3408.0 Social Justice at the Time of Birth: Improving Access and Quality of Maternity Services

Monday, November 8, 2010: 4:30 PM - 6:00 PM
This session will present an overview of new studies that make a significant contribution to the weight of evidence supporting the safety of planned home birth with midwives. It will also address further concern about unduly high levels of prematurity and Cesarean section in low-risk women receiving standard obstetrical care. It will report on findings of multivariate analyses to determine whether racial disparities persist after adjusting for other social and medical risks. It is the first known study to examine racial disparities in VBAC use in a state-wide population sample. It will reiterate how Midwives can help to transform a broken maternity care system into a healthcare model that works better, saves government and taxpayers' money, reduces disparities, and satisfies clients. It will also address how women who smoke during pregnancy have adverse pregnancy complications including low birth weight infants, preterm birth and SIDS is associated with prenatal smoking and SHS exposure.
Session Objectives: * Describe 3 recent home birth studies and how they contribute to the weight of evidence in favor of home birth. * Discuss one example of how the safety of homebirth has been misrepresented in a recent study. * Describe the trends in VBAC rates from the 1980ís through the present; * Describe the variation in VBAC use by demographic, social and medical risk characteristics; and *Describe the trend in the relative importance of patient race/ethnicity as a factor associated with the use of VBAC in the context of rapidly declining access overall. *Describe one example of how one of the recent home birth studies provides a new evidence angle on the safety of home birth. Describe the trends in VBAC rates from the 1980ís through the present; *List three ways in which the content of the midwifery model and the medical model differ. *three lessons learned about women's preferences and what matters to them in the childbearing year.
Carol A. Nelson, LM, CPM and Barbara Levin, MD, MPH
Barbara Levin, MD, MPH

GIFTS (Giving Infants and Families Tobacco-free Starts): A Bundled Approach to Help Pregnant Mothers Quit Smoking
Joyce Robl, MS, CGC, Kristin Beth Ashford, PhD, Irene Centers, BA, Andrea McCubbin, BS and Ruth Ann Shepherd, MD, FAAP, CPHQ
Vaginal birth after cesarean: Does race/ethnicity matter as rates plummet?
Lois McCloskey, DrPH, Eugene Declercq, PhD and Hannah Jong
Recent Home Birth Evidence: Publications, Politics and Social Justice
Kenneth C. Johnson, PhD and Betty-Anne Daviss, MSc, RM

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

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

CE Credits: Medical (CME), Health Education (CHES), Nursing (CNE), Public Health (CPH)