Late night session...

Yesterday was the last day of the legislative session and they work up until midnight. Unfortunately, we had to wait up until almost midnight to find out if the midwife amendments bill would pass or not. I was watching a video feed on my computer almost all day long and the bill kept moving up to the top of the list and then the House would move some other bills up ahead of it. This happened numerous times and finally at around 11:30 p.m. they got to the bill. There wasn't really any debate on it, just a couple of representatives got up and stated that this was truly a compromise bill between the UMA and the midwives group and that both groups agreed to not pursue anymore legislation on this issue until the end of the statistics reporting period in 2011. They had to vote on a couple of minor amendments and then the voting was almost unanimous to pass the bill.

Then the bill had to go back to the Senate for them to decide if they would accept the new substitute and changes that were made while it was in the House. Once the Senate received the bill, the whole voting process was over in less than 5 minutes. Senator Dayton just stood up and asked that everyone vote to concur with the House changes and then they voted - she didn't even state what the differences were from when they voted on it originally a couple of weeks ago. The bill passed both houses just barely before the midnight deadline.

I'm not quite sure how I feel about the bill passing. While the midwives won the majority of issues that they were fighting to preserve, there were a couple of issues that were lost which means fewer choices for women in the state. The two big issues that were lost were breech births & twin births. Now while I am not sure if I would want to have my baby/ies at home if I fell into either of these 2 categories, I know many women who would still like to do so. I know several midwives that deliver twins at home and are very competent at what they do. The sad fact is that both of these cases are almost a guaranteed C-section today in the hospital which is why some women would choose homebirth over the hospital. Women that fall into either of these 2 categories can still choose homebirth with an unlicensed midwife, but unlicensed midwives cannot legally carry things like pitocin for hemorrhaging or oxygen for resuscitating. I do like the fact though that the UMA has agreed to leave the issue alone until 2011 (we'll see if they keep their word) and that we did win VBAC homebirths if the woman signs a waiver. Overall I think that it was a great bill and I really can't see the UMA ever agreeing to a bill that allows breech or twin homebirths. I really wish they would allow a waiver though instead of making it a mandatory transfer so the woman still has the ability to choose for herself.

Compromise... finally

Wednesday morning I got up at 6 a.m., showered & got myself ready, ate breakfast, got Blondie & Kitty up and dressed and was out of the door by 7 a.m. We made it to the Capitol & parked around 7:35 and got to the committee meeting room around 7:40. I was surprised when we walked in the room that none of the midwives were there and the bill sponsor was not there either. Usually all of the major players are there in the room before I get there. About 10 minutes to 8:00 some of the House staff came into the room to get set up for the meeting and were surprised to find the room half full already. I heard one of the staff comment that usually there is no one in the room when she arrives and very few people there even when the meeting starts. From what I could tell the majority of people were midwife supporters, but still no midwives. By 8 a.m. most of the committee members were there and the chair spoke and said that he had just been informed that the UMA and LDEMs were in the middle of discussions to come up with a compromise bill to present to the committee. He said that they would wait for about 10-15 minutes for them to show up. So we sat around and waited for about 15 minutes and then the chair decided to bring the committee to order to discuss what to do. Someone got on the phone with someone from the negotiations and was told that it would take about 15-20 minutes to get the new substitute typed & printed up. So the committee decided to "saunter" until about 8:30 at which time there would hopefully be a bill to discuss.

At around 8:25 the midwives walked in and a few minutes later I recognized some of the UMA representatives. They then passed around a new substitute version of the bill and both sides testified to the committee that it was truly a compromise bill that both sides agreed to and that they would not present any more legislation on the issue until the trial period to gather statistics was over in the year 2011.

Overall I think that it is a good bill and definitely the best one that we have seen so far (that the UMA agrees to). The bill does not change anything for unlicensed midwives, but it does limit somewhat the scope of practice for licensed midwives (LDEMs). It looks like expectant moms can see an LDEM if she has had a previous C-section (VBAC) if she signs a waiver. The bill does not allow women to see an LDEM if they are expecting twins or if the baby is in the breech position at birth. That is how I understand the bill. I could tell that there were several doctors in the room who were NOT happy to see the section about VBACs in there. The truth is that there is a less than 1% risk of uterine rupture in a VBAC case and I think that women should have the right to choose their risks - either a VBAC at home or most likely a repeat C-section in the hospital - neither of which is going to be risk-free.

