Monday, February 24, 2014

Exclusive Wrap Design by ANM Mama Available for a Limited Time

by Glenni Lorick, IBCLC

We are so proud of ANM mama Katie Stokes! Her design has been selected by Baby Adorables to be made into an exclusive limited edition woven wrap! The print seen at the left is called "Love Song."

It went on order today, but there is a VERY limited window of opportunity to order it. All orders must be in by Wednesday night in order for them to go into production and be available by early May. The $145 price is in the average range for a high quality limited edition woven wrap.

If you are looking for an all-season versatile wrap-style carrier that will last through multiple children, then click here right now to order! If you're looking for the perfect gift for a very special mother in your life, look no further. She will treasure this gift for years to come!

Friday, February 14, 2014

Help Keep a CNM in North Alabama!

by Glenni Lorick, IBCLC
Athens Limestone Hospital has the only CNM in North Alabama.
Nineteen years ago I lived in Madison when I got pregnant with my third child. I had enjoyed a wonderful birth with a Certified Nurse Midwife CNM at a hospital in Tallahassee, FL just 3 years earlier, and I hoped to repeat that experience. I knew I wasn't comfortable with a home birth, and I honestly didn't want an Ob/Gyn. As I did my research I discovered that Dr. Gross in Athens actually had recently hired Roberta Ress, CNM. So I headed right over there to check things out. This was back before they renovated the  hospital to add on beautiful birthing rooms. I would end up giving birth in a sterile delivery room. Then I would be moved to an equally sterile (ugly might be a better word) hospital room. Nothing homey about it! But I chose that option over the beautiful new birthing rooms at Huntsville Hospital or the lovely suites at Humana Hospital for one reason: I wanted a hospital birth with a midwife.

Roberta Is Retiring

Fast forward nearly 20 years, and Roberta is at the point in her life where she's ready to retire. Her
Roberta Ress is the only CNM practicing in North Alabama.
kids live in various places; her husband is retired, and she is ready to enjoy the coming years with her family. I'm so happy for her! I have enjoyed her friendship over these last 20 years first as my midwife, and later as a wonderful resource person for other mothers. She should be able to approach her retirement with excitement and anticipation. Instead, as June 1 draws closer, Roberta has a heavy heart, knowing that Athens Limestone Hospital does not plan to replace her.

No More CNM's in North Alabama

Huntsville Hospital has a stipulation written into its bylaws stating that a doctor must be present for midwife deliveries. This is fairly unusual, given that even by Medicaid standards it is not necessary for a physician to be present. Several years ago, Athens Limestone Hospital became part of the Huntsville Hospital network. In 2011 the board that governs Athens Limestone quietly slipped a similar stipulation into their bylaws. Roberta was grandfathered in, but this means that upon her retirement, another midwife won't be able to take her place.  She notes, "I've already had patients transfer away because they're due after June 1. If Athens wants to keep them, they need to hire another midwife."

You Can Help

There is still a ray of hope. On Tuesday, March 11, the hospital board will meet to discuss the
situation. Roberta's goal is to have this stipulation removed. "I have fought this fight for 20 years to try to get moms to come to the hospital, not to be afraid of us, not to have your baby at home," says Ress. "I don't care who they hire; I just want to make sure the option is there. They think we have enough care providers here, but our female care provider has MD behind her name. It truly grieves me that this is going to be the end of an option for these women. But I will continue to fight to keep this option open." 
There are several action steps you can take:
  1. Join the Facebook Group that is dedicated to getting more midwives in local hospitals
  2. Write the CEO of Athens Limestone Hospital Kelli Powers asking her to make sure that Athens Limestone continues to offer this outstanding service for mothers and babies. Please cc Roberta Ress with any email you send.
  3. Write the CEO's of other North Alabama hospitals expressing your desire to see CNM's providing services there. Huntsville Hospital: David Spillers; Madison Hospital: Mary Lynn Wright; Crestwood Medical Center: Dr. Pam Hudson; Helen Keller Hospital: Doug Arnold; Eliza Coffee Memorial Hospital: Russell Pigg
  4. Call each hospital to ask if they will be offering the services of a CNM in the near future, and let them know that is an important factor for you in your choice of a place to give birth. 
(256) 386-4196 is the number for Helen Keller Hospital
(256) 768-9191 is the number for ECM Hospital
(256) 341-2000 is the number for Decatur General Hospital
(256) 265-2012 is the number for Madison Hospital
(256) 233-9292 is Athens Limestone Hospital
(256) 265-1000 is Huntsville Hospital

Remember that you catch more flies with honey than with vinegar, so be sure that any communication you have is positive. The fact is that offering the services of a CNM will only serve to increase their patient load AND their profitability. So let's get busy and help them do just that!

