Friday, July 30, 2010

Thanks be to God, the internet, hard work and all of you; the Midwifery Modernization Act was signed into NY state law today by Governor Paterson. In 90 days, it will take effect. Whew! This was a long labor.
Thanks to one and all for your support. However you celebrate, do it with joy for mothers and their midwives.

May all babies be born into loving hands... 

K. Michelle Doyle, CNM, NYS LM

Tuesday, July 20, 2010

Governor Paterson, Please Sign the Midwifery Modernization Act!

The Midwifery Modernization Act landed on New York's Governor's desk. Guess what? We are asking for your help again. Just follow the beautiful form below (courtesy of Free Our and you can send Governor Paterson a note showing your support of the MMA. So close, we are so close.... 

May all babies be born into loving hands... 

K. Michelle Doyle, CNM, NYS LM

Free Our

Governor Paterson, Please Sign the Midwifery Modernization Act!

by admin on July 20, 2010
It’s time to write the Governor!!! After the Midwifery Modernization Act swept through the Assembly and Senate (have we thanked you enough for that??), we’ve been patiently waiting for Governor Paterson to sign the bill into law, the final step in the legislative process.  We just received word that MMA has officially landed on the Governor’s desk. He has three choices in front of him: 1) he can sign the bill, 2) he can veto the bill, or 3) he can do nothing and the bill will become law in 10 days.
Now is the time to act! The Governor has a long list of bills in front of him right now. We need ours to stand out as having tremendous constituent support. And importantly, we need to help inform him about why this piece of legislation needs to become law. His job is to hold a wider vision of the needs of the state and our job is to help him focus in on this particular need.
ACOG (American Congress of Obstetricians and Gynecologists) has contacted the Governor voicing their opposition to the MMA. This is why your letter is critical right now.

Your Mission:

Contact the Governor using the form below.
In the message box, please include the greeting “Dear Governor Paterson” and make sure to include your full name and address. Below is a short sample to get you started. Please feel free to expand on the message and we strongly encourage you to include something about why it is personally important to you that New York State women have access to midwifery care.

The message:

Dear Governor Paterson,
I am writing to express my strong support for the Midwifery Modernization Act (A8117B) and to urge you to please sign this bill into law.
Midwifery care is safe, cost effective, and associated with excellent outcomes for mothers and babies. This legislation will increase access to midwifery care for women all over New York State and it will not cost the state anything. Physicians and hospitals are happy  to consult and collaborate with midwives without a Written Practice Agreement.
We have come so far.  We need a unified, empowered consumer voice to encourage the Governor to sign. Please take a few moments to send your letter using the simple form below. (Please remember to sign your message with your full name and address.)
This form will send your letters to the appropriate aid in the Governor’s office as well as the president of NYSALM (New York State Association of Licensed Midwives) and Free Our Midwives (for documentation purposes).
Your Name (required)

Your Email (required)

Zip Code (required)


Your Message

Are you a doctor?? Do you have a supportive doctor?? We very much need letters from physicians and /or hospitals highlighting their willingness and desire to collaborate, consult, and accept referrals without a written agreement. Those letters can be pasted directly into the form.

Wednesday, July 14, 2010

Maya Danyce Arrives!

This sweet baby danced her way into the world this morning. Bet you cannot guess her name! (Ok, maybe, you can...)

May all babies be born into loving hands...

K. Michelle Doyle, CNM, NYS LM

Monday, July 12, 2010

MMA Update

Here is an update from Free Our on the status of the Midwifery Modernization Act -all we need for the MMA to be the law of the land (in New York at least) is Governor Patterson's signature, or, the lack of his veto. Stand ready -we may need carefully timed support as the bill lands in the Governor's office. See below for details.

May all babies be born into loving hands...

