Unassisted Childbirth

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

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

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?

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

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

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

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

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

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

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

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

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

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

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

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

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

Blawging Moms

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

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

Immigration Raids Split Families

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

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?

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

Pork, Trademarks, and The Other White Milk

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

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

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

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.