Midwifery Scope of Practice, Arizona
Sweet Pea Births - ...celebrating every sweet pea and their birth
RSS Follow Become a Fan

Delivered by FeedBurner

Recent Posts

How to Reduce Breastfeeding Inequality
Postpartum Wellness Series: Nutrition
World Kindness Day 2017
Postpartum Wellness Series: SLEEP
In Their Own Words: Erica ~ Part 2

Most Popular Posts

An Inside Look: Modern Mommy Boutique
Breastfeeding Support Groups: La Leche League
A Look At the honest company
An Inside Look: Placenta Encapsulation
Mommy-Con Phoenix Ticket Giveaway


Artifical Rupture of Membranes
Ask the Doula
Avoiding harmful substances
Baby blues
Baby Concierge
Baby games
Baby-led weaning
Back Labor
Bag of Waters
Bedtime Routine
Belly Cast
Berman's Law
Big Latch On
Birth center
Birth Centers Phoenix AZ area
Birth Circle
Birth Mantra
Birth News
Birth place options
Birth plans
Birth Story
Birth Story Listening
Birthing From Within
Blog Carnival
Bradley Day Family Picnic
Bradley Method®
Bradley Method® birth story
Bradley Method® for next baby
Bradley Method® for second pregnancy
Bradley Method® outcome
Bradley® Coaches
Bradley® Dads
Bradley™ classes and the next baby
Bradley™ classes for next pregnancy
Bradley™ classes for second pregnancy
Breast Pumps
Breast Pumps and Workplace
Breastfeeding 101
Breastfeeding Awareness Month
Breastfeeding Challenges
Breastfeeding in Public
Breastfeeding support
Breech presentation
Breech turning techniques
Cassandra Okamoto
Cephalo-Pelvic Disproportion
Cesarean Birth
Cesarean Support Group
Cesarean Surgery
Child Spacing
Children's Books
Chiropractic Care
Co Sleeping
Coach's Corner
Comfort Measures
Cord Clamping
Cry It Out
Dairy Allergy
Debbie Gillespie, IBCLC, RLC
Dehydration and Pregnancy
Delayed Cord Clamping
Drinking during labor
Due Date
Eating during labor
Essential Oils
External Cephalic Version
Eye Drops
Eye Ointment
Eye Prophylaxis
Failure to Progress
Family Bed
Family Fest
Family Fun
Fear-Tension-Pain Cycle
Fetal Distress
First Birthday
First Foods for baby
First stage labor
First Trimester
Flower Essences
Fluid Retention
Full term
Fussy baby
Gestational Diabetes
Going to your birthplace
Green Nursery
Grief Counseling and Support Services
Healthy, Low-Risk
Hearing Screen
Heat Comfort Measures
Hospital Birth
Hyperemesis Gravidarum
Hyperthermia and Pregnancy
Immediate Cord Clamping
In Their Own Words
Increase Breastmilk
Induction of Labor
Infant Care
Infant Classes
Infections and Pregnancy
Info Sheet
Information Center
Information Sheet
Informed Consent
Inside Look
La Leche League
Labor Augmentation
Labor Induction
Labor Marathon
Labor Sprint
Labor Support
Lactation Consult
Lactation Consultation
Managing or coping with natural labor
Maternity Keepsake
Meet the Doula
Midwifery Care
Midwifery Scope of Practice Committee
Milk Supply
Miscarriage or Stillbirth
Modern Mommy Boutique
Monday Mantra
Morning Sickness
Natural Alignment Plateau
Natural birth
natural labor coping mechanisms
Natural labor coping techniques
Neonatal Eye Drops
Neonatal Eye Ointment
Neonatal Eye Prophylaxis
Newborn Care
Newborn jaundice
Newborn Procedures
Next baby
Next pregnancy
Nursing and Maternity Bras
Nursing In Public
Nursing Strike
Obstetrical Care
Pain management
Pain management natural labor
Past due date
Patient Bill of Rights
Phoenix Mommy-Con Mini
Placenta Encapsulation
Planning for Baby
Playing with baby
Postmature baby
Postpartum Depression
Postpartum Doula
Postpartum Plan
Pregnancy Loss
Premature Baby
Premature Ruptture of Membranes
Pre-term Labor
Prolonged Labor
Q&A with SPB
Rally to Improve Birth
Relaxation practice
Repeat Bradley™ classes
Rights for Homebirth
Rupture of Membranes
Scavenger Hunt
Second Stage Labor
Sensory games
Sibling Preparation for Newborn Arrival
Sleep Sharing
Soft-structured carrier
Starting Solids
Stripping Membranes
Support Groups
Sweeping Membranes
Sweet Pea Births
Swelling in Pregnancy
Tandem Nursing
The Bradley Method®
The Bradley Method® classes
The Bradley Method® pain management
Third Trimester
Thoughtful Thursday
Tongue Tie
Tongue Tie Procedure
Toxins, pesticides, chemicals and pregnancy
Upcoming Events
Use of vacuum extraction
Uterine Rupture
Vaginal Birth After Cesarean
Vaginal Birth After Multiple Cesareans
Variations and Complications
Vitamin K
Warning Labels
Webster Protocol
Weekend Activities
Why we chose the Bradley Method® childbirth classes
Wordless Wednesday
World Breastfeeding Week
powered by

Sweet Peas, Pods & Papas: All About Birth, B@@bs & Babies

Midwifery Scope of Practice, Arizona

I was thrilled to be part of a process in our state by which we as citizens can participate in the legislative process yesterday.  The Arizona Department of Health Services has started an Open Meeting process with the Midwifery Scope of Practice Advisory Committee.  