K. Michelle Doyle, CNM, NYS LM

MMA Update

by Free Our admin on July 12, 2010
We are all still celebrating our incredible victory in New York State Legislature. We want to say again what a wonderful job you all did making your voices heard and helping get the Midwifery Modernization Act passed! It has been quiet for the past week as the midwives and consumer advocates organize for the final step, which is the governor signing the bill into law. We fully expect this will happen, given the overwhelming bipartisan support in both the Assembly and the Senate. However, the bill needs to land on his desk with a strong showing of support from the citizens of New York State.
We are predicting this will happen soon. When it does, we will be calling upon all of you to contact the governor by letter (snail mail or fax) when the moment is right.  It is a good idea to begin crafting a personal letter now, so that when you receive notice that the governor has the legislation on his desk we can flood his office with positive support for the bill.
This will be incredibly important because The American Congress of Obstetricians and Gynecologists (ACOG) continues to lobby against the best interest and health of New York State women and babies. That is, they are encouraging the governor NOT to sign.  It is important that we stay unified in our message and movement until the bill is signed into law.
When we arrive at the moment for sending letters, we will have some sample messages for you.  We are waiting to write those until we know exactly what the letters should say. As you begin to draft your letter, however, keep in mind the following things:
The MMA will effectively remove the Written Practice Agreement from the law, which will give New York State women and babies more access to midwives.
Midwives are highly educated, licensed and independent health care professionals who are obligated to collaborate with appropriate physicians when the need arises.
Midwifery care is cost effective and associated with better health outcomes for women and babies.

This bill does not cost the state of New York anything! (please consider highlighting this point for the governor who is probably overwhelmed by budget concerns).

In other related news, the American Journal of Obstetrics and Gynecology has released a meta-analysis of planned home birth that erroneously claims that lower medical interventions in homebirths are linked to higher neo-natal mortality.
Numerous research-savvy professionals have already highlighted the many shortcomings of this analysis. Please check out this handful of critiques so that we can all be educated about the many flaws in this paper. If we as a community of birth advocates can understand the problems with this study, we can remain well informed about what the evidence actually shows, and can counter fear-based responses to the article.  Here are the links :
Science & Sensibility
Birth Sense
A Summary by Jennifer Block
The Big Push for Midwives- Press Release
ACNM’s Letter of Concern
Coalition for Improving Maternity Services- Press Release
CBC News Article
Be on the lookout for an action alert once the legislation hits the governor’s desk keep an eye out on facebook for news and updates.

Sunday, July 11, 2010

Announcing Miss Rachel Lucia

Miss Rachel Lucia, was born on 7/11, her due date, the new moon, a solar eclipse and her midwife's birthday. What a lucky baby (and lucky mommy too)!

May all babies be born into loving hands...

K. Michelle Doyle, CNM, NYS LM

Sunday, July 4, 2010

July 1st, Ava Rae arrives

So pretty! This photo doesn't do her justice. Ava Rae arrived sweet and serene and has already left her tracks on her daddy's heart. Welcome Ava!

May all babies be born into loving hands... 

K. Michelle Doyle, CNM, NYS LM

Friday, July 2, 2010

MMRV:Combo shot boosts kids' fever-related seizure risk

From CNN Health, information about the MMRV vaccine.

May all babies be born into loving hands...

