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Updated ~ Wednesday February 16, 2011 01:34 

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  CEO Archive of Correspondence Received  

  New Letters Posted in the last 30 days

#17 Trina Lincoln, RN, mother of three, September 8, 2004

#16 Jessica Eschen RN, PHN, maternity nurse and mother, July 29, 2004

#15 Rosanna Davis, Mother, Graduate Midwife, July 25, 2004

#14 Summer Mercado, registered voter, a taxpayer, and the mother of a 14-year-old daughter, July 20, 2004

#13 Jeanne Batacan, mother, childbirth educator, doula, and taxpayer, July 12th

 #12    Megan Roy, July 5

 #11    Keri Claussen, July 2

 #10   Renee S. Anker, L.M., Chair July 1

  # 9    Lilah Monger

  # 8    Kathryn Newburn, CNM -- June 30 

  # 7    Holly Mathews -- Mothers Day letter,  June 29

  # 6    CEO -- California Coordinator -- Mothers Day letter, June 28 

  # 5    On Episiotomy -- June 23 

  # 4    On Health Insurance -- Jun 17

  # 3    Sandy Caldwell -- Mothers Day letter, June 15

  # 2    Karen Ehrlich, LM, CPM -- Mothers Day letter  2004

  # 1    CCfHF/ Frank Cuny -- Mothers Day letter, May 17


Letter #1
California Citizens for Health Freedom
8048 Mamie Avenue, Oroville CA 95966-8214 ~ Phone:530.534.9758 ~ Fax:530.534.5854
              E-mail: Freedom@citizenshealth.org  ~  Website: www.citizenshealth.org
~ -------------- ~ ----------------- ~ ------------------------------ ~ ----------------- ~ --------------- ~
Advocates for citizens’ access to the broadest safe and effective options in health/medical care…

                                              Frank Cuny, Executive Director                  

                Maria Shriver
                Office of the First Lady
                State Capital Building
                Sacramento, CA 95814

                                                     May 17, 2000

        Dear First Lady,

This letter is on behalf of the Consortium for Evidence-base practice of Obstetrics (C.E.O.). Our citizen organization (California Citizens for Health Freedom) is a member of the C.E.O. The goal of this new consortium is to establish physiological management as the standard of care in California for all healthy women with normal pregnancies.  

The books The American Way of Birth & The Thinking Woman’s Guide  to a Better Birth  will hopefully serve as a positive introduction to why the physiological management of birth is an important issue to women and a challenge to the current view that childbirth in a healthy woman is not a normal process, but instead is a medical or surgical procedure.

Were physiological management of birth to becomes the standard of practice in California, like it is many other western nations,  C.E.O. members believe that it would :

In order to assist you in understanding this important issue we are inviting mothers to mail you letters about their positive experience of physiologically-managed labor and birth and others to recount their negative experience with the current medical model of intervention in normal birth. 

We believe that you, as a mother and an author of children’s books, will take an interest in this issue. We hope you will be open to having a representative of the CEO meet with you to share their perspective.

                     Sincerely

                     Frank Cuny
                     Executive Director

a 501-C-4 non-profit corporation specializing in  legislative advocacy


Letter #2

Karen Ehrlich, CPM, LM
11120 Oceanview Avenue
Felton, California  95018
831/335-9388 (message 425-3326)

Mother’s Day, 2004

Maria Shriver
Office of the First Lady
State Capital Building
Sacramento, CA  95814

Dear Ms. Shriver

I saw a recent appearance of yours on the Oprah Winfrey Show.  In it, you were discussing with Oprah that you aren’t sure what your mission should be as California’s First Lady.

May I suggest an incredibly important mission—one that is central to your passion for motherhood, children and family life?  That issue is how labor and birth are treated in conventional obstetrical care in California, and indeed throughout the U.S.—in ways that are not based in science, and raise the cost of childbirth care to staggering proportions of our budgets.

Medicalization of normal, healthy women is rampant in modern obstetrics.  If this medicalization improved outcomes for mothers and babies, those of us who have fought for years for a simpler approach to childbirth wouldn’t have much to make noise about.  However, the way modern obstetrics delivers maternity care does not improve outcomes for healthy women and their babies!  The United States stands a shameful 25th in the world for infant mortality.  And in recent years mortality for mothers, and in 2002 for newborns, has actually risen in our wealthy country, which pours more money into obstetrical services than any other in the world.

You will likely be receiving quite a few letters from those who, like me, are deeply concerned that the onslaught of ever-increasing medicalization is not based in science.  We hope that you will seriously consider taking on this crucial issue as intrinsic to the health of mothers and their children that you champion so fervently.

For more information on our campaign to take back normal birth, go to <http:// www.ScienceBasedBirth.com 

Sincerely

Karen Ehrlich, CPM, LM
Midwife


Letter #3

June 15, 2004

Sandy Caldwell
17 Foss Drive
Redwood City, CA 94062-3027

Maria Shriver
Office of the First Lady
State Capital Building
Sacramento, CA 95814

Dear First Lady Shriver,

I am the mother of three grown daughters who are all of childbearing age.  Two of my daughters were born at home and one in the hospital. I gave birth to them over 25 years ago in a normal, uncomplicated way.

Several years ago I rethought my own career as a marketing executive and determined that I wanted to do something that would have more meaning for me.  I learned about childbirth support assistance (birth doula) and happily took the necessary steps to certify with Doulas of North America (DONA).

My early experiences with supporting laboring women in a hospital setting truly opened my eyes and I was shocked by what I saw.  I saw a woman being instructed to push so hard at the moment of birth that I felt sure she would tear (she did).  I saw women restricted to certain positions for actual birth that made it hard for them to birth their children in a normal, physiological way.  I saw women scared into accepting certain procedures such as cesarean birth, because their babies showed distress signals on the monitors.  These babies were born completely healthy.  I listened as residents told women they weren’t progressing quickly enough (one centimeter an hour) and so would need Pitocin to speed things up.  This increased these women’s distress and difficulty in giving birth normally.

Needless to say, I saw that there is a prevailing fear-based environment in many of the doctor practices and local hospitals that limited options for these women.  I saw that may own daughters, should they decide to begin families in the SF Bay Area, have no optimal choices, only the lesser of bad choices if they choose to stay within the current medicalized care offered by most physicians and hospitals.

Many of my friends are local businesswomen who do not have children or whose children are grown.  In discussions with them I observe that they are unaware that women’s rights regarding their health care are being eroded by the non-scientific practice of obstetrics and by the insurance companies who seem to be the ones calling the shots on various options for pregnant and laboring women.  It’s not until a woman is pregnant that the awareness of the erosion of rights and options begins dawn in her mind.

As First Lady, I ask that you make providing evidence-based, safe and affordable wellness care for women from pre-conception through birth (and beyond!) a priority and focus of your great influence.  I ask you to support the development and integration of trained and experienced midwives (as done in many westernized countries) into our health care system to increase physiological, safe birth and the accompanying satisfaction and decrease health care costs.  Doing so has proven to lower the incidence of maternal and infant mortality in many other countries around the world.