Now the goal is to have it pass out of the House and then back to the Senate for concurrence. Hopefully this is the end of it for at least 3 more years (at which time I will most likely be finished having kids). :0)

Another committee meeting

Well, the bill has been put on the agenda for tomorrow's committee meeting (House of Representatives Health & Human Services Committee). It is the only item on the agenda for a 1 hour meeting (and this is the last day of committee meetings). It was originally on the agenda for last Friday but then was removed so we thought that it would just be sent to the House Floor for a floor vote. I think that this is a good thing because I know that several of the committee members are on our side. The meeting is at 8 a.m. (again) so I will be getting up bright & early to go with my 2 little ones. Stay tuned tomorrow for the outcome of the meeting...

Another trip to the Capitol

This morning DH & I (with Blondie & Kitty) went up to the Capitol to talk to our Representative about the midwife bill. Three years ago I talked to her about the original bill and she had some concerns about it but she never contacted me with any questions and ultimately voted against passing the bill. Today DH decided to go into work late so he could come with me and maybe the two of us together could make a difference. We had to drive around a few times before we found a place to park and then we had to wait a few minutes because she was presenting a bill on the floor right when we got there. After her bill was voted on we sent a note in to her and a few minutes after that she came out looking for us. We only had a few minutes to talk with her because unfortunately it was a busy time on the house floor for voting on bills. They kept ringing the bill to vote and she would have to leave us to go cast a vote on another bill. I think the meeting went pretty well and we told her a few of our concerns about the bill and we mentioned another representative in the house that is working on a substitute bill for the midwives. Our representative said that the substitute sponsor sits right behind her and that she would talk with her about it. So, hopefully she will at least vote for the substitute and then we don't care if it passes or dies at that point (except that if it passes then this might be the last year that we have to deal with the whole issue). Now we just need to send her a "thank-you" email for taking some time out of her day to speak to us.

From what I understand the House of Representatives is currently prioritizing bills and they will not get to any Senate bills until Wednesday or Thursday. Hopefully today was the last trip I will have to make up to the Capitol - the session ends Wednesday, March 5.

DH is in print!

Finally after 3 attempts at sending in a submission to the Reader's Forum of our paper (Deseret Morning News), one of his submissions was printed. DH has been trying over the past week & a half to get the paper to print a submission about the midwife amendments bill that is currently before the Utah legislature. We had pretty much given up that they would print one of his articles when I sat down this morning to eat some breakfast, opened up the paper & there it was! Here is the article that was printed:

UMA a monopoly run amok
Published: Friday, Feb. 22, 2008 12:53 a.m. MST

The Utah Medical Association has shown a disturbing trend to misrepresent, distort and outright lie when it suits its purposes. In the ongoing saga of SB93 (sponsored by Sen. Margaret Dayton) — the midwife bill only but a small number of people care about — the UMA feels it can do whatever it wants. Despite requests from the legislators that the UMA work together with the midwives, it has demanded, made promises and then substituted its own bill ignoring midwives outright. This is a monopoly run amok.

Bill moves forward, unfortunately...

Unfortunately the midwife amendments bill passed out of the Senate committee and was sent to the Senate floor to be voted on. There was some good that came out of the committee meeting though - in fact it went better than the midwives were expecting. There is an awesome Senator on the committee who asked some great questions about the bill and is completely on our side but his view was unfortunately outvoted 2-3. I was debating on Wednesday night whether or not I would go because I would need to get Blondie & Kitty up early again and I wanted to be out of the door by 6:45 a.m. to be sure that I got there on time and could get a seat. It's also even more work since I'm in my 7th month of pregnancy. Finally right before I went to bed though I made the decision that I needed to make the effort and be there to support my midwife and our cause - plus this doesn't happen every day. I also knew that this bill would be first on the agenda so it would definitely be heard and that I would be able to leave right afterwards and get home earlier than I did on Tuesday.

