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Get the latest midwifery research, WA-midwifery-related legislative news, conferences/continuing education for birth professionals, and more. Click here to read the latest MAWS eBulletin or here for a list of past editions.

Read the MAWS Annual Update (pdf) including "Reflections 2009 Vision 2010" and other highlights of MAWS' work in late 2009/early 2010

Midwives included in New Health Care Legislation

"Trends and Characteristics of Home and Other Out-of-Hospital Births in the United States, 1990-2006."

The report was published in early March by the CDC and covered throughout the nation including USA Today, NPR's Health Blog, a press release from The Big Push, as well as by dozens of other news outlets who ran the story. It includes demographic characteristics of out-of-hospital-birth populations, data regarding states with the greatest and fewest home births and data demonstrating significantly reduced rates of pre-term and low-birth weight in out-of-hospital-birth populations.

Click here to read the full report from the CDC/National Vital Statistics

H1N1 - Information for Midwives and their clients - click here

Fall 2009: home birth research from British Columbia and Ontario - click here

ARCHIVE: SPRING 2009 UPDATE ON MAWS WORK

The Midwives’ Association of Washington State (MAWS) has been very busy lately:

Faced with the worst budget crisis ever, legislators in Washington have been looking for ways to cut costs any way they can. With support from midwives and midwifery consumers throughout the state, the MAWS legislative committee successfully fought off attempts during this session to eliminate both the Midwifery Advisory Committee, a legislatively mandated entity that advises the Department of Health about regulatory matters affecting licensed midwifery, and the Joint Underwriting Association (JUA), the only avenue through which midwives and free-standing birth centers in Washington can obtain liability insurance. We also managed to get a budget proviso passed to maintain the current $450/year cap on the midwifery licensing fee for the 2009-2011 biennium.

Our strategy this year has been to play offense, rather than defense—instead of pleading with legislators to preserve licensed midwifery and the option of out-of-hospital birth, we approached them with the concept that licensed midwifery is part of the solution. In tough economic times, it makes more sense than ever to promote this safe and cost-effective form of care for low-risk pregnant women. MAWS also lobbied for passage of a bill to protect mothers nursing in public which also passed!

In late 2007, the Washington State Department of Health (DOH) released a study about the cost-benefits of licensed midwifery care which demonstrated that the State saves nearly half a million dollars biennially in cost-offsets to Medicaid when women give birth at home or in free-standing birth centers with licensed midwives rather than in the hospital. Impressive though this data was, it only considered the savings conferred by our lower c-section rate. It did not take into account how much licensed midwives save the state in avoided hospital facility fees and costly medical procedures like epidurals, external fetal monitoring, induction, etc.

At MAWS’ request, an updated analysis was recently completed: It turns out that we actually save the state over $3 million biennially. And that’s with only 102 licensed midwives! With this new data in hand, MAWS is making the case to both legislators and agencies like the DOH and HRSA (Medicaid) that midwifery care should not only be preserved but promoted as a way to lower maternity care costs and improve outcomes for mothers and babies. MAWS intends to share this information so that it can be used by midwifery associations in other states and by national midwifery advocates as well.

On a related note, MAWS is embarking on a public awareness/public education campaign called Better Birth Options. Funded by individual donations and a generous contribution from the Puget Sound Birth and Family Center, the campaign will get the word out about the benefits of giving birth at home or in a birth center through press releases, public service announcements, paid advertising (including bus ads), social media, and local, community-sponsored events. MAWS is also exploring with the DOH and HRSA opportunities for licensed midwives to provide prenatal care in community health clinics and local health departments.

And finally, here’s an update on the work MAWS is engaged in with the Department of Health’s Perinatal Advisory Committee (PAC). MAWS is being represented in both the Physician-Midwife Workgroup and the C-section Subcommittee of the PAC. The MD-LM workgroup developed a hospital transport guideline that is currently being incorporated into a demonstration project. This document outlines for hospital staff the training of licensed midwives, the equipment we carry to births, the most common reasons for intrapartum transports, and the expectations for both the midwife and the receiving facility when women need to be transferred to a hospital from a planned home or birth center birth. The goal is to improve inter-professional communication, enhance the safety and the satisfaction of birthing families, and decrease liability for all the practitioners involved.

The newly formed C-section subcommittee of the PAC has been charged with exploring the unintended variation in the c-section rate across Washington State and improving the quality of maternity care. While the c-section rate at some hospitals is as low as 15%, the rate at other hospitals is as high as 37%. Inductions of first-time mothers for non-medical reasons has been identified as one of the significant contributors to an increased c-section rate as has the distressing lack of access to VBAC.

Among other projects, this group is evaluating various “patient decision aids” that provide pregnant women with evidence-based information about the risk and benefits of induction, VBAC, and elective c-sections. The Chief Medical Officer at HRSA (Medicaid) is the co-chair of this group and, motivated by cost issues as well as by an awareness of the overwhelming evidence in support of VBAC, is committed to ensuring that this remain a viable option for birthing women in our state. The MAWS Board is energized by all this exciting work and anticipates a productive year ahead.

Audrey Levine, LM, CPM
President, Midwives’ Association of Washington State

NEW YORK TIMES ARTICLE ON HOME BIRTH

The November 13th edition of the New York Times reports that "local midwives say they have been swamped with calls and requests in recent months, in some cases increasing their workload from two, three or four deliveries a month to as many as 10." The article includes a slide show of home births in NYC.

The Washington State Department of Health published a report in August 2008 on the staggering increase in c-section rate from 1997 to 2005 (60% in that time period). They also found the Puget Sound Region to have the highest rate in the state. The report notes "women living in the Puget Sound region had 275 (about 10 percent) more C-sections per year than would be expected when compared to women living outside the region. These women were giving birth to a single child and had no prior C-sections or noted risk factors". Click here to read the DOH press release or download the report here.

PARTICIPATION REQUESTED IN RESEARCH STUDY

Research is being conducted to evaluate the effects of secondary trauma on birth professionals. If you have witnessed or participated in a traumatic birth experience and wish to be interviewed, please reply by email to: RESTStudy@gmail.com with name (first name is fine), email address, contact number and a good time to reach you. A day and time will be set up for an interview. Participation is anonymous. We are looking for midwives, doulas, OB nurses, students, anyone involved in birth. And feel free to email any questions you may have as well.

ALI TOPEROSKY FEATURED IN A NEW BOOK!

Ali Toperosky, LM, CPM has been featured in a compelling new book, Hands at Work. This is a collection of dramatic black & white portraits by Summer Moon Scriver along with companion profiles by Iris Graville. It captures the drama and tells the stories of people who work with their hands. See the work of our hands, shown by Ali as she catches a beautiful newborn in a recent water birth.