Please go to https://sciencebasedbirth.com/ for more information on the current situation and how you can help.  I would appreciate your taking time to meet with the leaders of the Consortium of Evidence-based Obstetrics and California Citizens for Health Freedom by contacting Donna Russell, 530.534.9758 or info@sciencebasedbirth.com so that you can hear first-hand what’s happening and how you might best help create California as a national leader in reforming poor and common obstetrical practices, restoring physiological birth, reducing health care costs and increasing satisfaction with birth.  Doing so will aid in the development of healthy families.

With great sincerity and warm regards,

Sandy Caldwell CD (DONA)

650.261.9171


Letter #4 (temporarily missing)


Letter #5

ankara <ankara@baynet.net>

6/23/2004

Dear CEO coordinator,

The following organization in France has begun litigation for assault [episiotomy] and a campaign to ensure that all women are in control of their own bodies. It's time for the USA and Canada to get on board - to state one's refusal in writing prior to admission (an "advance directive") to any and all procedures and to ensure that laboring women are consulted rather than assaulted.

The litigation is long overdue - it will serve us all and those who follow will be armed with the right to refuse [before it's too late].

Stéphanie  St-Amant <st-amant.stephanie@courrier.uqam.ca>
Date: Thu Jun 10, 2004  9:21:49  AM America/New_York
Subject: Re: L'episiotomie est-elle une mutilation genitale?

Some ressources in english against episiotomy:
        www.aims.org.uk
        www.fraternet.org/afar/mdf.htm
        www.fraternet.org/afar/episiotomie-conf-beverley.pdf
        www.birthlove.com/free/rape_complimentary.html
        birthingnaturally.net/barp/episiotomy.html


Letter # 6

Consortium for the Evidence-based practice of Obstetrics
American College for Evidence-based Obstetrics
3889 Middlefield Road
Palo Alto, CA
650 / 328-8491

California First Lady Maria Shriver

Office of the First Lady
State Capital Building
Sacramento, CA 95814

Mothers’ Day 2004 Letter

RE: (1) Bringing the attention of the public and the legislature to the profoundly dysfunctional and economically wasteful nature of the current obstetrical system for healthy women

(2) Establishing a forum for public dialogue with obstetricians on the potentially harmful & unscientific practices of contemporary obstetrical care, especially as applied to healthy women

To First Lady Maria Shriver:

We’d like to introduce you to the Consortium for the Evidence-based practice of Obstetrics (CEO) and enlist your support in achieving its mission as stated above. You have publicly affirmed the important but difficult role of mothers and children in our society and expressed interest in supporting this cause. We concur and share your hopes and dreams on behalf of California families and the mothers that are so central to the wellbeing of their families.

The Consortium for the Evidence-based practice of Obstetrics is a new and broadly based organization of consumers, taxpayers and childbirth and public health professionals. Our membership is acutely aware of the many serious problems that healthy women with normal pregnancies face finding appropriate care in a dysfunctional maternity care system that fails to meet the needs of healthy childbearing women, practitioners, taxpayers or society. 

In response to these problems, CEO is committed to reforming our maternity care policy and dedicated to bringing science-based maternity care to all childbearing women. A_CEO is an affiliated group for physicians who wish to re-establish the scientific foundation of their profession and reclaim their expertise in the use of physiological management for normal birth.  

The CEO web site is www.SciencebasedBirth.com. In addition to the scientific literature cited on the CEO web site, additional scientific research confirming the assertions of CEO is published by the Maternity Center Association of NYC and available @ www.maternityWise.org.

CEO’s kick-off political activity began on Mothers’ Day 2004 and is a letter writing campaign to you as California’s First Lady. We ask that you extend your influence as First Lady to the following:

(1)   Bringing about public discourse thru legislative hearings that address the ever-climbing induction, cesarean section and maternal mortality rates, the off-label use of Cytotec for labor induction, the danger of promoting the ‘maternal choice’ cesarean as the so-called ‘ideal’ form of childbirth, lack of access to VBAC services and the physically damaging effects on the pelvic floor and pelvic organs associated with the current, medically-interventive & anti-gravitational management of vaginal birth

(2)    Facilitating passage of legislation mandating that physicians obtain true informed consent before substituting medical and surgical interventions in place of the safer, evidence-based principles of physiological management and that full information be provided about the risks of medical or surgical interventions and the mother’s consent obtained before being used during labor

Current Political Realties

Healthy childbearing families, post-cesarean mothers, hospital-based nurse-midwifery programs and professional midwives of all backgrounds face extremely serious problems under our highly politicalized and deeply dysfunctional obstetrical system. Interventionist obstetrics as applied to virtually all healthy women introduces artificial and unnecessary harm. At present, the obstetrical profession systematically fails in its most important job -- to preserve and protect already healthy childbearing women, which is 70% of the childbearing populations.

A healthcare system that over treats three-quarters of its patients is both expensive and dangerous. According to the scientific literature and vital statistics records, conventional obstetrics exposes healthy mothers and babies to unnecessary physical and mental suffering and increased rates of preventable death and disability. The medicalization of vaginal birth causes stress incontinence and other long-term problems. Another area of extreme concern is the ever-increasing Cesarean and maternal mortality rate and the issue of non-consensual obstetrical treatments and procedures and mandatory cesareans for healthy women with unusual circumstances.

False & Outrageous claims by A_COG

Recently the obstetrical profession has veered even further from common sense and science-based maternity care. The American College of Obstetricians and Gynecologists’ (A_COG) is publicly claiming that Cesarean section is safer and better for mothers and babies than normal spontaneous birth. An October 31, 2003 a press release by A_COG announced a decision by their Ethics Committee that it was now considered "ethical" for obstetricians to perform purely elective – that is, medically unnecessary or so-called “maternal choice” cesarean surgery. Substituting a euphemistic term like “maternal choice” can’t negate the danger and pain of major abdominal surgery. The obstetrical profession fails to see the connection between the routine use of drastic interventions in normal birth and damage to maternal tissue. Convinced as they are that pelvic floor dysfunction is merely the unpreventable “collateral damage” of vaginal birth, many obstetricians predict that cesarean will completely replace normal birth within the next 10 or 15 years as the official standard of care.

Forty percent of all childbirth services are paid for out of public funds. Interventionist obstetrics misdirects approximately 14% of our total health care budget (2.4% of GNP) to healthy women. It also systemically creates expensive, often long-term iatrogenic complications. This is a fiscal disgrace that reduces medical services to the ill, injured and elderly; the increased tax burden and inflated cost of employee health insurance also reduces job growth and the ability of California businesses to compete in the global economy.

