Posts Tagged ‘bill’

Using Evidence to Reach Consensus

December 11th, 2012

Some of you might remember a protest about a year ago in front of our 150 Building.  About 100 folks were carrying placards asking us to make it easier to have a home-birth in AZ.  They were mostly young families and some licensed midwives- and they were urging us to change our licensing rules for midwives.  That day last December, I met with 2 representatives from the group and set up a roadmap to work out the issues.  We set up a dialog so we could come up with a solution together and the Stakeholder team shepherded a bill through the process that will help us solve some of the issues they were concerned about.  The bill gave us exempt rulemaking authority to overhaul our rules for licensing AZ midwives and set up an advisory committee to help us with the decision-making.

We had our first advisory committee meeting last week.  While we made some progress- we didn’t make as much as I would have liked.  We’ll be making modifications to the procedures at the next meeting, which will be held on Monday, December 17 from 2 to 4 p.m. in the basement of the 1740 W. Adams building.  I’ll be co-chairing the future meetings with Dr. Cara Christ.  The meeting notices and minutes will be posted on this website. 

We’ve been asked by consumers to consider changing the scope of practice for midwives to allow them to attend vaginal births after a previous cesarean, breech (feet first) presentation, and delivering twins, among other things.  These are currently considered out of the scope of practice for midwives.  It was clear at our first committee meeting that there’s currently little consensus among the Stakeholders (obstetricians, midwives and consumers) about whether the scope of practice for midwives should be expanded to include these types of things. 

I still have hope that we can come up with a set of final regulations that all sides can live with… but getting there will require a review of the scientific literature regarding the safety and risks of home births attended by midwives.  That’s why we’ve asked the U of A’s College of Public Health to conduct a review of the scientific literature regarding the relative risks of vaginal births after cesarean, breech (feet first) presentation, and delivering twins at home.  They’ll begin work shortly on a scientific literature review and provide us with an analysis in early 2013.  By using scientific evidence I’m hoping we’ll find some common ground.

 

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Midwifery & the Democratic Process

March 28th, 2012

Here’s a short story about using the democratic process to get things done.  Some of you might remember a protest last December in front of our 150 Building.  About 100 folks or so were carrying placards in front of our building asking us to make it easier to have a home-birth in AZ. 

Many of you probably didn’t know that ADHS licenses 60 Midwives who practice in Arizona.  Our licensing rules for Midwives were last revised in the mid 1990’s and are out of date; the application is too complicated.  That day last December, Colby Bower and I met with 2 community folks, Allyson Fernstrom and Sarah Macklin, and 2 midwives including Connie Canada, during the demonstration- and we had a productive discussion.  We set up a dialog so we could come up with a solution together.  Allyson and Sarah followed through with flying colors, built an effective coalition, worked with our team (Colby and Rohno Geppert) and the state legislature- and shepherded a bill through the process that will go a long way toward solving some of the issues they were concerned about. 

The Governor signed the bill yesterday- providing us with exempt rulemaking authority to overhaul our rules for licensing AZ Midwives and setting up an advisory committee and process to review the official “Scope of Practice” for AZ Midwives.  You can check out the final bill online. We’ll also have some information up on our Midwife website shortly that will highlight where we go from here.

It just goes to show you that the democratic process works…  that ordinary folks, like Allyson and Sarah, can get together, organize, and petition their government and elected officials to get things done.  The key is working within the process, staying involved, and applying the most important skill anybody can have- working well with others (the most important grade any of us get in our academic career).  Well done all.

P.S. There was a study published in the British Medical Journal recently suggesting that there’s little difference in complications among the babies of women with low-risk pregnancies who delivered in hospitals vs. those who gave birth at home with a midwife.  Of course- the article is more complicated than that- so visit the journal website.

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Child Nutrition Act

June 29th, 2010

As you remember from previous posts- the Child Nutrition Act has been introduced in the Senate and moved out of Committee.  This month, a bipartisan group of members in the U.S. House introduced a similar bill to reauthorize and amend the Child Nutrition Act, “Improving Nutrition for America’s Children Act.”  The bill is posted at Improving Nutrition for Americas Children Act, but it’s 253 pages long- so don’t print!

The bill in the Senate to include elements of our Empower Pack . The Amendment directs the Secretary of Agriculture to work with the Secretary of HHS to encourage state licensing agencies to include wellness standards within state licensing standards in order to ensure that licensed and regulated child care centers and family child care homes provide physical activity opportunities, limit screen time and offer food consistent with the healthy meals patterns and nutrition standards.  More than 31 million school kids participate in the National School Lunch Program and 11 million qualify for the School Breakfast Program. Many children get ½ of their daily calories at schools- making this program a great leverage point to improve nutrition for kids by placing more rigorous nutrition standards on the foods that are served in the program.

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