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Letters to protect the rights

Page history last edited by PBworks 17 years, 5 months ago

Louisiana Licensed Midwives Need Your Help!

PLEASE HOLD OFF ON LETTERS UNTIL FURTHER NOTICE

(on 11/17/06)

Okay folks, apparently we were premature in urging letter writing to the board. While our efforts did not go unnoticed, letter writing at this point needs to wait until the board develops a final draft proposal and is made public in order to invite comment from doctors, nurses, midwives and well, the public. At that point letters will be crucial, but for right now, please hold onto them until I am notified by the members of the Advisory Committee to send them.

Thank you!

Please pass this along to any groups who were notified of this letter writing campaign.

Kris

Dear Friends,

This message is a call to action – your letters are needed! Please don't be put off the length – this message includes all the information you need. Letters are needed as soon as possible. You do not have to live in Louisiana to write a letter!!

First, you should read the letter below from Louisiana midwife Kathy Acree which describes the situation and the issues. Basically, the Louisiana Board of Medical Examiners has developed its own suggestions for rules changes (rather than working with the suggestions from the official Midwifery Advisory Committee). These suggested changes would restrict Licensed Midwives and decrease access for consumers. The Louisiana Licensed Midwives are asking for letters to be written so that the members of the Board of Medical Examiners and other key people will hear from YOU that specific rules changes (described below) should not be enacted.

You don't have to live in Louisiana. Whenever a state enacts more restrictive rules it sets a precedent that can affect other states. Even if you don't live in Louisiana, or even know anyone who lives there, you have friends or family members who might live there in the future and want to have a midwife, and you can mention that in your letter.

In addition to Kathy's letter, below you will find a sample letter and a list of people who should receive letters. Do NOT copy the letter verbatim! Write your own letter, in your own words! It does not have to be as long as the sample, and it does not even have to cover all the points. You can write one letter to the President of the Board, and send a copy with a brief handwritten cover note to the other people on the list, or you can send the same letter to all the people. If you feel you cannot send letters to everyone, there are four most important people listed first. If you can send a few more letters, write to the other members of the Board of Medical Examiners. If you can write to everyone on the list, terrific!!

In addition, the president of Louisiana Midwives Association has set up a petition online. If you feel you cannot write letters to the board members, please consider signing the petition. More information may be found on this site on the Protect the Rights of Childbearing Women page.

You may sign anonymously.

Please feel free to forward this message to as many people as you can! All women, whether supporters of home birth or not, will support birthing choice.

Letter from Kathy Acree of the Louisiana Midwives Association:

Kathy Acree, LM, CPM

234 East Smiley Street

Opelousas, LA 70570

September 27, 2006

Dear Friends of Louisiana Midwives:

The Louisiana Advisory Committee on Midwifery has been working with the Louisiana State Board of Medical Examiners (LSBME) to update the rules and regulations for Licensed Midwives in our state. The LSBME has proposed suggestions and modifications to our rules and regulations which could have a far reaching impact on both consumers and midwifery providers in our state. We are asking for you, as a friend of Louisiana Midwives, to help the midwives in their negotiations with the LSBME. It is imperative as a consumer that you are aware of these suggestions, that you forward this information to other interested parties and that you write your concerns to the LSBME to facilitate open communication between the public that the midwifery community serves and the agency(LSBME) that oversees the midwives.

Your rights as a consumer can be vastly limited with their proposals.

Enclosed you will find a letter from the LSBME to me. I am the chairman of the Advisory Committee on Midwifery. Read it and consider this in your future plans as a consumer of midwifery services. Realize that these are proposed suggestions, not "the rules" as such, but they can become so without your help. If you wish to have the entire revised chapter 53 (either our revisions or theirs) please call, email, or write Kris Harper, LMA secretary at (318)869-0916, 259 Carrollton Avenue, Shreveport, LA 71105. Her email address is lotsaharpers@sport.rr.com

The Louisiana Midwives Association points of concern and contention are:

1) The LMA would like the radius requirement eradicated. We feel this inhibits women's choices to give birth where and with whom they wish. Most midwifery transports are for non-emergent care and are not life threatening. Many areas in Louisiana are rural and do not have access to a hospital within "25 miles or 25 minutes" of a client's home. Do doctors insist their clients live within these boundaries before being accepted into their care? We feel this proposal would limit the ability of midwives to provide care and would be illegal under the rights of childbearing women.

