Emailed to Senator Maria Cantwell of Washington State:

Dear Senator Cantwell,

Thank you for being a champion for reproductive justice. In a just world, a woman would never make a choice about when, where or how to bear children because of what is covered by her insurance. She would not give birth to an unwanted child because an abortion costs more than she can afford. And she would not accept unnecessary routine interventions in a hospital that are paid for by her Medicaid when she would have preferred a cheaper physiologic birth with a midwife. You have shown time and again that you understand these issues, and in this you truly represent Washington state, where poor women can access Medicaid to pay for care with any licensed provider she chooses to see for her pregnancy, be it an abortion provider or a home-birth midwife. The language you championed in the Senate Finance Committee's healthcare bill which would require Medicaid to reimburse any licensed care provider working in a free-standing birth center is a step in the right direction for our nation, and I cannot thank you enough.

As you know, the House of Representatives has shown significantly less respect for women's health and reproductive justice. The Stupak abortion coverage ban is bad policy. Conservatives tout the importance of "patient choice" as an argument against any healthcare reform, but then they single out this one legal medical procedure and restrict women's abiltiy to choose to access that service. The Stupak ban does not maintain the status quo in regard to aboriton access. Rather, it would deny a woman the ability to purchase insurance covering abortion, even when that coverage will be provided soley from funds taken from women's own premiums rather than federal dollars. The Senate is our only hope for ensuring that this affront to women's self-determination does not become law. I know that you will fight as hard against Stupak-like language in the Senate healthcare bill as always do for women and families.

In August, I organized a meeting between a group of moms, dads and midwives and one of your staff members. We spoke about the importance of a real pulic option in healthcare reform, the specific challenges faced by women and young people in accessing comprehensive healthcare benefits, and the importance of midwifery care as part of a full range of reproductive health choices. Thank you for listening. Thank you for fighting for us.

God bless you,

Alison Cole Duren-Sutherland

 

How long have I been making noise for healthcare reform?  But I just can't feel like the House "reform" vote is a victory, though I know it is. But eliminating insurance coverage for abortion is NOT what I had been looking, hoping, and advocating for. Once again, the health of women is a political football. It is not about what's best for us, it's about political expediency, and that's just bullshit. The Stupak amendment is not about ensuring tax dollars don't pay for abortions -- the Capps amendment provided for that, along with the notorious Hyde amendment. It is about restricting women's access to healthcare.

 

Here's what our government says to women:  Making an intimate personal choice to end a pregnancy? No insurance coverage. Want to give birth in the privacy of your own home with a midwife and minimize costly intervention?  You may or may not be covered. Pressured into an unnecessary induction, epidural and cesarean because the ultrasound shows that the baby is big/small/whatever? Where's the checkbook?  At least in Washington State, the government is refusing to pay more for cesareans than for vaginal birth.  At least in Washington State, poor women can get Medicaid to pay for a midwife-attended birth or an abortion. 
 

My tax dollars pay for military action I do not support, and anti-abortion people refuse to allow premiums paid by individual women to go toward abortion coverage within their health plan. Why is my concern for life less valid than theirs? Please defund the Pentagon before asking me to give up my autonomy.  Women (& men) deserve the freedom to make our own best choices with dignity. Legal, covered abortion & homebirth for all women, now!

 

Emailed to TODAY@nbcuni.com:

To Whom It May Concern:

In a segment aired on the Today Show 9/11/09, your station purported to delve into "The Perils of Home Births."  A large portion of the segment was devoted to interviews with a grieving family who had lost their baby.  My heart aches for this family, but their experience does not shed light on the safety of birthing at home, just as the story of one family mourning the loss of a hospital-born baby is not evidence that all births should be removed from the hospital.

Biomedicine purports to be evidence-based, eschewing emotion-based "anecdotal evidence" for the stark light of fact.  However, no scientific evidence was presented in your segment to support the contention that planned home birth with a Certified Professional Midwife is more dangerous for mom or baby that going to a hospital.  As the segment itself points out, more babies die in hospitals (per 1000 babies born there) than at home.  I am surprised, however, that the growing body of evidence which supports the safety of out-of-hospital birth was ignored.  2009 has seen the release of two studies, one from the Netherlands and one from Canada, which support the safety of birthing at home with trained midwives who are integrated into the health-care delivery system.  While the impact of birth experience on an individual family is too important to allow for random assignment of families to home or hospital birth  (as advocates of evdience-based care prefer), the Canadian study especially controls for variables remarkably well by comparing women in similar states of health who were cared for by the same practice.  One important of scientific conclusions is that they must be replicable, and the studies mentioned above replicate the results of a 2005 study of out-of-hospital births with Certified Professional Midwives in North America.  The best available evidence shows that out-of-hospial birth is nor more dangers for mother or baby.  However, out-of-hospital birth has been shown to reduce rates of expensive medical insterventions including surgical birth. 