Most of all, this is a crisis for our daughters, granddaughter and all young women who face the very real possibility that they will never even have the chance to have a normal vaginal birth or if they do, they will be permanently harmed as a result of the faulty understanding of normal birth by the obstetrical profession and the massive use of damaging medical and surgical interventions, episiotomy and instruments such as forceps or vacuum extraction.

Criticism of these serious systemic problems is not meant as a criticism of individual obstetricians, many of whom do a superhuman job under very trying conditions. Physicians too have been victims of organized medicine’s historical agenda to discredit physiologic principles. Since 1910, medical students have been taught that normal birth was a “nine month disease” that required a medical and surgical “cure”. As a result, medical educators did not teach the principles of physiological management to medical students and OB residents. As practicing physicians, obstetricians are unable to use the strategies of physiological management due to lack of training and experience and because our tort laws require physicians to do only what other physicians of the same specialty are doing. Obstetrical practice is defined by A_COG, which universally promotes a highly medicalized and interventive style as the official “standard of care”. Obstetricians who fail to intervene do so at their peril, as they are vulnerable to lawsuits and loss of their medical license for providing so-called negligent or “substandard” care.

Truth does not need to be defended, only revealed

Physiological management is the evidenced-based model of maternity care. It is associated with the lowest rate of maternal and perinatal mortality, is protective of the mother's pelvic floor, has the best psychological outcomes and the highest rate of breastfed babies. Use of physiological principles results in the fewest number of medical interventions, lowest rates of anesthetic use, obstetrical complications, episiotomy, instrumental deliveries, Cesarean surgery, post-operative complications, delayed and downstream complications in future pregnancies.

By comparison, conventional obstetrics as applied to healthy women is the opposite of evidence-based, physiological management. Its associated with high levels of medical intervention, obstetrical complications, anesthetic use, instrumental deliveries, Cesarean surgery and post-operative complications including emergency hysterectomy, delayed complications such as stress incontinence and pelvic organ prolapse, downstream complications in future pregnancies such as placental abnormalities and stillbirths, long-term psychological problems such as postpartum depression, lower rates of breastfeeding and increased rates of asthma in babies born by cesarean section. Conventional obstetrics for healthy women is neither safe nor cost-effective.

A long over-due, and much needed reform of our national health care policy would integrate physiological principles with the best advances in obstetrical medicine to create a single, evidence-based standard for all healthy women. Physiological management should be the foremost standard for all healthy women with normal pregnancies, used by all practitioners (physicians and midwives) and for all birth settings (home, hospital, birth center). This “social model” of normal childbirth includes the appropriate use of obstetrical intervention for complications or at the mother’s request.

The most efficient response to the dangerous disconnect between science and the obstetrical arts would be recognition by A_COG that physiological management is the evidence-based model of maternity care for healthy women and therefore, the official A_COG standard for this population. This would prompt medical schools to teach the philosophy, principles and skills of physiological management to medical students, practicing physicians to learn and use the strategies of physiological management and insurance companies to reimburse obstetricians for this safe and cost-effective care. For this to occur, we need a fundamental change in the public discourse and political dynamics between citizens, A_COG and other representatives of organized medicine.

On behalf of mothers and babies and the membership of CEO, I ask for whatever assistance you may be able to offer in this regard. I look forward to your reply.

Faith Gibson, California Coordinator, CEO / A_CEO


Letter # 7

Holly Mathews
1556 Plateau Ave. Apt #1
Los Altos Hills, CA 94024

Maria Shriver
Office of the First Lady
State Capital Building
Sacramento, CA 95814

RE:  Reforming Maternity Care,
        Holding Public Hearings about Obstetrical Excesses 

June 29, 2004

Dear Ms. Shriver,

I am a new member of the Consortium for Evidence-based practice of Obstetrics and convinced that the way obstetrical care is provided to healthy women is a bad system. It needs to change as soon as possible. Let me tell you why.

I haven’t had children myself yet but my mom had all three of us normally, without drama or trauma. The same is true for other, older relatives. I’ve seen normal births with midwives. Now my women friends are having babies. I am appalled at the many interventions and problems that they all describe. How can every one of my healthy friends, each with a perfectly normal pregnancy, have so many problems? Out of ten new babies, not a one of them had a simple “normal” birth. Although none of them or their babies had any serious medical problems, all but one was induced. They were usually told that being induced was easier or better than waiting for labor to start naturally. Their OBs said a lot of things but a truthful description of the facts didn’t seem to be one of them.

As a long-time friend, I was with several of them in the hospital during labor and what I saw was very upsetting. Being induced seems like a really hard way to have a baby. It means having many different tubes and needles put in your body, wires strapping you down to the bed, not being allowed to get out of bed or eat or drink anything and lots of pain. For some of them, this went on for more than 2 days. After days and nights of labor, no food and no sleep, they were told to push their babies out uphill, while lying on their back. Most of my friends weren’t strong enough to do that. It seems that doctors don’t know much about the laws of gravity either.

Out of my ten friends, all had epidurals, six of them had episiotomies and stitches, three had unexpected C-sections, 2 had a vacuum or forceps used, and one of them got an infection in her stitches. One of babies broke its collar bone during the birth and was in the NICU for several days. Their hospital bills were at least $20,000 dollars and that didn’t count the C-sections or the baby with the broken bone. Maybe my friends were just unlucky but it seemed to me that the care they received made things harder and actually caused many of these problems.

I don’t know exactly how to fix this but somebody needs to do something. Obstetricians need to hear from women and explain why, after 14 years of medical school, they can’t simply deliver a baby without doing major painful stuff to the mother. I know many midwives and they do simple normal births all the time, so a woman’s pelvis must still work OK. Why can’t doctors learn how to deliver a baby normally? Let them explain that in a public hearing.

Thank you,
Holly Mathews 


Letter # 8

June 30, 2004

Dear Maria Shriver,

As a certified nurse midwife, I am committed to providing women safe and healthy choices in regards to their maternity care. 

I beseech you to carefully read the research related to nurse midwives, and I hope that you will support the autonomous role midwives deserve when providing such excellent care to women and their families.

Sincerely,

Kathryn Newburn, RNP, CNM, PHN

Burlingame, CA

Journal of Epidemiology and Community Health, Vol 52, 310-317

Midwifery care, social and medical risk factors, and birth outcomes in the USA

MF MacDorman and GK Singh
Centers for Disease Control and Prevention, National Center for Health Statistics, Hyattsville, MD 20782, USA.