K. Michelle Doyle, CNM, NYS LM

June 28th, 2010
09:38 AM ET

By Miriam Falco
CNN Medical News Managing Editor

Children who get a combination of measles, mumps, rubella and chickenpox vaccines in one shot are at a slightly increased risk of getting a fever-related seizure, compared with children getting two separate shots – one containing measles, mumps and rubella and the another containing the chickenpox (varicella) vaccine, according to a new study published in the journal Pediatrics.
"The risk of a febrile seizure after any measles-containing vaccine is low – about one febrile seizure in 1,000 doses" says lead study author, Dr. Nicola Klein, co-director of Kaiser Permanente's Vaccine Study Center. "But if a child gets the combination vaccine, the risk doubles," says Klein.
Researchers looked at vaccine-safety data from more than 459,000 toddlers between the ages of 12 and 23 months and found there was one additional case of febrile seizure for every 2,300 doses of MMRV (measles, mumps, rubella, varicella) vaccine given. The seizures occurred seven to 10 days after the injection.
According to the Centers for Disease Control and Prevention, a febrile seizure is a fever-related seizure, which can occur when a child has a fever at or above 102°F or when a high fever is going down.
"Febrile seizures are benign," Klein says, meaning they're generally not dangerous. "They are very frightening to parents, but do not lead to long-term seizures or epilepsy." The American Academy of Pediatrics agrees: "While febrile seizures may be very scary, they are harmless to the child. Febrile seizures do not cause brain damage, nervous system problems, paralysis, mental retardation, or death."
Febrile seizures can occur in children ages 6 months to 5 years, but are most common in toddlers ages 12 months to 18 months, according to the American Academy of Family Physicians. Klein says up to 5 percent of children will have a febrile seizure between 6 months and 5 years, but that they are more likely to be caused by a common cold or other infections.
This combination vaccine was first approved in 2005. "The benefit of the MMRV is ease of administration," says Dr. William Schaffner, chairman, Department of Preventive Medicine at Vanderbilt University and a liaison to the Advisory Committee on Immunization Practices, the CDC's vaccine advisory board.
It was that ease – a single shot for four vaccines, which led the ACIP to recommend a preference for this new vaccine back in 2006, says Schaffner.
Klein presented early research to the ACIP in 2008 suggesting an increased risk of seizures. This led to the CDC to change its recommendation last year from preferring the combination vaccine to having no preference. This means MMRV or the MMR plus chickenpox vaccine may be given for the first dose for children 12-23 months.
This new study confirms Klein's earlier research. This "final result is exactly what we expected," says Schaffner. "This study provides a basis for every pediatrician."
""The ACIP has quite clearly said both [MMRV and MMR plus chickenpox separately] are good – both provide protection." But Schaffner says if there is any doubt for the parents or pediatrician, "two [vaccinations] is the way to go."
Klein says the benefit of the MMRV is "one less injection for children." Her study concludes that pediatricians who choose to use this combination vaccine need to be aware of the risks, albeit small, and clearly communicate them to parents. If parents choose to go with separate vaccinations, their child will get the MMR vaccine in one arm and the chickenpox vaccine in the other arm.
Although the MMRV has been available for five years now, usage of this combination vaccine dropped significantly after the manufacturer, Merck, announced it would be unavailable after July 2007 because of a shortage of the chickenpox vaccine.
According to the CDC, Merck was taking orders for the MMRV vaccine starting on May 10 of this year and according to the manufacturer, the vaccine is now available again.
The updated package insert for the MMRV vaccine say it "is associated with higher rates of fever and febrile seizures at 5 to 12 days after vaccination," compared with children who got the MMR and chickenpox shots separately.

Thursday, July 1, 2010

MMA: Victory! We did it together!

More on the Passage on the MMA. This time from our friend Free Our Midwives, the tireless group from NY's Ithaca area. Ah.... so good when hard work comes to fruition.

May all babies be born into loving hands... 

K. Michelle Doyle, CNM, NYS LM

Victory! We did it together!

by Free Our admin on July 1, 2010
SageAcross the state last night, the champagne flowed as women and their families celebrated the passage of the Midwifery Modernization Act!img_0190
Why did this bill pass during such a difficult time in New York State politics?  Because women – and those who love and support them – stood shoulder-to-shoulder with midwives despite formidable opponents, limited resources, and little time to get organized.
Together, women strategized, fundraised, spread the word, and gathered supporters.  The result was a truly grassroots effort that was able to stand up to established and powerful opponents.  Thanks to your time on the phone, writing IMG_7488e-mails, and sending faxes, legislators were able to learn the truth about the importance of birth choices for women.
Thanks to your efforts, women will continue to have access to midwives in New York.   Before this law was passed, many currently practicing midwives were in jeopardy – now they can continue to care for woimg_9984_0men.  In other areas of the state, midwives will now be able to practice, thanks to your hard work.   There are women pregnant today who will now receive the high quality prenatal care a midwive can provide, thanks to you.

Time to give thanks!

IMG_8645Please take a moment to thank your Senator and Assemblyperson for supporting the bill.   The Senate vote was unanimous, so please thank yours ASAP!  Check here for your Assemblyperson’s vote to see if they supported the bill.  Find your Assemblyperson here and your Senator here and thank them for supporting the Midwifery Modernization Act.

Watch for any last steps

This bill has now been passed by the Assembly and Senate and must go to the Governor’s desk to be sigHuck2ned.  If we need to contact the Governor’s office to encourage him to take action, we’ll let you know!

