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</o:shapelayout></xml><![endif]--></head><body lang=EN-US link=blue vlink=purple><div class=WordSection1><p class=MsoNormal><span style='color:#1F497D'>Unfortunately, Idaho’s licensing regulations were written by people expert at magical thinking . . . or have you missed the Idaho news reports of the tragic preventable deaths & lifelong disabilities at the hands of Idaho midwives, Roger?<o:p></o:p></span></p><p class=MsoNormal><span style='color:#1F497D'><o:p> </o:p></span></p><p class=MsoNormal><span style='color:#1F497D'>I’m sincerely glad your grandchild’s home birth was uneventful – I’m sure the loved ones of the scores of babies & mothers whose experiences weren’t uneventful wish they could say the same. But, with your science background, I know you’ll understand when I say that while a personal testimonial is interesting, it’s not scientific proof of anything valid.<o:p></o:p></span></p><p class=MsoNormal><span style='color:#1F497D'><o:p> </o:p></span></p><p class=MsoNormal><span style='color:#1F497D'>I’m a huge supporter of a certified nurse midwife (CNM) system, but it’s seems beyond crazy to me that some anti-feminist birth Nazis want to relegate maternal & perinatal care to third world country standards. And, even crazier is that these non-professionals are lining their pockets on the taxpayers’ dimes. Services to our differently-abled children and adults in Idaho have been gutted, but our whack-a-do legislators in their insanity have decided that shelling out money to non-professionals who dishonestly misrepresent the risks of home births and the associated third-world standards can be paid by the State.<o:p></o:p></span></p><p class=MsoNormal><span style='color:#1F497D'><o:p> </o:p></span></p><p class=MsoNormal><span style='color:#1F497D'>Good for the AAP for coming out with guidelines! I don’t think they go far enough, but they are an improvement. Now, if only all those yahoos who advocate for less for women & newborns would be required to provide these Guidelines to potential clients, that would <b>truly</b> be a step in a woman’s ability to make <b>informed</b> childbirth choices rather than relying on the completely faulty and scientifically unsound self-reports of non-qualified people who want to play at catching babies.<o:p></o:p></span></p><p class=MsoNormal><span style='color:#1F497D'><o:p> </o:p></span></p><p class=MsoNormal><span style='color:#1F497D'><o:p> </o:p></span></p><p class=MsoNormal><span style='color:#1F497D'><o:p> </o:p></span></p><p class=MsoNormal><span style='color:#1F497D'>Saundra<o:p></o:p></span></p><p class=MsoNormal><span style='color:#1F497D'>Moscow, ID<o:p></o:p></span></p><p class=MsoNormal><span style='color:#1F497D'><o:p> </o:p></span></p><p class=MsoNormal><span style='color:#1F497D'>Our lives begin to end the day we become silent about things that matter.<o:p></o:p></span></p><p class=MsoNormal><span style='color:#1F497D'>~ Dr. Martin Luther King, Jr.<o:p></o:p></span></p><p class=MsoNormal><span style='color:#1F497D'><o:p> </o:p></span></p><p class=MsoNormal><span style='color:#1F497D'><o:p> </o:p></span></p><p class=MsoNormal><span style='color:#1F497D'><o:p> </o:p></span></p><p class=MsoNormal><b><span style='font-size:10.0pt;font-family:"Tahoma","sans-serif"'>From:</span></b><span style='font-size:10.0pt;font-family:"Tahoma","sans-serif"'> vision2020-bounces@moscow.com [mailto:vision2020-bounces@moscow.com] <b>On Behalf Of </b>lfalen<br><b>Sent:</b> Tuesday, April 30, 2013 12:01 PM<br><b>To:</b> Moscow Vision 2020; Rosemary Huskey<br><b>Subject:</b> Re: [Vision2020] [Spam 4.70] Home Birth and Birthing Clinics<o:p></o:p></span></p><p class=MsoNormal><o:p> </o:p></p><div><div><p class=MsoNormal>I won't argue that a home birth is less safe, it probably is if there are complications. However if that is what a woman wants it should be up to them. My youngest daughter had her second child delivered by a local midwife ( Nancy Draznin). There weren't any problems. Her first child was a C-section and she wanted to have one as a natural child birth.