The stated goal of this committee is to review and update the rules and regulations that govern Lay Midwives and Certified Professional Midwives that practice in the state of Arizona.  As a consumer, am hopeful that they will be modernized to reflect current evidence-based practices. 

Historically, there has been animosity and prejudice between midwives and obstetricians.  When it comes to homebirth advocates, the stance is that birth is safer at home; the other side argues that birth is safer in a hospital.  Both sides are correct.  In healthy, low-risk pregnancies, a birth at home is perfectly safe.  There are circumstances in which a birth at a hospital is the best choice.  And then there is a chasm, a gray area, in which births can go either way.

However, the forgotten component here is: what does the consumer want?  Even if her risks are higher in one place or the other, where does the birthing mother feel the safest?  Where does she want to choose to give birth to her child(ren)?

The truth is that in the “land of the free”, women of Arizona are shackled in their birth choices.  The only option for a mother who has a breech baby, who is carrying multiples, and who has a history of previous cesarean is birth in a hospital setting.  (At least now, in many cases, access to Certified Nurse Midwives is growing, so that a woman can still have midwifery care in a hospital setting.  Even so, they are a considered a threat by some OB's).  In some places, women with previous cesareans are not even allowed a trial of labor.  They are forced to have repeat cesareans, despite evidence that best practice should be to allow women to labor for a vaginal birth.

Is every birth outcome going to be perfect? No.  That is unrealistic.  However, each woman should have the option to approach the care provider of her choice to have the conversation about the possibility of having her birth wishes honored and come to fruition.  If a woman is willing to assume the risk of any of these births at home, and if she can find a homebirth midwife who is willing to travel that path with her, then they, as two consenting adults, should have the right to enter into that contract together without fear of repercussion from the state in which they live.

What I suspect is missing from the discussion is the understanding that no mother and no care provider would knowingly and willingly endanger the life of a child.  A mother knows her mind.  A care provider knows their abilities.  If the two do not mesh, then a different choice will be made, a choice that ensures the safety of the child.

Here is my speech from yesterday during the “Call to Public” portion of the meeting.  As a mother who carried a breech baby, I felt that I could speak to that aspect of the law:

My name is Krystyna Bowman.  I am the mother of four children.  Three were born in the hospital, and our last was born at home.  I am here to address you today to ask you to consider the choices that are available to women in Arizona today.

Anything other than a uterus intact, head-down, singleton pregnancy at the time of labor is considered high-risk under the medical model.  There is rarely any assessment of the mother or the child as individuals, nor is there any belief that any other variation of labor can tolerate a natural labor and birth.

We had a breech presentation with our third child.  We had two options under Arizona state law since trained midwives are not allowed to deliver breeches at home and our obstetricians were not willing to share the names of any doctors trained in breech birth.

1.  We could have a cesarean birth after a trial of labor.

2.  We could drive to Tennessee, where there is a group of midwives who are trained and legally allowed to deliver breech babies. 

Are these reasonable choices in this day and age?  I could agree to undergo major abdominal surgery fraught with it’s own risks and complications; or I could load up my entire family of four and drive 1,600 miles, hoping not to go into labor along the way, so that I could have legal and professional care.

We are asking you to recognize that educated, informed healthy women want to have the choice to approach other trained, educated women about their care.  It is up to a woman to decide if she wants midwifery care in a home setting, and it is up to the licensed midwife to decide if she will accept a patient into her practice.

The beauty of the midwifery model is that skilled people, trained under a time-honored model of education know how to recognize the difference between a low-risk pregnancy and labor and one that needs a more medical approach.  The one-to-one care during labor allows a midwife to assess when it might be time transfer a patient for medical observation much sooner than the impersonal, ticker-tape of a fetal monitor.  Take under consideration that the fetal monitor is being watched on a screen by a nurse who is caring for two to four women, it’s feasible that a distress signal would be missed. 

We would like the opportunity to show the personalization of the midwifery model works for women outside of the paradigm of healthy, low-risk mothers with vertex presentations and intact uteruses.  Mothers with breech, multiples pregnancy, and previous cesareans should also have the choice to seek care within the home midwifery model. 

If two parties can come to an agreement, then care should be able to proceed in such a manner that our intelligence and our choices are honored by the state and the country in which we are supposed to be free citizens.  Freedom to choose, and sometimes to choose differently, should not be legislated.  When a state starts to “protect” instead of endow, we enter a slippery slope of rules and regulations that slowly strip away our freedoms.

We ask for the freedom to choose our birth as long as we can find a midwife who is willing to travel that journey with us because she can do so without fear of repercussions from the state in which we live.

I hope that you will do some reading, visit the Rights for Homebirth webpage and Facebook page.  Get involved.  You have a voice.  The Arizona Department of Health is listening.

Bradley Method® natural childbirth classes offered in Arizona: Chandler, Tempe, Ahwatukee, Gilbert, Mesa, Scottsdale, Payson Disclaimer: 
The material included on this site is for informational purposes only.
It is not intended nor implied to be a substitute for professional medical advice. The reader should always consult her or his healthcare provider to determine the appropriateness of the information for their own situation.  Krystyna and Bruss Bowman and Bowman House, LLC accept no liability for the content of this site, or for the consequences of any actions taken on the basis of the information provided.  This blog contains information about our classes available in Chandler, AZ and Payson, AZ and is not the official website of The Bradley Method®. The views contained on this blog do not necessarily reflect those of The Bradley Method® or the American Academy of Husband-Coached Childbirth®.

0 Comments to Midwifery Scope of Practice, Arizona:

Comments RSS

Add a Comment

Your Name:
Email Address: (Required)
Make your text bigger, bold, italic and more with HTML tags. We'll show you how.
Post Comment
Website Builder provided by  Vistaprint