Finally, it is important to remember that, far from being an advocate for evidence-based practices, the American College of Obstetricians and Gynocologists (ACOG) is an organization designed to advocate for the interestes of OB/GYNs.  Rather than responding to the scientific literature cited above, ACOG has recently been soliciting anecdotal evidence on bad outcomes of out-of-hospital birth.  When the professional organization of hospital birth providers tells us that the only safe place for birth is in the hospital, we must approach this with the same healthy skepticism with which we would approach claims from oil-industry executives on the dangers of wind energy. 

I encourage the Today Show to further the health of childbearing women by featuring a segment on evidence-based maternity care rather than resorting to sensationalized scare-tactics which obscure the facts of this issue. 

Sincerley,

Alison Duren-Sutherland
Homebirth Mom

Emailed to Ben, Senator Cantwell's scheduler: 

Dear Ben, Senator Cantwell, and other staff,

I am writing to inquire about the status of the meeting I requested with Senator Cantwell or her staff to discuss health care reform.  I have attached the request form which I sent in over two weeks ago.  Since then, I have had one other MomsRising supporter and women's health advocate commit to attending the meeting, and many others who are interested but cannot commit until a date has been set, due to work and child-care obligations.  We very much hope to be able to schedule a meeting sometime in the first two weeks of August, with Tuesdays and Fridays being my prefered days. 

I know that so much is happening in "the other Washington" right now, and I'm sure everyone at your office is very busy.  However, I want to remind you that moms have a unique perspective on health care, and sitting down with us to discuss our health care reform priorities would provide some important insight for the Senator and her staff.  Generally, it is women who assist children in accessing health care.  Women often help aging relatives negotiate the health care system.  Childbirth is a major cause of hospitalization in the US, and women are the majority of paramedical staff working in hospitals, nurisng homes, and private physician's offices.  My own experience working in insurance billing has informed my strong desire to see a more streamlined, patient-focused (as opposed to profit-focused) public health plan come out of any reform legislation which passes this session.  I believe that we have many important ideas to offer the Senator to inform the good work she is already doing on these issues, and I hope that she will be able to prioritize meeting with us, her constituents, to disucss these important issues. 

Many thanks for all you do.  Looking forward to hearing from you, 

Alison Cole Duren-Sutherland

Units two and three of the distance midwifery program found to be acceptable by the powers that be.  Now only...9 more units to get feedback on, a final exam to take, my CPM to get.  Hurry up!

I'm looking forward to my workshop at Rainbow Natural Remedies in July, my initial visits with two midwifery clients this week, trying to schedule a meeting w/ Senator Cantwell (or, more likely, her staff) to talk out of hospital birth and the crapiness of the insurance industry in the context of health care reform.  But really, what I'd like is some time w/ Jamie to play Mario Kart Wii and for my broken rib to stop hurting.

Posted at http://change.gov/page/s/yourvision:

Dear President Obama,

I am a mother, student midwife and abortion-care worker.  I am writing to share my experience as a health care worker and consumer both within the Western medical establishment and in the alternative health care field in hopes that it will help you in rethinking the way our nation does health care.

My daughter was born at the beginning of the year.  Being a parent is hard work.  I knew this was true before I was a mom, but I didn't know how true it is.  My ability to rise to the challenges of parenting comes in large part from the fact that I chose to be a parent.  I had access to and coverage for contraception (and, had contraception failed, abortion) to ensure that I would not become a mother until I had the money, partner, and stable home to provide for a healthy, happy child.  I don't know how I could have done this if I hadn't wanted to be a mother.  Poorly-timed pregnancy often leads to poverty for women and children. I know you are committed to access to contraception and abortion, and I want to say only that I hope that any government-sponsored health insurance plan will give women affordable access to the birth control and abortion services that help us raise healthy families.  

In keeping with my desire to optimize the health of my family, my daughter Ramona was born at home.  I was given no drugs during labor, birth or postpartum.  No machines or surgeries were required.  Minimal waste was generated, and all the associated costs of inpatient admission to a hospital facility were avoided.  In reality, most healthy women could achieve this type of  safe, satisfying birth outside the hospital at a huge cost savings to the health care system.  As the British Medical Journal states, "Planned home birth for low risk women in North America using certified professional midwives was associated with lower rates of medical intervention but similar intrapartum and neonatal mortality to that of low risk hospital births in the United States." (http://www.bmj.com/cgi/content/full/330/7505/1416?ehom)

I am studying to become a Certified Professional Midwife or CPM (http://www.nacpm.org/what-is-cpm.html), a non-medical health care provider helping women become active participants in promoting their own and their babies' health during pregnancy and birth.  It is imperative that women receive coverage for out-of-hospital birth and midwifery care by Certified Professional Midwives through any government-sponsored health care program.  In the Scandinavian countries, where infant mortality rates are significantly better than in the US, a much higher percentage of births take place in homes attended by midwives (and there is better access to comprehensive sex ed and contraception).  American obstetrics is opposed to midwifery care in the face of the evidence of it's benefits.  Please consider the midwifery perspective and help promote the Midwives' Model of Care (http://cfmidwifery.org/mmoc/define.aspx) as a way to improve the health of women and children while saving health care dollars.  Generally, our nation needs coverage for alternative health care providers, including midwives, naturopaths, homeopaths, acupuncturists, chiropractors and massage therapists.  Their wellness-promoting styles of practice save money in the long run by fostering health rather than responding to disease once it is already established. 

