3421.0 Politics and Policy: Childbirth at the Crossroads

Monday, November 5, 2007: 4:30 PM
In recent years birthing families' access to prenatal care and consistent birthing support has been diminished by provider shortages, rising insurance costs, demographic shifts, and national policy. In the face of the de-coupling of cash assistance from Medicaid and changes in policies concerning pregnant and birthing immigrants, two vulnerable populations, low-income pregnant and parenting women and their children, are at risk for detrimental outcomes. Although programs such as Healthy Start and WIC continue to underscore the importance of early intervention on the health of low-income families, health care and social support during the childbearing year are increasingly fragmented and difficult to access. There has been a significant amount of research done on obstetric service trends but much less on midwifery trends, especially on local levels. Because midwives account for about 10 percent of all deliveries in the United States, it seemed logical to extend the same levels of attention to Certified Nurse Midwives/Certified Professional Midwives as obstetricians. “Outcomes of planned home births with certified professional midwives: large prospective study in North America,“ published June 18, 2005 in the British Medical Journal (BMJ), concluded that Certified Professional Midwives attending home births had similar perinatal mortality outcomes to low risk hospital birth. The take home messages: 1) home birth with certified professional midwives is a safe option for low-risk woman and 2) the amount of intervention presently being used in hospital does not appear to be warranted.
Session Objectives: 1. Recognize how the development and publication of a report about the status of health care for childbearing families has been/can be used to influence public policy. 2. Discuss recent legislative changes that made use of the BMJ study and the APHA resolution on out-of-hospital birth. 3. Clarify any trends in midwifery usage in recent years and/or pinpoint any planned future changes in policies. 4. Describe how changes in two government policies affect national birth outcomes.
Barbara Levin, MD, MPH , Carol A. Nelson, LM, CPM and Ceclila Wachdorf, CNM, PhD
Barbara Levin, MD, MPH
Barbara Levin, MD, MPH

4:30 PM
Childbirth at a Crossroads: Politics and public policy
Letty Thall, ACSW and JoAnne Fischer, MSS
4:50 PM
Evidence used, evidence ignored: The case of home birth policy
Betty-Anne Daviss, MSc, RM and Kenneth C. Johnson, PhD
5:10 PM
Analysis of hospital policies on midwifery
Rana E. Leed, MPH, Marjie Mogul, PhD, Jennifer Kolker, MPH and Letty Thall, ACSW

See individual abstracts for presenting author's disclosure statement and author's information.

Organized by: Maternal and Child Health
Endorsed by: Women's Caucus, Socialist Caucus, APHA-Committee on Women's Rights

CE Credits: CME, Health Education (CHES), Nursing