So I got up Thursday morning at 6 a.m. and while I was getting myself ready DH got up and said that he would stay home and watch the girls for me so that I wouldn't have to haul them along. We had been waffling somewhat on our schedule for Thursday because of the committee meeting at the capitol and then the Family & Church History Department of the church (which DH works for) was having its annual department meeting at 1:30 that afternoon down in Salt Lake that employees & spouses were invited to attend. So since DH works down in Utah county he decided to do some work from home in the morning so that he could watch the girls for me and then we would go together to the department meeting in the afternoon.

Well, I left at 6:45 for the committee meeting and I got there in record time. I was at the Capitol and had found a parking space by 7:20 so I sat in the car for a little while and took some time to write down some thoughts in case I had the opportunity to speak to the committee.

Unfortunately they only let three people speak who opposed the bill and I wasn't one of them. My midwife spoke (who is the head of the LDEM board), our sponsor of the original licensing bill from the House of Representatives, Jackie Biskupski, spoke and then a homebirthing mom spoke. Rep. Biskupski said that she had spoken with the Senate President about this bill and he said that he wanted some results this year so that this issue doesn't keep appearing each year. The legislators are definitely getting sick of seeing our group each year and having to listen to the same issues each year.

The Utah Medical Association (UMA) and LDEMs had a meeting scheduled yesterday afternoon to try and work out their differences and they are in the process of trying to work out a compromise between the two groups. I'm actually somewhat fearful of the concessions that the midwives are going to have to make to appease the UMA.

The committee chair from the meeting said that he would vote to pass the bill out of committee under the assumption that the two groups would meet and hopefully work out any differences and come up with an amendment to the bill that could then be voted on by the Senate.

I'm glad that I went to the committee meeting but I was somewhat frustrated with some of the opinions of the medical community and the committee members (my senator included). There was a rules process set up in statute when the original bill passed 3 years ago and the rules set up have been working. The UMA could have objected to any of the rules that were proposed, but their representative on the rule-making board decided to not show up to any of the meetings.

If anyone wants to listen to the audio file of the committee meeting, click on this link and then pick the date February 7, 2008:
Senate Health & Human Services Committee Meetings

Nothing today

The midwife bill was on the agenda today for a committee meeting and they didn't get to it. I got up super early and left with Blondie & Kitty so that we could be there by 8:00. We ended up being a little late and the room was jam packed so I sat out in the hall until they got further down on the agenda and some space cleared up in the conference room. After the meeting ended the girls & I walked over to the main Capitol building which was recently opened after some extensive renovations. We walked around the building a little and then I went up to the Senate chambers and sent in a message to my senator. I'm still not sure where he stands on the issue. After that we walked back to the car and dropped the family calendar off at my sister's apartment - she was just diagnosed with strep throat so we didn't stay at all. Then we went over to the dealership where we bought our minivan to get the oil changed. On the way home I stopped at the elementary school to vote. All I can say is that it has been a very long day and I am very tired. I crashed on the couch for a little while after we got home.

The midwife bill is first on the agenda for Thursday morning at 8 a.m...

Bill sent to committee

The midwife amendments bill that has been proposed in the Utah senate has now been sent to the Senate Health and Human Services Committee and is on the agenda for tomorrow morning. Blondie has a ballet class, but I think we will skip it this once and attend the committee meeting. I think the more people we get to show up the better it looks for us - so the legislators sees that this bill will affect many average people who really care. I am composing a letter to my senator right now - who just happens to be the committee chair of this committee. I am told that of the 5 members on the committee, two are definitely in favor of it, two are pretty sure against it and the 5th one we are unsure of (my senator). He told the midwife group 3 years ago that he would vote in favor of the original bill if they needed his vote and then voted against it because we didn't need his vote (it was very close though). I'll let you know how things go tomorrow...

At it again...