Saturday, February 8, 2014

ANM Is On Instagram Now!

One of our first Instagram posts was
this basket from Magic Bum
by Glenni Lorick, IBCLC
Yesterday I stepped into the world of Instagram. Here's how it happened: I went by the T-Mobile kiosk at the mall to check on getting my phone fixed. I ended up leaving with an Ipad Air. One really cool thing about the Ipad is now I can do Facetime consults in addition to Skype consults. When I brought the Ipad in to the store yesterday afternoon, Marley set up Instagram on it!

We really want to interact with you via Instagram. When you take a picture of yourself or your baby wearing something you got from A Nurturing Moment, please tag us #anurturingmoment
Follow us at anurturingmoment, and we'll try to make sure we keep you up to date on everything that comes in via Instagram!

Win Using Instagram

To kick off our life on Instagram, we're going to give away a $25 gift certificate. Every time you post a picture using #anurturingmoment AND #ANMoninstagram between now and Feb. 22, you will receive one entry. The winner will be announced Monday, February 24.

Got a suggestion for a good instagram contest? Let us know!


Thursday, February 6, 2014

Political Tactics Deprive “Home Birth Safety Act” of Promised Vote

Rep. Mike Ball from Madison
has sponsored HB 67.
by Anna Bertone, MPH  Guest Blogger

The Senate Judiciary Committee held a hearing yesterday for House Bill 67, and Senate Bill 99, "The Home Birth Safety Act." The bill, sponsored by Rep. Mike Ball, R-Madison, and Sen. Paul Bussman, R-Cullman would have decriminalized the practice of Certified Professional Midwives (CPMs) in an effort to improve out-of-hospital maternity care in Alabama.

Supporters from across the state filled the room and waited through hours of less popular bills to the last on the agenda – the midwifery bill. The committee allowed three testimonies from the opposition and two from the proponents. Legislators were preparing to vote as planned when Sen. Bryan Taylor, R-Prattville made a late arrival and halted the legislative process by calling for the bill to be tabled. The "no" votes on tabling the bill were Sen. Orr, Sen. Ward and Sen. Williams.
Sen. Bryan Taylor arrived late and
called for SB 99 to be tabled.

The disappointing end to the public hearing came after passionate testimony from both sides of the issue. The opposition cited a not yet published study on national birth certificate data  that found an elevated relative risk of neonatal death for home births. They gave no discussion of absolute risks or the limitations of using administrative records for research purposes. They recounted examples of tragic outcomes from Alabama home births in such detail that many in the audience could identify the cases being described.  

Supporters referenced favorable results from a recent observational study that used “intention to treat” methodology. This study design avoids many of the limitations in using birth records. It involves enrolling women who are planning a home birth early in prenatal care and then following them to document the outcome. They also explained to legislators that credentialed midwives should not be blamed for poor outcomes occurring at unattended home births or births attended by lay midwives (as were the anecdotal scare stories). On the contrary, this legislation seeks to address unsafe out-of-hospital birth practices.
 "Although the Committee on Obstetric Practice believes that hospitals and birthing centers are the safest setting for birth, it respects the right of a woman to make a medically informed decision about delivery."      ACOG 2011 Statement
The Medical Association of the State of Alabama uses powerful political leverage to oppose home birth safety legislation year after year. They acknowledge that parents are choosing home birth in increasing numbers, that it is within their legal right to do so, and that birth carries risk of injury and death to mother and child. Nevertheless, they refuse to come to the table with parents and midwives to discuss safety measures. Medical opponents agree in principal but not practice with the official American College of Obstetricians and Gynecologists 2011 statement on planned home birth, to “respect the right of a woman to make a medically informed decision about delivery.”  We are not respecting women’s choices in childbirth if we strive for standards and quality improvement in the hospital setting but refuse to implement safety measures for alternative choices.