STUDY OBJECTIVE: To determine if there are significant differences in birth outcomes and survival for infants delivered by certified nurse midwives compared with those delivered by physicians, and whether these differences, if they exist, remain after controlling for sociodemographic and medical risk factors. DESIGN: Logistic regression models were used to examine differences between certified nurse midwife and physician delivered births in infant, neonatal, and postneonatal mortality, and risk of low birthweight after controlling for a variety of social and medical risk factors. Ordinary least squares regression models were used to examine differences in mean birthweight after controlling for the same risk factors. STUDY SETTING: United States. PATIENTS: The study included all singleton, vaginal births at 35-43 weeks gestation delivered either by physicians or certified nurse midwives in the United States in 1991. MAIN RESULTS: After controlling for social and medical risk factors, the risk of experiencing an infant death was 19% lower for certified nurse midwife attended than for physician attended births, the risk of neonatal mortality was 33% lower, and the risk of delivering a low birthweight infant 31% lower. Mean birthweight was 37 grams heavier for the certified nurse midwife attended than for physician attended births.

CONCLUSIONS: National data support the findings of previous local studies that certified nurse midwives have excellent birth outcomes. These findings are discussed in light of differences between certified nurse midwives and physicians in prenatal care and labour and delivery care practices. Certified nurse midwives provide a safe and viable alternative to maternity care in the United States, particularly for low to moderate risk women.


Letter #9

                                                                                                               Santa Clara, California 95050

June 25, 2004

Maria Shriver
Office of the First Lady
State Capital Building
Sacramento, California 95814

Dear Ms. Shriver,

I am writing on behalf of myself and all other women of childbearing age, both present and future, and on behalf of the Consortium for the Evidence-Based practice of Obstetrics to encourage you to use your considerable influence as First Lady of California to improve our current maternity care system. Physiological management of pregnancy, labor, and birth is the safest, most cost-effective, and most ethical model for our maternity care system, and I urge you to act to bring public awareness of the great need to reform our current expensive and obsolete system of maternity care to bring it in line with the science-based physiological model. 

Having experienced both medicalized delivery in a hospital setting and natural (physiological) birth at home, I can attest to the many benefits of the physiological management of pregnancy, labor, and childbirth.  I would like to share with you some of my experiences to help you understand the advantages of the physiological model of maternity care over the medical model.

My first birth went exactly by the book; each stage of my labor progressed just as the many books I read had described the typical labor.  I was confident in my body’s ability to give birth and I was eager to experience it.  I had often expressed to my obstetricians my desire to have a natural birth without any unnecessary interventions, but the medical idea of “natural” and “necessary” are unfortunately not the same as mine. It was quite upsetting to me to submit to the various “routine procedures” of the hospital - having an IV, having to lie in bed with the belt of the electronic fetal monitor strapped around my abdomen, not being allowed to eat or drink, having my water broken, giving birth flat on my back with my legs held up at a ninety-degree angle (which reduced my pelvic opening and forced me to push my baby out against the force of gravity), being directed to hold my breath and push while the doctor slowly counted to ten, being given an episiotomy and the subsequent stitches to repair it, having my baby whisked away to be cleaned and examined before getting even one touch, having my placenta tugged from my uterus instead of allowing it to be expelled naturally.  The event as a whole was very traumatic.

My dissatisfaction with that experience led me to seek midwifery care for my subsequent pregnancies.  I have received care from three midwives in three states with three legal situations regarding midwifery – first in an a-legal state which had no laws governing midwifery care; second in an illegal state where the practice of non-nurse midwifery is a misdemeanor crime; and finally here in California where midwifery is licensed but the laws are written in such a way that they are impossible to abide.  Each of the three midwives was certified by the North American Registry of Midwives and was imminently qualified to provide care to a healthy woman with a normal, low-risk pregnancy. 

The care I received from each of these midwives, in my opinion, far surpasses the care I received from an obstetrician.  Each prenatal appointment with a midwife lasted an hour or more, while I was lucky to get five minutes of a busy obstetrician’s time.   The midwives treated me as a whole person, inquiring about my emotional, financial, and marital well-being as well as my physical health.  The physical assessment of my and my baby’s health was much more comprehensive than that I received during appointments with an obstetrician. I had the same access to prenatal testing and was encouraged to make my own informed opinion about which tests and procedures I would like to have performed. I appreciated being an active participant in my own prenatal care and I especially appreciated the fact that my pregnancy was considered a normal part of my lifecycle rather than a pathological condition fraught with danger which my lack of medical training left me unable to comprehend.

With each of my midwife-attended home births, I labored comfortably in my home, caring for my family and going about the normal business of the day.  I ate and drank as necessary, allowing my body to be nourished and hydrated for the strenuous work of giving birth.  I checked in periodically by phone with my midwife and decided when I was ready for her to come.  Once she arrived, she set up her equipment and performed an assessment and I continued to labor in whatever place and position I felt most comfortable.  Her periodic assessments were not intrusive and were performed in a manner that respected my needs and desires. 

I chose to labor on my feet, allowing the force of gravity to assist my labor, until my water spontaneously broke.  I gave birth upright or semi-upright supported by my husband, positions which allow much easier descent of the baby through the birth canal than a back-lying position.  I pushed with the force of each contraction – a very natural and irresistible impulse – instead of being directed to push according to someone else’s arbitrary count.  I didn’t need an episiotomy, in spite of the scar tissue left from my first birth, and I didn’t tear. 

My newborn baby was handed to me immediately, allowing my baby skin-to-skin contact with me and the comforting, familiar sound of my heartbeat.  The umbilical cord was not cut until it had stopped pulsating, allowing my baby the full benefits of the rich cord blood. My husband and I were able to examine and enjoy our baby at leisure, even before the placenta was expelled, which happened naturally with the help of a few mild contractions.  My midwife performed a thorough neonatal assessment with my baby always within reach of my touch.  She made sure everything was cleaned up and we were all settled in comfortably before she made her departure, and she returned for two home visits in the next few days to check on us and ensure our continued well-being. 

I recognize that technological interventions have their place in compromised pregnancies and am grateful that doctors have mastered techniques which allow them to save lives of mothers and babies when complications arise.  Too often, though, medical interventions are performed when there is no real need and they produce complications rather than prevent them.  Labor is called labor for a reason; it’s hard work.  The healthy female body, however, is wonderfully designed to withstand the rigors of labor and birth when events are allowed to unfold naturally, and this fact seems to be ignored or downplayed. 

True necessity for intervention in labor and birth is uncommon, yet it is even more uncommon today to experience intervention-free birth in a hospital setting.  “Normal” has become something unnatural.  The system that has allowed this situation to develop is flawed and needs to be reformed. 

In conclusion

I am asking you, as First Lady of the State of California, to make the rehabilitation of our maternity care system a priority.  The standard of care for normal, healthy mothers and babies must be made to conform to proven scientific principles that recognize the superiority of the physiological model over the medical model of maternity care.

Thank you for your consideration of this matter.

Respectfully,                                                                                                      Lilah Monger

cc: California Citizens for Health Freedom


Letter 10

Ms. Maria Shriver
Office of the First Lady
State Capital Bldg.
Sacramento, CA 95814

Re: Mother’s Day Initiative for the Consortium for Evidence-Based Practice of Obstetrics (C.E.O)

Dear Ms. Shriver,

We are writing to you as part of a state-wide effort to call attention to the fact that pregnant women in California are slowly having their choices and access to the full range of childbirth options taken away from them. Healthcare during the childbearing years is increasingly being dictated by malpractice concerns and the ever-increasing use of technology—all without any scientific evidence that it provides better outcomes.  This has lead to increased healthcare costs due to the inappropriate use of technology.

