, yet very avoidable, public relations fiasco. On the other hand, as they say, there is no such thing as bad press.

I have two pet peeves, one for each side. I hate it when businesses say "our company policy permits nursing in our store." I want to scream when I hear that. In a state where breastfeeding in public is permitted by law, it is not up to the business to "permit" or "forbid" breastfeeding on their premesis. They can be welcoming or not, educate their employees or not, but it is not up to them to "allow" it.

On the other side, almost all of the articles about the Nurse-In will quote someone saying something like "you see more in their magazines and store windows than you do when a mother nurses". While technically that is true, and I am in no way defending Victoria's Secret's (and popular culture in general's) abhorent lack of modesty, it is all about nipples. In our society, you can show all of the breast but that. Any any woman who claims that all of the nipple is in the baby's mouth while breastfeeding in public is either lying, or has unusually small nipples (or a baby with an unusually large mouth) . Ok, sorry to be so blunt, and please don't leave me nasty comments, but it's the truth.

Here are a few links, and I'll update with some of the better news items as they trickle in:

Breastfeeding Moms Blast Victoria's Secret in Nationwide Protests
Victoria's Dirty Little Secret
Reluctant Lactivist
CITIZEN-TIMES.com: Breastfeeding mothers to stage protest at Asheville Mall
Fox 42 Nebraska
Huntsville Times


**Update 7/05/2006**

The Cleveland Plain Dealer published a truly sensational and bizarre article:

Lactation and lacy lingerie were the subjects of a national nurse-in Saturday as breast-feeding mothers across the country let their kids chug-a-lug in front of Victoria's Secret stores.

Fifteen mothers armed with hungry babies gathered on the sidewalk outside the Crocker Park Victoria's Secret store in Westlake where scantily clad mannequins seemed delighted by the peaceful, half-hour demonstration.

"It's kind of ironic that Victoria's Secret, which plasters breasts everywhere, is offended at seeing breasts used for their intended purpose," said Anna Mauser-Martinez, who organized the local nurse-in and volunteered that she happened to be wearing a pair of Victoria's Secret underwear.
...
Back on the sidewalk, the mothers caught Aaron Bonk's eye. A juggler and stilt walker, he towered over them on 4-foot stilts. "Oh," Bonk said, sounding surprised. "You're nursing right here? Good!"

Looking up from her suckling child, Amy Klomfas said, "It'd be fun to breast-feed on stilts" - a notion that Bonk advised against.