After studying the issue, Dr. Pippa Abston
supports the licensure of CPM's.
According to an Alabama pediatrician:

"I have studied this issue in detail and have learned that the CPM certification process  is rigorous and appropriate.  With well-trained attendants, planned home birth can be a safe option for low risk pregnancies.  Even for higher risk cases, women who decide to give birth at home have significantly better outcomes if they are able to have a well-trained midwife present than if they are not.  Home births without such help, happening now in our state, are dangerous to both mother and newborn.  I support the licensure or at least the decriminalization of CPM practice, to improve the safety of mothers and newborns." -- Pippa Abston, MD, PhD

Women choose to birth outside of the hospital for a variety of cultural, spiritual, economic and personal reasons. For some, a previous negative hospital experience has left them seeking alternative care in a state with no freestanding birth centers. Others hope to avoid the risks associated with routine hospital interventions or hospital-acquired infections. The rising cesarean rate (now 1 in 3 in AL) may be contributing to women choosing a setting more conducive to physiologic birth. Some women who have experienced sexual trauma or forms of discrimination prefer to birth in a familiar setting. There are individuals and communities (Amish, Mennonites) that hold pregnancy and birth to be normal but private life events belonging to the family. Costly hospital services are enough to deter some uninsured or underinsured individuals from utilization.

The 28 states already authorizing the practice of CPMs have come to the common sense
The Alabama Birth Coalition will
keep fighting for the birthing
rights of Alabama mothers.
conclusion that it’s absurd to allow home births but outlaw qualified care providers to attend them. The safest possible course is to license and regulate credentialed midwives while collecting publicly available data on maternal and child outcomes.

Families choosing home birth are fed up with bullying tactics from powerful special interest groups and want to let the legislative process work to come up with real solutions to real problems. We at the Alabama Birth Coalition agree with the American Public Health Association’s resolution  to increase access to trained out-of-hospital maternity care providers as an important step in improving public health and safety. We support the safest possible care for all Alabama families, regardless of chosen birth setting. 

For more information, visit or find the organization on Facebook.
The Alabama Birth Coalition (ABC) is a 501c4 non-profit, grassroots organization.

Tuesday, February 4, 2014

Will Alabama Actually Make Home Birth Safer?

By Glenni Lorick, IBCLC

For the last several years, the Alabama Birth Coalition has worked tirelessly to pass legislation providing for the licensing and regulation of Certified Professional Midwives. Each year, their efforts have fallen short, as the bill has either not made it out of committee or been terribly altered by unfriendly ammendments. There is good reason to hope that this year will be different!

A New Committee

Instead of presenting a bill to the Health Committee like they have in past years, this year they have taken a different approach: they have provided a bill to the Judiciary committee! The focus of the bill is the decriminalization of home birth. House Bill 67 and Senate Bill 99, "The Home Birth Safety Act," would decriminalize the practice of Certified Professional Midwives (CPM's).  According to the Alabama Department of Public Health, 1,448 women gave birth outside of the hospital from 2005-2012. Many of those mothers had no medical assistance, increasing the risk dramatically. 

While it is not illegal for a mother to give birth in the comfort of her home, it IS illegal for anybody with any medical training to provide assistance to her. This bill provides immunity to midwives and certain healthcare providers who assist in "physiologic childbirth." In other words, specially trained professionals will not be prosecuted for helping a mother give birth at home.

The Debate

Opponents argue that home birth is inherently unsafe. They insist that a woman should only give birth in the safe confines of a hospital. In fact the president of the Medical Association of the State of Alabama weighed in heavily against this bill. Nevertheless, even Governor Bentley recognizes that Alabama mothers ARE having babies at home, and the wisest thing to do is make it as safe as possible for them by allowing trained professionals to attend those births. 

Proponents of the Home Birth Safety Act recognize that the bill on the table actually helps to ensure the safety of mothers by authorizing only "midwives who hold a current midwifery certification from an organization accredited by the Institute for Credentialing Excellence." Certified Professional Midwives are specifically trained in dealing with out-of-hospital births. They are experienced professionals who have undergone thorough testing of their knowledge base.

You Can Help

Tomorrow at 1:00 pm a public hearing is scheduled before the Senate Judiciary Committee followed by a committee vote. Many members of the Alabama Birth Coalition will travel to Montgomery to show their support. Assuming this bill passes the committee tomorrow, you need to contact your state senator, asking him or her to vote in favor of this bill when it comes to a full vote of the senate. Hopefully, the same process will take place in the House.

Eventually the Alabama Birth Coalition would like to see the practice of midwifery licensed and regulated by the state. This would confer even greater protection on childbearing families. Nevertheless, decriminalization is a very important first step!

Whether you personally would be comfortable with a home birth or not, it is time to recognize that every mother has the right to choose how she wants to give birth. Some women just want their epidural in the hospital, and that is their right. Others want a natural birth in a hospital setting. Some even want a Certified Nurse Midwife.  If a woman has the right to choose to end the life of her child, then she should certainly have the right to choose where and under what birthing circumstances her child's life outside of the womb will begin.