Keep this victory going

IMG_7464We’ve all learned so much about how to make an impact on the legislative process and the lives of women.  Keep up the good work!  Join your local BirthNet, tell the story of your amazing midwife-supported birth, and stay connected – there is still much to be done to ensure all women have a full range of birth options in New York State.
On a personal note – we cannot even begin to express our gratitude to each and every person who made a call, wrote a letter, or sent in faxes, all while juggling children, jobs, and day-to-day life.   Those of us at Free Our Midwives are filled with awe at the power of women and their families working together.  Thank you.

The Midwifery Modernization Act passed the NYS Senate

It Passed! The Midwifery Modernization Act passed the NYS Senate unanimously! I was busy practicing midwifery, but not too busy to share a hug with a sister midwife. Now it is time for bed... Celebrate for me today!

May all babies be born into loving hands... 

K. Michelle Doyle, CNM, NYS LM


 Assembly Health Committee Chair
 Richard N. Gottfried
            822 Legislative Office Building, Albany, NY 12248 - Tel: 518-455-4941
            250 Broadway, #2232, New York, NY 10007 - Tel: 212-312-1492

Contact:                                                                      For Immediate Release:
Ryan Streeter 518-455-4941                                          Thursday, July 1, 2010

Midwife Reform Bill Passes Legislature

          Licensed professional midwives would be able to practice independently under a bill that passed the Senate on Wednesday by a vote of 61-0.  "This is an important step forward for women's health," said Assembly Health Committee chair Richard N. Gottfried, author of the bill, A. 8117-B, which overwhelming passed the Assembly on Monday, June 28, by a vote of 95-17.  The bill now heads to Governor David Paterson to be signed into law.

            Professional midwives have been licensed in New York State for decades. They provide prenatal care, deliveries, and primary gynecological care.  However, they are required to have a "written practice agreement" with an obstetrician or a hospital that provides obstetric services.  The bill would repeal the requirement for a written practice agreement.

            "This is a major victory for women's health.  The 1,300 licensed midwives in New York perform about 15% of the non-Caesarean deliveries, with exceptionally high rates of successful outcomes and patient satisfaction," Gottfried said.  "The written practice agreement is an unnecessary restriction that blocks many midwives from serving the community." 

            When a pregnancy or delivery develops complications or becomes high risk, a midwife refers the patient to a physician.  While some people associate the word "midwife" with home birth, the vast majority of midwives deliver babies exclusively in a hospital.

            "Every physician commonly has to refer a patient to a specialist or a hospital, but the law doesn't bar them from practicing without a written practice agreement with specialists or hospitals," said Gottfried.  Midwives currently practice in 15 states (AK, AZ, CT, DC, ID, IA, ME, MN, MT, NH, NM, OR, RI, WA, WY) without signed practice agreements.

            "Too often, the written practice agreement requirement is an obstacle to midwifery care," Senator Duane said.  "In some rural communities, there are no physicians available and willing to sign an agreement.  The written practice agreement requirement can be an obstacle even in urban areas.  When St. Vincent's Hospital closed in April in my area in Manhattan, midwives affiliated with the hospital or the hospital's physicians had to scramble for new arrangements."

            In New York City, St. Vincent's was one of the only hospitals that provided written practice agreements for midwives who do home births.  Hundreds of their pregnant patients were left without care when St. Vincent's closed.  "Many of the home birth midwives remain without written practice agreements, causing upheaval for families who had chosen home birth in the expectation of a peaceful birth experience without medical intervention," Gottfried added.

            The bill is supported by the New York State Association of Licensed Midwives, the American College of Nurse-Midwives, SUNY Downstate Medical Center, Citizens for Midwifery, National Organization for Women - NYS Chapter, New York State Perinatal Association, New York State Nurses Association, and The Nurse Practitioner Association of New York State.

            "In rural Tompkins and Cortland counties, we have several midwives who are being forced to leave the community because the local physicians are not willing to sign agreements with them," said Assembly Member Barbara Lifton, who represents that area.  "Their malpractice insurance company may think it adds to the physician's liability, or some of the physicians don't want the competition.  But the result is a more severe health care shortage for the women of New York."

            "All three of my children were delivered by a midwife," said Assembly Member Amy Paulin.  "We chose home birth for two of them.  I live in Westchester. The midwife was affiliated with a hospital in the Bronx, about half an hour away.  If I had needed to go to a hospital, we would have gone to the nearest hospital in Westchester, not to the hospital in the Bronx.  So the written practice agreement was totally pointless."