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Updated ~ Wednesday February 16, 2011 01:34 

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READ ME FIRST : Many have asked for a simple form letter that could just be printed out, signed and mailed. The bad news is that legislators pay little attention to three type of political activism -- petitions, emails and form letters -- they consider them a type of "junk mail" that does not represents a passionately committed constituency.

So I'm posting a 'next generation' form letter -- a 'Chinese menu' template with two or three choices for each category so that people can cut and paste one-of-a-kind form letter. Writers may also go to the Letter Archive, read the correspondence already sent, use any of those ideas or cut and paste text from those sources to their own unique letter.

However, for those who just don't have the time for the build-your-own version, click the link below for a real, sure-enough form letter. Be sure to delete the heading  (red type) and add your name before printing.


'Next Generation' Template for Letter-writing  

A 'Chinese Menu' template contains stand-alone comments that
 you can cut and paste to create a "form" letter to Maria Shriver

Like a Chinese menu, the writer can choose one from category A, two from B, one from C, etc and presto, a nice letter without having to wade thru all the documents on the CEO website.  


 Examples of letters compiled by using the 'Chinese Menu' template ~  #1     #2     #3    #4 

 Mail the original to Maria Shriver and email a copy to

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

 6-part template -- A (Writer)B (CEO), C (Problem),  D (Examples),  E (Action), F (Solutions

 A - About you ~ the writer ~ Describe yourself simply:  

  I'm a mother, a father, a childbearing woman, a consumer,
    a taxpayer, a concern citizen, a childbirth professional, a physician, etc                        

 B - About CEO & its goals ~ choose one or make up your own:

(1) I/we am/are 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. 

(2) This letter is on behalf of the Consortium for Evidence-base practice of Obstetrics. I/we support the goals of the C.E.O. to establish physiological management as the standard of care in California for all healthy women with normal pregnancies. We need public dialog to bring about appropriate changes in our national maternity care policy and reform potentially harmful obstetrical practices.

(3) Physiological management of birth is an important issue to women and one that get little notice in the newspaper and television. The Consortium for Evidence-base practice of Obstetrics (CEO) challenges the obstetrical opinion that childbirth in a healthy woman is fundamentally flawed and must be conducted as a medical or surgical procedure. On the contrary, physiological management is the evidenced-based model of maternity care and is associated with the lowest rate of maternal and perinatal mortality and the greatest wellbeing of mother and baby.

 C - Problem Statement ~ choose one or two:

(1) The ever-increasing medicalization of normal, healthy women :

I /we am/are 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, granddaughter 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.

(2) Women’s rights regarding health care being eroded:

I/we 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.

(3) Health care crisis and fiscal disaster:

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.

  D - Examples of the problem or contrasts with appropriate care  ~ choose one or two :

(1) Even though we pour more money into obstetrical services than any other in the world, the United States is a shameful 25th in the world for infant mortality and 30th for maternal mortality. Mortality for mothers, and in 2002 for newborns, has actually rising in our wealthy country in recent years.

(2) 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.

(3)  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.

 E -- Solutions & Description of Appropriate Care:

(1) 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 required 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.

(2) 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 :

(3) 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.

 F -- Request for Action ~ choose one or two:

(1) 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.

(2) 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.

(3) We hope that you would agree to meet with a small number of women who have compelling personal stories to share with you and to discuss how to proceed with the efforts of CEO to bring about meaningful dialogue between women and obstetricians.

Congratulation, you can now sign your name and mail your letter.

Don't forget to email a copy to be included in the CEO archive.