One example of misused technology is unnecessary c-sections. California’s Center for Health Statistics recommends a caesarean rate of no more than 15% based on research and analysis of current data. This rate provides optimal outcomes for mothers and babies, while lowering serious complications and additional healthcare costs caused by unnecessary surgery. But in obstetrics today the number of caesareans is climbing to all time highs. In the latest health statistics for California (2000) there were 124,467 c-sections recorded. This figure represents 22.7 % of all births in that year. This means that in 2000 alone, 9,584 women had surgery for no reason. That’s 26 women each and every day being exposed to the increased morbidity and mortality that accompanies major abdominal surgery!

Sadly, since 2000, caesarean rates have gone up to 26.8%. One of the most prevalent reasons for the increase is that more and more hospitals are refusing to allow women with a previous c-section to attempt a VBAC. Women’s’ choices in labor and delivery are being narrowed by those whose motivation is not the safety and care of patients. So we have increased costs from surgery and increased complications from surgery without any indication of benefits to mother or baby. In fact the only beneficiaries of unnecessary c-sections are the hospitals who are able to move more patients through labor and delivery, and the physician, who can charge more and go home rather than having to stay on the floor monitoring laboring women.

We believe that the answer to this problem, and others of a similar nature, lies in increasing consumers’ access to the midwifery model of care. Midwives offer less expensive, less interventive care, that has scientifically proven to provide equal or better outcomes in women experiencing normal healthy pregnancies (approx. 70% of the pregnant population), than the current medical model does.

How is this possible? The midwifery model of care focuses on women’s social and emotional needs, along with her medical needs. It also relies on the judicious use of technology—just because we can utilize technology doesn’t mean we should do so. In short, midwives try to see each client as an individual with individual needs and desires. By contrast the medical model has devolved into seeing the pregnant woman as separate from her uterus and baby, with machines to monitor them and each individual as a potential litigant or disaster waiting to happen.

Please note that this is not a criticism of obstetrical care for women experiencing a high-risk pregnancy or other serious complication. We welcome the advances in medicine and the skills of physicians to provide the best medical care for such situations.  However, we want to see such care reserved to treat only those who need it, rather than using it unnecessarily on the entire population of healthy patients. This approach offers the best outcomes for mothers and babies AND it has the added benefit that it will save our state money

The first step in increasing access to the midwifery model of care is to remove the many barriers to practice that exists in California.  How can we do this? We must have a system that grants midwives autonomy and replaces mandatory physician supervision with collaboration, creating mutually respectful relationships between medical personnel and midwives. No less than the World Health Organization recognizes midwifery as an autonomous profession, with midwives being the recognized experts in normal pregnancy and birth.  This will only serve the women of California by providing them with increased safety and more choices during their childbearing years.

We thank you for your support.

Sincerely,

Renee S. Anker, L.M.
Chair, CALM


Letter #11

7/02/04
Keri Claussen
8719 Rosewood Av
LA, CA 90048

Maria Shriver
Office of the First Lady
State Capital Building
Sacramento, CA 95814

Mothers Day 2004

Dear First Lady,

I am writing on behalf of the Consortium for the Evidence-based practice of Obstetrics (CEO). The medically-interventive, obstetrical model used routinely on healthy women causes major problems. Obstetrical intervention for healthy women is not scientifically-based. We need public dialog to bring about appropriate changes in our national maternity care policy and the reform these potentially harmful obstetrical practices.

Physiological management provides the safest and most cost-effective form of maternity care and is associated with the lowest rate of maternal and perinatal mortality and the greatest wellbeing of mother and baby. Science-based or ‘physiological’ model of childbirth should be the universal standard for healthy women with normal pregnancies for healthy populations.

Legislative hearings are necessary so childbearing families who have had negative experiences with the current system can testify on problems such as:

(1) off-label use of Cytotec for labor induction & increasing percentage of non-medical induction
(2) the ever-climbing cesarean section and maternal mortality rate that is 30th in the developed world
(3) the danger in promoting the maternal choice cesarean as an idealized form of childbirth
(4) the physically damaging effects on the pelvic floor and pelvic organs associated with medical management of vaginal birth --

Examples include: procedures or policies that keep a laboring woman confined to bed such as continuous electronic fetal monitoring, the use of artificial hormones to stimulate or accelerate labor, narcotics, epidural anesthesia, requiring the mother to labor or push in anti-gradational positions, prolonged-breathe holding, episiotomy, operative delivery, etc

The need for a new law requiring physicians to provide full information about the risks of each significant medical or surgical intervention and to obtain truly informed consent before substituting medical and surgical interventions in place of the safer, evidence-based principles of physiological management.

Thanking you in advance,
Keri Claussen


Letter # 12

July 2, 2004

Dear Ms.Shriver,

I am writing to you on behalf of the Consorteum for the Evidence Based Practice of Obstetrics. I am a midwifery student,but first and foremost, I am a mother.I have given birth to three beautiful, healthy children,two in the hospital and one out of the hospital. I would like to share my different experiences with you.

My first son was born in the hospital ten years ago.During my four hour labor with no pain medication, I was given an I.V. against my will, (even though I had been told by my doctor that I didn't have to have one.) I was kept on the electronic fetal monitoring device for my entire labor,(even though the hospital policy stated that monitoring was only required for 15 minutes of every hour.) I was not allowed to get out of the hospital bed even to urinate. When it was time to push my baby out, I wanted to be upright, but I was forced to lay back and put my feet into stirrups and I was covered with sterile drapes so I couldn't even see when my baby came out. I was given an episiotomy even though my son was small, because my baby came so fast that my doctor didn't make it.The doctor that was on call payed no attention to my birth plan or the written instructions of my doctor that were posted in my chart. I felt completely taken advantage of and powerless!

Needless to say, when I became pregnant again, even though I had no insurance, no money and Medi-Cal wouldn't pay for midwifery care,I sought out a midwife! During the course of this pregnancy I had every question answered and my midwife spent at least forty five minutes with me at every appointment. (and that is the standard in midwifery care!) I was so thrilled! She even helped me get started in my own study of the art of midwifery. When I was thirty one weeks pregnant, I had to go to the hospital to be treated for premature labor. I was released, but my second son was born two weeks later and because of the prematurity we had to go to the hospital for his birth. I was still very disappointed, but my experience was so different from the first time. My midwife accompanied me to the hospital. She was by my side the entire time I labored, keeping me smiling, keeping me hydrated and adjusting the fetal monitor. When I pushed my baby out, she kept a warm compress on my perineum to keep me from tearing (she remembered that I did not want another episiotomy!) The nurses that were present at the birth said that they were amazed, because the doctor who did the delivery always gives episiotomies and I did not get one! My baby was big for being so early, was breathing well and nursed well so he only had to stay in the hospital for a week. I was very lucky!