2) The required eight (8) prenatal visits by a midwife (two physician visits included) would dictate at what point the consumer could choose midwifery care. Some consumers make the decisions late in pregnancy to seek midwifery care. It should be left up to the midwife to decide if she is comfortable taking clients late in pregnancy because it is the midwife who bears the responsibility and liability of providing the care to the consumer. Just as physicians are not limited in accepting care at any point in the pregnancy, nor should midwives. There are no prenatal visit limitations for CNM's, so why should there be for Licensed Midwives?

3) LSBME is also seeking to disallow midwives from attending vaginal births after caesareans. The Louisiana Midwives Association feels this does not serve the women of our state. Women who have had a previous c-section with a lower transverse uterine incision, with double suture layer closure, who are not induced with pitocin or who do not receive cytotec to induce labor have a 0.2% thru 0.7% risk of uterine rupture. Women should have the ability to seek informed consent to choose the site and provider of their choice. If the LSBME has allowed Licensed Midwives the ability to provide care in homes, hospitals, birth centers, and clinics, it would prevent clients from obtaining VBAC's with midwives in any setting. Such a precedent would again violate the rights of childbearing women and would force women to undergo caesarean surgeries if no physicians or midwives were willing or able to do so because of the proposed suggestions. Women are being allowed to choose "C-Sections on demand" so why are they in turn being denied access to VBAC's with the health care provider of their choice? The American College of Nurse Midwives and the North American Registry of Midwives have both allowed CNM's and CPM's the ability to provide such care. The C-Section rate in the U.S. has grown at an astounding rate of 40% in the last 10 years nationwide. This further increases health care costs to YOU the consumer through increased insurance premiums! If this trend is not reversed, we will continue to see rising premiums and limited providers and birthing options.

If you want to see choice in childbirth; if you want to preserve Licensed Midwifery care; if you want to contain health care costs; and if you want to choose where and with whom you may give birth, please write to the enclosed address list. Help protect the rights of childbearing women. DO IT TODAY! And thank you for helping us to maintain Licensed Midwifery in Louisiana.

Sincerely,

Kathy Acree, LM, CPM

Chairman

A Sample Letter to a Board Member:

You can use the following as a springboard to write your own letters. Please do not copy it verbatim! You can write in the first person as a consumer, and the letter can be briefer than this sample. You can include a sentence or two about your own birth experience if pertinent.

The letters going to people not on the Medical Board (see list below)should urge them to put pressure on the Board.

Dear Sir or Madam,

With the ever increasing demand for prenatal care in our state, midwives fulfill a vital role, both historically and presently.

Today's woman demands information, choice and the freedom to make those choices. Women want to be the directors of their own care, albeit obstetrical or general. Midwives have built their practices upon choice, education, information and partnership with women and their families to provide safe alternatives during their childbearing years.

I have recently learned of changes that have been proposed to the Louisiana Midwives regarding their practices within the state. Some of these changes needed to be made in order to ensure the safety of women and their babies, however I feel that other changes would be a detriment to my rights as a woman and mother. The benefits of midwifery care have a huge impact on our state and more specifically, me. Greater maternal satisfaction, increased normal birth rate, reduced caesarean section rate, increased breastfeeding rates, reduced costs of maternity services, and reduced incidence of postpartum depression are just some of these benefits. Please help to keep birth in the home as a safe, available option to women in Louisiana.