Well, the Utah state legislature is at it again trying to modify the existing direct-entry midwife law. It looks like I will be spending some more time up at Capitol Hill again this year. Senator Margaret Dayton has introduced a bill once again that would strictly limit the practice of direct-entry (homebirth) midwives in the state. We worked really hard at getting the current law passed three years ago and statistics are great so I really don't see any need for this bill other than the Utah Medical Association trying to assert more control over the practice of these midwives... Stay tuned for more developments.

You can view the proposed bill here:
Utah Senate Bill 93

Sunset

Here is a picture of the sunset tonight. By the time I got to my camera and was able to take a picture, it was almost gone (in just a matter of a minute or two)...
On another note, the hostile midwife amendments bill that was proposed in the Utah legislature this year has reached it's sunset as well. On Friday, the sponsor of the bill chose to remove it from the senate reading calendar and send it to an interim committee to study the issue during the off-season of the legislature. Another win for the midwives!! Yea!! Now hopefully the committee that is chosen to study the issue will realize that it is not needed or will actually have an open dialog with the midwives to see which limitations are reasonable and which ones are not.

My prediction...

My prediction regarding the midwife bill is that it will not make it out of the Utah Senate - either because it won't get enough votes or because they will run out of time. At the end of yesterday's Senate session they sent all of the senate bills that were on the 2nd reading calendar back to the senate rules committee to prioritize them. The legislative session ends 2 weeks from today and they are needing to cut back on the bills they consider and deal with those that are before them now (especially those that have been passed and sent over from the house of representatives).

On a similar note, there was an excellent editorial in the Salt Lake Tribune this morning that was written by their editorial board. It basically said that they think Sen. Dayton is trying to solve a problem that doesn't exist by proposing this bill.

Here's a link to the editorial if you would like to read it:
The midwife way: Current home-birth regulations are sufficient

Also, there was an article in the paper the other day where Sen. Dayton said that she specifically requested that the midwife bill be assigned to her committee instead of the Health & Human Services committee so that it could progress more quickly...

Making headway?

After the committee hearing in the Utah senate last Thursday, I was a little disturbed by some of the misinformation that was being shared regarding this bill. So, I decided to go out on a limb and write an email to the senator that was chairing the committee to address some of that misinformation. The committee chair that day is one of the senators that is a definite 'yes' vote already so I figured that I couldn't do much damage by trying to contact him. My email basically said that contrary to what was said at the committee meeting, this bill will affect ALL homebirth midwives, not just the ones that are licensed by the state. He specifically asked the bill sponsor at the committee meeting if this bill will affect the "lay" midwives in the state to which she answered that it will not - it will only affect those that are licensed. If you read the actual law that is in place already and how this bill will change that law, it is clear that the bill that is proposed is changing the definition of the practice of direct-entry midwifery which will affect ALL midwives. I even sited to him where in the law that is stated.

Well, I was actually surprised when I got a response from this senator on Sunday evening. (I haven't even gotten an answer from my own senator whom I emailed on Wednesday...) I could tell by this senator's response to me that he hadn't even read my email, or if he did that he just skimmed through it. So, I decided to email him back and state very clearly that a "lay" midwife IS a direct-entry midwife and that this bill will affect all of the direct-entry midwives in the state, not just the licensed ones. I wrote a very nice letter to him and said that I felt that it was important that he understand this point, regardless of whether or not it changes his vote. I also thanked him for his time in reading my email.

Not 15 minutes after I sent off that email, he emailed me back and said that he would check into it and "Thanks for the heads-up."

So, even if it doesn't end up changing his vote, I hope that he does look into it and will pass the word along. Maybe then more of the legislators will understand the concerns that the midwives and homebirthers have.

Didn't make it...

Blondie developed a stomach ache and fever last night so I decided not to try going to the capitol this morning. I was able to listen on my computer at home and it was very frustrating listening to those that spoke (both for and against the bill). Those that spoke for the bill were all doctors (of course) and they like to tell horror stories and scare the legislators into believing that everyone who chooses to give birth at home will die (or their baby will). Unfortunately, they are much more organized though than the opposition to the bill. There was very limited time for comments on the bill before the vote was taken and the 3 who spoke for the opposition I thought were not very good people to have speak. One was a man whose wife gave birth at home 8 weeks ago, one didn't state who she was representing (I actually think she is the president of the Utah Friends of Midwives grassroots group) and the third person was a practicing midwife who didn't say if she is licensed with the state or not. I didn't think that any of the 3 gave very persuasive arguments for our side.