<o:p></o:p></p><p class=MsoNormal>Roger<o:p></o:p></p><blockquote style='border:none;border-left:solid blue 1.5pt;padding:0in 0in 0in 12.0pt;margin-left:12.0pt;margin-top:5.0pt;margin-bottom:5.0pt'><p class=MsoNormal><o:p> </o:p></p><div class=MsoNormal align=center style='text-align:center'><span style='font-size:10.0pt;font-family:"Tahoma","sans-serif"'><hr size=1 width="100%" align=center></span></div><p class=MsoNormal style='margin-bottom:12.0pt'><span style='font-size:10.0pt;font-family:"Tahoma","sans-serif"'>-----Original Message-----<br>From: "Rosemary Huskey" <<a href="mailto:donaldrose@cpcinternet.com">donaldrose@cpcinternet.com</a>><br>To: "Moscow Vision 2020" <<a href="mailto:vision2020@moscow.com">vision2020@moscow.com</a>><br>Date: 04/30/13 08:38<br>Subject: [Spam 4.70] [Vision2020] Home Birth and Birthing Clinics<o:p></o:p></span></p><p class=MsoNormal><span style='font-size:10.0pt;font-family:"Tahoma","sans-serif"'> <o:p></o:p></span></p><p class=MsoNormal><span style='font-size:13.0pt'>Recently a proposed “birthing center” in Moscow has received publicity in the local newspaper. The providers of this do-it-yourself style medical care who are <b>self-educated</b> in obstetrics/pediatrics and <b>apprenticeship trained</b> by other similarly self-educated lay people continue to defend their services as reasonable and safe for most pregnant women, including women who have had previous Caesarian sections. Professionally educated medical personal have a different understanding of the risks involved based on their formal educational training and years of supervised direct experience. (A compelling source of a lay person’s awareness of obstetrical and pediatric emergencies can be acquired in an afternoon by wandering through a 19<sup>th</sup> century cemetery.) It is my profound hope that in the near future our community will have access to the services of <u>nurse midwives</u> (practitioners who have a BS in Nursing and post graduate training in midwifery) so that the granny-style midwife – known in Idaho by the manufactured title “certified, professional midwives” – an example of extraordinary hyperbole - will be a distant, embarrassing memory. I agree with the position held by American Academy of Pediatrics described below, except, in my opinion, a “birth center” staffed by self-educated, apprenticeship “trained” midwives obviously carries the same risks as a home birth attended by the same women. </span><span style='font-size:12.0pt;font-family:"Times New Roman","serif"'><o:p></o:p></span></p><p class=MsoNormal><span style='font-size:13.0pt'>Rose Huskey</span><span style='font-size:12.0pt;font-family:"Times New Roman","serif"'><o:p></o:p></span></p><p class=MsoNormal><span style='font-size:13.0pt'><a href="http://www.skepticalob.com/2013/04/aap-to-homebirth-advocates-dont-trust-birth.html">source</a> </span><span style='font-size:12.0pt;font-family:"Times New Roman","serif"'><o:p></o:p></span></p><p class=MsoNormal><span style='font-size:13.0pt'>“The American Academy of Pediatrics has issued a <a href="http://pediatrics.aappublications.org/content/early/2013/04/24/peds.2013-0575.full.pdf+html" target="_blank">policy statement on homebirth</a>. It has been getting a lot of press, but most mainstream media sources seemed to have missed its true significance. NBCnews.com, Time, The Huffington Post and The Atlantic, among others, have highlighted the fact that the AAP issued guidelines at all, and haven’t noticed that most American homebirths fail to meet virtually all the guidelines. Rather than supporting homebirth as it currently exists, the AAP is actually condemning it.</span><span style='font-size:12.0pt;font-family:"Times New Roman","serif"'><o:p></o:p></span></p><p class=MsoNormal><span style='font-size:13.0pt'>The policy statement starts by stating the obvious: the homebirth is not as safe as hospital birth. The American Academy of Pediatrics concurs with the recent statement of the American College of Obstetricians and Gynecologists affirming that hospitals and birthing centers are the safest settings for birth in the United States …</span><span style='font-size:12.0pt;font-family:"Times New Roman","serif"'><o:p></o:p></span></p><p class=MsoNormal><span style='font-size:13.0pt'>But for those women who would rather choose the less safe option, the AAP offers guidelines to minimized the increased risk, summarized in the following chart. [Please follow the link provided above to see the chart in its original form.]</span><span style='font-size:12.0pt;font-family:"Times New Roman","serif"'><o:p></o:p></span></p><p class=MsoNormal><span style='font-size:13.0pt'>They can be summarized as follows:</span><span style='font-size:12.0pt;font-family:"Times New Roman","serif"'><o:p></o:p></span></p><p class=MsoNormal><strong><span style='font-size:13.0pt;font-family:"Calibri","sans-serif"'>No</span></strong><span style='font-size:12.0pt;font-family:"Times New Roman","serif"'> </span><span style='font-size:13.0pt'>homebirth midwives (only certified nurse midwives are safe practitioners.)