With my third pregnancy, I was determined to stay out of the hospital!! We had previously determined with the help of my family doctor that my second baby was premature because I had an undiagnosed liver problem. So with my doctor's go ahead, My midwife helped me find a nutritionist and I took special classes so that I could carry my baby to term. My third baby was born out of the hospital, on his due date, with only three hours of labor and weighed nine pounds! I did not tear my perineum, nor did I have an episiotomy.I was allowed to move freely during my labor, encouraged to eat and drink, I was not given an I.V. and I had the wonderful pain relief of water to help me cope with contractions. What a huge difference in the quality of care!! My midwife has such faith in the ability of a woman's body to naturally do what it is supposed to do. I do not see that in doctors and nurses in most hospitals.

Midwives are trained to help healthy women deliver healthy babies the way we have been delivering babies since the dawn of time.Midwives are also trained to recognise when someone needs care that is beyond their scope of practise,and they refer these mothers to doctors in their communities that are trained to handle illnesses or emergencies.

Most doctors treat pregnancy as a disease when it usually is the healthiest time in a woman's life.(She may eat better,quit smoking,start exercising , take vitamins, all things that tend to improve health overall!)Doctors are trained to treat disease.Pregnancy and birth is not a disease, so for the protection of those women who do not want an out of hospital birth, we need to change the policies and procedures governing pregnancy and birth. We need to change how doctors view pregnancy and birth. We need to reinstill faith in the human body of a pregnant woman so they will allow her to birth naturally and comfortably without being strapped to a bed, filled with drugs, given an episiotomy etc. We need to change hospital policies that protect the hospitals in our sue happy society instead of protecting the wellfare of the mothers and babies! We need to change the policies that allow for insurance companies to dictate to doctors and hospitals instead of providing care for clients! We need legislative hearings so that our government can hear what is happening!

Thank you for taking the time to read this letter, and please consider what I am saying. We really do have a problem with the system as it is. It is time for a change that takes into consideration the people for once!

Sincerely,
Megan Roy


Letter #13

July 12, 2004

Maria Shriver
Office of the First Lady
State Capital Building
Sacramento, CA 95814

Dear Maria,

I am a mother, childbirth educator, doula, and taxpayer. I implore your help and support in gaining state attention to reforming our maternity care policies. 

If you will not help in this important cause….who will?

I am writing this on behalf of the Consortium for Evidence-base practice of Obstetrics (CEO). As you already know, CEO is dedicated to bringing science-based maternity care and physiological management to all childbearing women.

For the vast majority of pregnant women, pregnancy and childbirth is not an illness and should not be treated as such. California has one of the nation’s highest cesarean section rates. Is anyone, in power, asking why? The answer is “no.”  For that, I am asking why?

The toll on women and our healthcare system from medicalized obstetrics is astounding, and yet there is silence and non-action on the part of our policy makers, medical associations, and state health department. Again, I am asking why?

I am joining with CEO, as well as the Coalition for the Improvement of  Maternity Services (CIMS), the Association of Nurse Advocates for Childbirth Solutions (ANACS), Maternity Care Association (MCA), Lamaze International (LI), the International Childbirth Education Association (ICEA), Doulas of North America (DONA), the Cochrane Database (a database for doctors), Maternity Wise, my city’s own Bay Area Birth Information (BABI) and many other organizations who support evidence-based, physiologically managed childbirth.

Again, I implore your help in making a difference to the families and taxpayers in our state by bringing this issue to light. Please, take a stand.

Sincerely,

Jeanne Batacan
5835 Terrazzo Court
San Jose, CA 95123


Letter # 14

July 20, 2004

Maria Shriver
Office of the First Lady
State Capital Building
Sacramento, CA 95814

Dear First Lady,

I am a registered voter, a taxpayer, and the mother of a 14-year-old daughter. I am writing you today because I want my daughter to have a scientifically based model of care, when she is ready to give birth to her family. I am writing on behalf of the Consortium for Evidence-base practice of Obstetrics (CEO), which is committed to reforming our maternity care policy and dedicated to bringing science-based or physiologically based maternity care to all childbearing women.

Physiologically based maternity care is the scientifically proven way to achieve the best outcomes for healthy women having normal pregnancies, and this care model is less expensive and has been proven to provide equal or superior outcomes. In contrast, the medical-model of care practiced by most obstetricians does not stand up scientifically, nor statistically since maternal/infant mortality/morbidity rates are much higher than they should be and operative deliveries are increasing every year.

If physiologically based maternity care became the standard of practice in California, CEO members believe that is would

Increase the safety of childbirth and the level of wellness for both the mother and baby.

Reduce the number of unnecessary and cost-added medical interventions, including cesarean sections, thereby lowering medical costs, insurance premiums and taxes.

Enable low-income women, particularly those in rural, inner city and migrant populations who are served by welfare programs, to obtain better prenatal and delivery care.

Assist in restoring women as the primary providers of assistance to women in childbirth.

I ask that you make evidence-based, safe and affordable wellness care for women from preconception through birth (and beyond) a priority focus. I ask you to support the development and integration of trained and experienced midwives into our health care system, as done in many westernized countries.

Thank you,

Summer Mercado


Sent: Sunday, July 25, 2004 9:40 PM

                                                                                     Letter # 15

Mother’s Day Initiative                                        

May 9, 2004

Maria Shriver
Office of the First Lady
State Capital Building
Sacramento, CA 95814

Dear First Lady Shriver,

I live in the San Francisco Bay area.  I provide professional labor support to mothers and families during childbirth.  I’ve worked at a dozen different hospitals in the area.  I have attended more than 200 births, in hospitals, in birth centers and in women’s homes.  I also teach prenatal yoga classes and childbirth preparation classes in my community.

I am also a graduate of National Midwifery Institute and a recently licensed midwife in the state of California.  I would like to call your attention to the fact that California, the 'physician supervision clause', in both the certified nurse-midwife and licensed midwifery acts in California, must be repealed

I have attached an excerpt of an article from www.sciencebasebirth.com that explains the situation.  I hope you’ll take the time to read it.

There are other maternity care problems that need to be addressed in the state of California.  Please go to https://sciencebasedbirth.com/ for more information on the current situation and how you can help.  I would appreciate your taking time to meet with the leaders of the Consortium of Evidence-based Obstetrics and California Citizens for Health Freedom via Donna Russell, 530.534.9758 or Donna@citizensHealth.org so that you can hear first-hand what's happening and how you might best help create California as a national leader in reforming poor and common obstetrical practices, restoring physiological birth, reducing health care costs and increasing satisfaction with birth.  Doing so will aid in the development of healthy families.