Getting rid of the mileage requirement is the first step. Doctors do not have to abide by this rule in order to serve their patients, so why must consumers(I) be subject to this arbitrary number? Do you want to encourage women to give birth in hotels or drive great distances in order to obtain home births in other states? Consumers (I) have the right to give birth where and with whom they (I) please!

Secondly, requiring consumers, to have six prenatal visits with the midwife prior to their expected date of delivery might, at times, be impossible. Sometimes people are caught having to move late in their pregnancies due to job changes, etc. and should not be kept from midwifery care because of it. If consumers can prove that they've had adequate prenatal care, then shouldn't that decision be left up to the consumer and the midwife to decide on when "enough is enough?" The decision to take clients late in a pregnancy should be the responsibility of the midwife as she is the one taking on the liability,not the Board.

And lastly, The American College of Nurse Midwives and the North American Registry of Midwives both have allowed CNM's and CPM's the ability to provide care to women who have had a previous caesarean surgery. I feel that if a woman is at a lower risk for developing complications in labor, even if she's had a previous uterine surgery,then she should be allowed the opportunity for Informed Consent and to choose the caregiver and place of birth that she wants. Licensed Midwives use risk assessments to evaluate their clients and allow their clients to make decisions that are specific to their care. No two clients are alike and no two births are alike. To make a general blanket rule for all women is to strip them of their rights. I do hope the Board will not allow this to happen. VBACs should be allowed within the home, if a woman so chooses and her midwife agrees.

Women should have the opportunity for Informed Consent! Please consider the proposals made by the Midwifery Advisory Committee, which have three Licensed Midwives, two doctors and one consumer on their committee. Their proposals were not made lightly and were heavily researched!

Sincerely,

The 4 most important people who should receive letters are the two board members who made these recommendations to the LSBME (Louisiana State Board of Medical Examiners), plus the two non-midwife members of the Midwifery Advisory Committee. It is important for these four to understand that the advisory committee was designed to help regulate midwives and that the board should not have made a subcommittee to "second guess" the recommendations by the advisory committee.

The Board Members can all be mailed letters to the following address:

LSBME

P.O. Box 30250

New Orleans, Louisiana 70190-0250

(1) Board Member: Linda Gage-White, M.D., Ph.D.

Dr. Gage-White also has a practice at LSUS as an ENT and is on the subcommittee formed by the LSBME to counter the proposals.

(2) Board Member: Tonya Hawkins Sheppard, M.D.

Dr. Sheppard is an OB practicing in Monroe and is also on the subcommittee. She and Dr. Gage-White made the recommendations to the board that we are now asked to approve.

The Midwifery Advisory Committee members that need letters are:

*(3) Dr. Rula Freije, MD (pediatrician)

621 North Avenue K

Crowley, LA 70526-4513

(4) Dr. Whitney Gonsoulin, MD (he is a maternal-fetal specialist in high risk OB)

1144-C Coolidge

Lafayette, LA 70503

If you can send more letters, here is the list of additional people:

The Board Members can all be mailed letters to the following address:

LSBME

P.O. Box 30250

New Orleans, Louisiana 70190-0250

The members include:

President: Kim Edward LeBlanc, M.D., Ph.D.

Vice President: Kweli J. Amusa, M.D.

Secretary-Treasurer: Melvin G. Bourgeois, M.D.

Board Member: Mark Dawson, M.D.

Board Member: Keith C. Ferdinand, M.D.

(Board Members Linda Gage-White, M.D., Ph.D. and Tonya Hawkins Sheppard, M.D. are listed above as priorities.)

The Midwifery Advisory Committee members in addition to the two priority members listed above would like to see a copy of what you are sending, and you can mail them to:

Kathy Acree LM, CPM

234 East Smiley Street

Opelousas, LA 70570

(Emmy Trammel and Ann Lastraps can be sent mail together at the same address)

Other people that need to know what is going on and may be able to pressure the LSBME to ratify the proposals by the advisory committee(your letter should ask them to raise these issues with the LSBME and request that the LSBME not adopt the problematic rules changes):