<br><strong><span style='font-family:"Calibri","sans-serif"'>No</span></strong> twins.<br><strong><span style='font-family:"Calibri","sans-serif"'>No</span></strong> breech.<br><strong><span style='font-family:"Calibri","sans-serif"'>No</span></strong> VBAC.<br><strong><span style='font-family:"Calibri","sans-serif"'>No</span></strong> postdates.<br><strong><span style='font-family:"Calibri","sans-serif"'>No</span></strong> macrosomic babies.<br><strong><span style='font-family:"Calibri","sans-serif"'>No</span></strong> pregnancy complications of any kind.</span><span style='font-size:12.0pt;font-family:"Times New Roman","serif"'><o:p></o:p></span></p><p class=MsoNormal><span style='font-size:13.0pt'>Contrary to the prattling of homebirth midwives, <strong><span style='font-family:"Calibri","sans-serif"'>NONE</span></strong> of those issues are variations of normal; ALL are complications.</span><span style='font-size:12.0pt;font-family:"Times New Roman","serif"'><o:p></o:p></span></p><p class=MsoNormal><span style='font-size:13.0pt'>Once all complications are excluded, there are still additional safety steps that should be taken:</span><span style='font-size:12.0pt;font-family:"Times New Roman","serif"'><o:p></o:p></span></p><p class=MsoNormal><span style='font-size:13.0pt'>The midwife must be practicing within the medical system.<br>A second midwife (or pediatrician) must be available to care for only the baby.<br>Physician backup.<br>A PRE-EXISTING arrangement with a hospital for transfer.</span><span style='font-size:12.0pt;font-family:"Times New Roman","serif"'><o:p></o:p></span></p><p class=MsoNormal><span style='font-size:13.0pt'>In other words:</span><span style='font-size:12.0pt;font-family:"Times New Roman","serif"'><o:p></o:p></span></p><p class=MsoNormal><strong><span style='font-size:13.0pt;font-family:"Calibri","sans-serif"'>Don’t undertake homebirth when there is ANY increased risk of complications. Don’t undertake homebirth without 2 midwives, integrated into the health care system, who have physician back up and a pre-existing transfer arrangement with a nearby hospital.</span></strong><span style='font-size:12.0pt;font-family:"Times New Roman","serif"'><o:p></o:p></span></p><p class=MsoNormal><strong><span style='font-size:13.0pt;font-family:"Calibri","sans-serif"'>The AAP recognizes that childbirth is dangerous, complications are common, any risk factors mean that the mother is not an appropriate candidate, and systems must be in place for the additional complications that will inevitably occur.</span></strong><span style='font-size:12.0pt;font-family:"Times New Roman","serif"'><o:p></o:p></span></p><p class=MsoNormal><span style='font-size:13.0pt'>The AAP guidelines can be summed up very simply:</span><span style='font-size:12.0pt;font-family:"Times New Roman","serif"'><o:p></o:p></span></p><p class=MsoNormal><strong><span style='font-size:13.0pt;font-family:"Calibri","sans-serif"'>Don’t trust birth!</span></strong><span style='font-size:12.0pt;font-family:"Times New Roman","serif"'><o:p></o:p></span></p><p class=MsoNormal><span style='font-size:13.0pt'>Even leaving aside their inadequate education and training, American homebirth midwives (CPMs, LMs, DEMS and lay midwives) routinely violate every guideline set forth by the AAP. That’s why they are unsafe practitioners and why the CPM credential must be abolished.</span><span style='font-size:12.0pt;font-family:"Times New Roman","serif"'><o:p></o:p></span></p><p class=MsoNormal><span style='font-size:13.0pt'>Mainstream media sources seemed to have missed the central point of the AAP guidelines, homebirth as it is currently practiced in the US not merely less safe than the hospital, it is unsafe.”</span><span style='font-size:12.0pt;font-family:"Times New Roman","serif"'><o:p></o:p></span></p><p class=MsoNormal> <o:p></o:p></p><p class=MsoNormal><span style='font-size:10.0pt;font-family:"Tahoma","sans-serif"'> <o:p></o:p></span></p><div class=MsoNormal align=center style='text-align:center'><span style='font-size:10.0pt;font-family:"Tahoma","sans-serif"'><hr size=2 width="100%" align=center></span></div><p class=MsoNormal><span style='font-size:10.0pt;font-family:"Tahoma","sans-serif"'>=======================================================<br>List services made available by First Step Internet,<br>serving the communities of the Palouse since 1994.<br> <a href="http://www.fsr.net">http://www.fsr.net</a><br> mailto:<a href="mailto:Vision2020@moscow.com">Vision2020@moscow.com</a><br>=======================================================<o:p></o:p></span></p></blockquote></div></div></div></body></html>