Sincerely,

Rosanna M. Davis
Burlingame, California

Excerpts from the Consortium for Evidence-Based Obstetrics (C.E.O)   www.sciencebasedbirth.com

Professionally licensed midwives (LMs and CNMs) should address the fatally flawed nature of California licensing laws, which mandate that midwives have physician supervision but does NOT mandate that physicians provide supervision. This puts total control of the profession into the hands of an economic competitor.

 In California, the 'physician supervision clause', in both the certified nurse-midwife and licensed midwifery acts, must be repealed. It creates unnatural and unnecessary vicarious liability for physicians, which totally blocks the ability of midwife-friendly physicians to consult with midwives or midwifery clients. Both CNM and LM licensing statutes were originally written by organized medicine. Lobbyists promised the Legislature that a law requiring physician supervision would promote public safety by guaranteeing appropriate access to medical services by pregnant women. Instead of the promised stepping stone, this provision turned out to be a stumbling block.

In addition, there is the inherent insanity of identifying doctors, who are neither trained nor experienced in physiological management (i.e., the midwifery model of care) as the proper source of "supervision" for practitioners who provide physiologically managed care. Since obstetricians have no education, training or experience in physiological management--they should be required to be supervised by professional midwives whenever they attempt to provide care to healthy women with normal pregnancies!

Hospital protocols and self-serving policies of malpractice insurance companies also conspire to deny childbearing families even the smallest opportunities for true choices in regard to the manner and circumstances of their normal labor and birth. Few obstetricians practicing today know how to delivery a baby who is in a breech position. Most are afraid of providing normal care to women carrying twins or who want a normal labor after cesarean section. Post-cesarean mothers and those carrying twins or a breech baby are being forced into non-consensual treatment via medically unnecessary and unwanted cesarean surgery.

Other topics could include the impossibility of MediCal reimbursement, insurance reimbursement, and the recommendations of the Pew Charitable Trust Report on the importance of mainstreaming professional midwifery care. The Pew report reiterates what midwives already know--that professional midwives can only function as guardians of normal birth (and as a braking system to prevent run-away obstetrical intervention) when midwifery is an autonomous profession.

Midwifery must be an autonomous profession. The law must be changed. The unworkable relationship between physicians and midwives must be replaced with a voluntary one defined as 'collaborative', in which midwives consult with physicians as needed and are respected by medical and obstetrical providers as colleagues. 


Letter #16

Jessica Eschen RN, PHN
951 S. Larch St.
Canby, OR 97013

July 29, 2004

Maria Shriver
Office of the First Lady
State Capital Building
Sacramento, CA 95814

Dear First Lady Shriver,

As a RN and mother, I know the benefits of midwifery care.  I worked in the post-partum ward of a hospital before I had two children safely and comfortably in our home.   I was assisted by caring, knowledgeable midwives during both pregnancies and births.  My first birth experience was in Whittier, CA, my second in Canby, OR.  If I were to go back to work, I would seek a career in midwifery, not in hospital nursing, because I believe in the practices wholeheartedly. 

My husband and I wanted home births assisted by midwives so badly that we paid out of our own pockets (our insurance covered only a portion of the cost).  The insurance companies will fork out an obscene amount of money to a doctor and a hospital for a birth, but for a midwife’s nominal fee they won’t fit the bill.

I am writing on behalf of the Consortium for Evidence-base practice of Obstetrics (CEO), which is committed to reforming our maternity care policy and dedicated to bringing science-based maternity care to all childbearing women.

I am deeply concerned about the ever-increasing medicalization of normal, healthy women by the obstetrical profession. Modern obstetrics does not improve outcomes for healthy women and their babies, which is 70% of the childbearing population. Obstetrical intervention for healthy women is not scientifically based. Unscientific care raises the cost of normal childbirth to a staggering proportion of our healthcare budget. As a result, our current maternity care system fails to meet the needs of healthy childbearing women, practitioners, taxpayers or society.

This a crisis for our daughters, granddaughters and all young women. They may never even have the chance to have a normal vaginal birth or if they do, they risk being permanently harmed as a result of the the obstetrical profession's faulty understanding of normal birth and by the routine use of damaging medical and surgical interventions, episiotomy and instruments such as forceps or vacuum extraction.

I believe that women’s rights regarding their health care are being constantly eroded by the non-scientific practice of obstetrics. Conventional obstetrics practices, especially as they apply to normal labor and birth, are not based on scientific principles. The medicalization of vaginal birth is known to cause stress incontinence and other long-term problems and yet the obstetrical profession doesn't seem to notice the connection between their drastic interventions in normal birth and the high rate of damage to maternal tissue. The ever-increasing Cesarean and maternal mortality rate is even a greater problem. We need public dialog to bring about appropriate changes in our national maternity care policy and reform potentially harmful obstetrical practices.

The obstetrical profession has veered very far from common sense and science-based maternity care. The American College of Obstetricians and Gynecologists’ is publicly claiming that Cesarean section is safer and better for mothers and babies than normal spontaneous birth. According to ACOG, it is now considered "ethical" for obstetricians to perform purely elective – that is, medically unnecessary or the so-called “maternal choice” -- cesarean surgery. Many obstetricians predict that cesarean will completely replace normal birth within the next 10 or 15 years as the official standard of care. For this and other reasons,  it is my observation that contemporary obstetrics is failing in its most important job --  preserving and protecting already healthy childbearing women from the excesses of the medical system.

There is a health care crisis in California and all across this country that nobody is talking about. I am referring to the extremely serious problems that healthy childbearing families, post-cesarean mothers, hospital-based nurse-midwifery programs and professional midwives all face under our highly politicalized and deeply dysfunctional obstetrical system. Interventionist obstetrics as applied to virtually all healthy women introduces artificial and unnecessary harm. This unscientific care raises the cost of normal childbirth, eating up far more than a fair or appropriate share of our healthcare budget.

Forty percent of all childbirth services are paid for out of public funds. Interventionist obstetrics misdirects approximately 14% of our total health care budget (2.4% of GNP) to healthy women. It also systemically creates expensive, often long-term iatrogenic complications. This is a fiscal disaster that reduces medical services to the ill, injured and elderly; the increased tax burden and inflated cost of employee health insurance also reduces job growth and the ability of California businesses to compete in the global economy. We need public dialog to bring about appropriate changes in our national maternity care policy and reform potentially harmful obstetrical practices.

My experience providing labor support to women in a hospital setting opened my eyes and I was shocked by what I saw.  Woman are being instructed to push so hard at the moment of birth that they tear.  Women are restricted to certain positions for actual birth that makes it hard for them to birth their children in a normal, physiological way.  I saw women scared into accepting certain procedures such as cesarean birth, because their babies showed distress signals on the fetal monitor and yet these babies were actually healthy and born completely normal. Residents told women they weren’t progressing quickly enough (one centimeter an hour) and so would need Pitocin to speed things up. This increased these women’s distress and difficulty in giving birth normally.