I recently went back to work at the reproductive health clinic where I worked as a paramedical employee before Ramona was born.  Now I am doing the insurance billing for this small business.  Health care providers desperately need a universal, straightforward, and streamlined electronic system for being reimbursed by third-party payers and accessing patient records.  Again, the money this would save in the long run is not insignificant. 

I hear my daughter stirring, and will go soothe her back to sleep.  Thank you for taking the time to consider my thoughts.  I am praying for your success in all things. 

Very Sincerely,

Alison Duren-Sutherland
Now you go there and post your vision.  He needs our help. 

This morning as we walked out to the car, I realized I had forgotten to get gas, and the tank was empty.  Then when we got out to the car, the windshield was icy and I couldn't find the scraper.  Plus, my heater core had to be bypassed in July because it was making my car fill up with antifreeze smell and overheat.  So now I don't have a heater or the ability to defrost my windshield.  I'm driving my family to the Starbucks from the gas station, so Jamie can buy a New York times and distract the baby from my departure for work, and now I'm running late, and I can't see through my the front window of my car. When I got to the parking garage, the machine wouldn't take my card, and I went to get cash, and returned to see somebody else be able to use the machine, so I tried again.  Still no luck, and now I see that I didn't have to go walk through the cold to get cash, because I already had $10 in my wallet, and plus the parking garage doesn't take cash.  So, unable to feel my fingers, I drive to a different parking place, pay my $10 and go to work to discover that my computer can't find any of the printers, my email, or any of the documents I need.  It just kept going, to.  I ended my day by leaving the breastmilk I pumped today sitting on the counter at work and getting off the freeway at the wrong exit on the way home.   How did I do either of those things?  Today, I was mostly irritated.  

But Jamie was going to get the paper because today is a day unlike any other before it.  The United States of America last night proved that it had the capacity to judge a person not by the color of his skin, but by the content of his character.  Barack Obama has truly given the disenfranchised people in this country and around the world HOPE.  This country can find its president among a group that was once enslaved.  Change for the better is possible.  Driving to work, glaring out of my foggy, smeary windshield, I listened to the radio with tears in my eyes.  Last night, I was in bed with the baby when they called it for Obama.  Hearing snippets of the accpetance speech this morning, and of people's reactions, I realized that it was true.  As they said on the radio, this is aperson they will name schools and streets after.  This is a big fucking deal.  Ramona, and all of her generation, will grow up taking it for granted that the president of the US can be black.  That's the change we need. 

Today was a good, important day that will go down in history.  But for those of us living it, it was also just another day.

I am troubled by Sarah Palin and the furor surrounding her, and yet I'm going to contribute to it by writing this post.  As a midwife, I'm supposed to keep my politics to myself, but as a midwife I have a hard time not speaking out against anyone who would deny women autonomy over their own bodies.  It is a fact that the push for fetal  "personhood" and fetal rights which trump those of the pregnant woman has lead to hospitals getting court orders to perform cesareans on unconsenting women who wish to birth outside the hospital or simply wait to give birth in their bodies' own time (see National Advocates for Pregnant Women for more on this scary phenomenon).  People who want freedom to birth in their own way need to think twice before supporting politicians who want the law to respect the rights of fertilized eggs more than the rights of grown women.  Women need to be trusted to know what's best for their families.  Sarah Palin and her daughter have both made choices about their childbearing that need to be respected.  Women who choose homebirth make choices about their childbearing that need to be respected.  And women who choose abortion are also making valid choices that deserve to be respected.  I have seen women with disabled children choose abortion so that they can continue to provide full-time care to the special-needs child they already have.  It takes more than an antiabortion stance to support special-needs families.  It takes government-subsidized healthcare, childcare, sick and family leave.  I don't agree with Ms Palin's assertion that we necessarily need to reduce the number of abortions in this country, unless she's talking about reducing the number of unplanned pregnancies.  Shaming women into bearing children they do not want and cannot afford while denying them the education to prevent unwanted pregnancy is not valid goal, and that is all that Sarah Palin has to offer if she advocates both abstinence-only sex education and reduing the number of abortions.  But I am more deeply troubled by the way in which Sarah Palin and her daughter are being used by the old boys of the Republican party.  They knew her daughter was pregnant, that she had a disabled child, and they picked her to showcase these ways in which she did her woman duty and chose "life" (note that she had the choice).  They have allowed her to speak freely a total of once so far, and in that interview with Charlie Gibson she was less conversant than most of the people I know on foreign policy.  But she is the Republican's ticket onto the cover of People  magazine, and so what is between her ears is less important than her uterus.  And they can use her femaleness to call foul on any reasonable criticism of her as a candidate.  It will be a tragedy if her nomination leads to the defeat of candidates who pledge to help mothers and families with programs like paid family leave and equal pay for equal work.