Anyways, the bill was voted on and passed out of committee 4 votes to 2. Right now I think it has been sent to the Division of Professional Licensing for fiscal input. Then it will go to the bottom of the list for the Senate Floor to vote on.

Midwife Bill Update

Well, the Utah Senate assigned the midwife amendments bill to the Senate Natural Resources, Agriculture, and Environment Standing Committee of all places. The last time I checked, midwives & homebirth have nothing to do with natural resource, agriculture or the environment. We all thought that it would go to the committee related to the issue which is the Health & Human Resources committee. The unfortunate thing about this assignment is that Sen. Dayton (the author of the bill) is on this committee along with another staunch opponent. My midwife believes that it will make it out of committee and to the Senate floor easily. It's on the committee agenda for Thursday morning at 8 a.m. So, I guess Blondie & Kitty & I will be making an early morning trip up to the capitol tomorrow. Unfortunately neither of them are morning people so I have a feeling they are not going to be too happy while we are there. (Hopefully they will sleep in the car. :) It's very interesting and frustrating at times getting involved in the political process. I have definitely learned a lot about how the legislative process works over the past couple of years.

I'll post what happens tomorrow...

Midwives in Utah

Well, the Utah Legislature is at it again. Two years ago the Direct-entry Midwives finally succeeded in getting a bill passed in the Utah legislature to officially legalize homebirth with a direct-entry midwife and allow a form of licensure for those homebirth midwives that want to be able to carry and administer certain drugs that they are not allowed to otherwise. The battle to get this law passed actually started at least 5 years ago and I was involved with the lobbying the year that it passed and the year prior to the passing. I have sent emails to my legislators and met with a few of them in person. I have spent hours at the Utah Capitol building attending committee meetings and trying to meet with legislators. Just when we thought that things were in the clear, a senator from Utah County has introduced an amendment to the bill last Friday that would just about make it impossible for the overwhelming majority of women to qualify for a homebirth with a licensed direct-entry midwife (LDEM).

The senator's name is Margaret Dayton and she was an OB nurse and her husband is an OB/GYN. The LDEMs that are currently licensed with the state looked over their clients/births from the previous year and determined that 96% of those births would not have qualified for a homebirth under the current amendment changes.

Everyone is hoping that this bill will be killed quickly because it is so unreasonable. There have been a couple of studies recently published that should also help our cause. In addition to these studies (one of which is by the Utah State Health Department), the report to the Utah Division of Professional Licensing (DOPL) was nothing but positive. The law that was passed 2 years ago required the LDEM board to compile statistics each year of mother/baby outcomes and to determine if any negligence is occurring in any of the LDEM practices.

All of the midwives have fought so long and hard for the law that we currently have that it would be so sad to see that ruined by this senator who is trying to instill unfounded fear in her fellow legislators. The truly amazing part of the law that was passed is that in addition to allowing midwives to become licensed, it still allows midwives who choose not to license to practice without fear of prosecution. I believe Utah was the first state to pass such a law.

The biggest thing that we all wanted to accomplish with this bill was to allow women to CHOOSE where they give birth and to allow them to CHOOSE a care provider that they feel the most comfortable and confident with. There are no guarantees with birth, but some women feel that more complications are introduced when giving birth in a hospital. Midwives are there with a woman the whole labor and are trained in "normal" birth and how to detect when something is not right before it has escalated to an "emergency".

Here are some links to some studies for those of you interested in reading them or wonder about the safety of homebirth:

DOPL Outcome Report for LDEM homebirths from January 2006-August 2006
British Medical Journal Study on planned homebirths in North America for the year 2000
Utah Health Department Study Home Birth Trends in Utah, 1992-2005