Obstetricians need to hear from women and explain why, after 14 years of medical school, they can’t facilitate a normal spontaneous vaginal birth, without first subjecting the mother to painful medical and surgical interventions. What's missing is the use of physiologic principles. Physiological management is the evidenced-based model of maternity care. It is associated with the lowest rate of maternal and perinatal mortality, is protective of the mother's pelvic floor, has the best psychological outcomes and the highest rate of breastfed babies. Use of physiological principles results in the fewest number of medical interventions, lowest rates of anesthetic use, obstetrical complications, episiotomy, instrumental deliveries, Cesarean surgery, post-operative complications, delayed and downstream complications in future pregnancies.

We need to bring the attention of the public and the legislature to the dysfunctional and wasteful nature of the current obstetrical system for healthy women and establish a forum for public dialogue with obstetricians regarding the potentially harmful & unscientific practices of contemporary obstetrical care, especially as applied to healthy women, and the great need for reforming the maternity care policies.

Reforming our national health care policy would integrate physiological principles with the best advances in obstetrical medicine to create a single, evidence-based standard for all healthy women. This would require medical schools to teach the philosophy, principles and skills of physiological management to medical students, practicing physicians to learn and use the strategies of physiological management and insurance companies to reimburse obstetricians for this safe and cost-effective care.

Were physiological management of birth to become the standard of practice in California, like it is in many other western nations,  C.E.O. members believe that it would :

*Increase the safety of childbirth and the level of wellness for both the mother and baby. 

*Reduce the number of unnecessary and cost-added medical interventions including cesarean-sections, thereby lowering medical costs, insurance premiums and taxes.

*Enable low income women, particularly those in rural, inner-city and migrant populations  who are served by welfare programs, to obtain better prenatal and delivery care.

*Assist in restoring women as the primary providers of assistance to women in childbirth.

*Give women appropriate choice and control in their maternity care.

Physiological management should be the foremost standard for all healthy women with normal pregnancies, used by all practitioners (physicians and midwives) and for all birth settings (home, hospital, birth center). This “social model” of normal childbirth includes the appropriate use of obstetrical intervention for complications or at the mother’s request.

We need your help to elevate the public's awareness of these problems. We need legislative hearings that will publicly look into the ever-climbing induction, cesarean section and maternal mortality rates, the off-label use of Cytotec for labor induction, the danger of promoting the ‘maternal choice’ cesarean as the so-called ‘ideal’ form of childbirth, lack of access to VBAC services and the physically damaging effects on the pelvic floor and pelvic organs associated with the current, medically-interventive & anti-gravitational management of vaginal birth.

We also need new legislation that would physicians to obtain true informed consent before substituting medical and surgical interventions in place of the safer, evidence-based principles of physiological management and that full information be provided about the risks of medical or surgical interventions and the mother’s consent obtained before being used during labor.

I ask that you make evidence-based, safe and affordable wellness care for women from pre-conception through birth (and beyond!) a priority and focus of your great influence. I ask you to support the development and integration of trained and experienced midwives (as done in many westernized countries) into our health care system to increase physiological, safe birth and the accompanying satisfaction and decrease health care costs.  Doing so has proven to lower the incidence of maternal and infant mortality in many other countries around the world.

Please help support our choice to birth naturally & safely.  Thank you for your time.

Sincerely,

          Jessica Eschen, RN, PHN


Letter # 17

Maria Shriver
Office of the First Lady State
State Capital Building
Sacramento, CA  95814 

Dear First Lady,                                                                                                                September 8, 2004

 

     I am writing this letter on behalf of the Consortium for Evidence-base practice of Obstetrics (C.E.O.).  I am definitely in favor of labors and births being managed by physiological means verses medical interventions.

     I am a mother of three children and am currently pregnant with a fourth child.  I have been fortunate to delivered all three of my children under the care of midwives.  The first two were born in a local community hospital under the care of a Certified Nurse Midwife (CNM).  The third baby was born at home under the care of a Certified Professional Midwife (CPM).  All three experiences have been wonderful despite the 20+ hours of labor for two of them. 

     I attribute my positive experiences to good physiological management of my labors.  I was allowed to change positions, walk around freely, eat and drink until I no longer desired (this kept my energy intact considering the length of labor.)  Periodic fetal monitoring was provided, as well as, monitoring of my well-being and progress.  Being allowed to push the babies out when it felt right not just when my cervix became completely dilated.  And last but not least I was not given an episiotomy with a silly explanation that it speeds up the delivery.  My experience was nothing like what many of my friends and what most women have experienced.  Many are told they need to have an IV, continuous fetal monitoring (which has not been shown to improve fetal outcomes in low or high risk births), and being told when and how hard to push as their babies descend not to mention the ever so popular episiotomy performed for quick delivery.

     In the U.S. 85% of the childbearing women enter labor at “low-risk” for problems, but virtually 100% of U.S. women have at least one intervention.  I am saddened to hear of several of my friends undergoing Cesarean sections for a variety of reasons.  They are young (26-33 year old) women in good health with uncomplicated pregnancies who go in for a vaginal delivery and end up having C-sections.  Some of them do not fully understand why it all happened.  Then they are being told that all subsequent children will have to be delivered by C-section as well (even when the c-section was for such things as breech presentation.)  As referenced from documentation of C.E.O.’s, I am appalled that the “American College of Obstetricians and Gynecologists’ (ACOG) claims that Cesarean section is safer and better for mothers and babies than normal spontaneous birth.”  No wonder our nations c-section rate is at greater than 25%.  I think it is ridiculous to tell women that their bodies are “lemons”, unable to do what women have been doing for millennia.  What message are we sending to ourselves, our daughters, and to young women in general.   Women in this country are so strong; they have fought for political rights, working rights and many other rights and now it is time to protect our childbearing rights. 

     I do know that there are times and situations and a small percentage of women who require medical intervention.  For that reason I am grateful for the technologies that have been developed to assist with childbirth.  However, I believe that women are being sold short by a system that teaches them not to trust their bodies and natural strength.  Childbirth is a natural process and should be supported with physiological management. The current system of care is flawed and needs to be reformed.  We need more support of midwives.  We need Obstetricians and nurses to be trained to manage labors with a physiological approach, not a constant intervention approach.  CHILDBIRTH IS NOT AN ILLNESS!

     I am asking you, as First Lady of the State of California, to make the rehabilitation of our maternity care system a priority.  The standard of care for normal, healthy mothers and babies must be made to conform to proven scientific principles that recognize the superiority of the physiological model over the medical model of maternal care.

Thank you for your support.

 

Sincerely, 

Trina K. Lincoln


www.ScienceBasedBirth.com

CEO / A-CEO // Contact Information //
 California Citizens for Health Freedom
              
1- 530-534-9758         Donna Russell      info@sciencebasedbirth.com