September 2014: First midwife goes to court. Enforcement against our beloved midwives is increasing hugely! This is an atrocity! Midwives who give good care are being prosecuted! Read this brave midwife’s story on her blog.
October 2013: Midwives pulled the Sunrise application due to unfavorable legislators. This problem still needs to be addressed!
August 1, 2013: In creating a stir with the rule change it was brought to our attention that medications might be a challenge for midwives. We support the midwives in their Sunrise process to obtain, carry and administer medications.
July 1, 2013: The new midwifery rules came out! We got VBACs and Breeches!!! The VBAC and Breech rules go into effect in 1 year! There is a host of other things that were changed in the process. If you want to check out the new rules go here.
June 3, 2013: Was our final meeting as the Midwife Advisory Committee. AZDHS recorded all 7 sessions. You can find the recordings on their website.
December 4, 2012:The Midwife Advisory Committe Meeting is December 17, 2012 at 2pm at AZDHS. If you can go to the meeting, please do! It is so important that we have consumer support. If you go, please wear black and hold a piece of paper with the word CONSUMER written on it. We will also have t-shirts for $5 or donation at the door. The department needs to see this is consumer driven and not just the midwives that want these changes to take place. Thank you!
November 27, 2012: The first Advisory Committee meeting was held. Fairly unproductive with the exception of meeting all the other members and hearing a bit from them. Our main walk away was WE NEED YOUR SUPPORT!!! We (consumers) must come in full force next time! Our voices must be loud! We are asking for this and if we really want change like we say we want change we need to let the world know! The advisory committee will meet again soon. We will post the date and time of the meeting as soon as we find out. After participating in today’s meeting, I CAN NOT express how important it is for consumers to let their voices be heard AGAIN! Your presence at the next meeting matters! The committee and the Health Department NEED to hear and see you. There is time for public comments at the end of all meetings. Members of the public will have a VERY brief amount of time to speak. The committee NEEDS to hear your voice! Even if you don’t want to speak at the meeting, your presence speaks loudly! In the meantime, consider drafting an email to those at the Department who will be writing the rules. You may have written in the past, but it never hurts to remind them of the changes you want to see. It doesn’t have to be long. It can be as simple as, “I am a consumer of out-of-hospital” birth and I want to see (insert whatever change you want) because…” You can write about why you chose an out-of-hospital birth. You can write about why you could not have a midwife attend your birth because of current rules. (Please see “where to write” tab)
March 14, 2012: The bill passed through the 1st reading by the health committee in the SENATE unanimously!!
HEARING OF HB 2247 IN THE HOUSE
Wednesday February 1, 2012 at 9:00am, our bill HB 2247 was heard for the first time in the House of Representatives. The bill passed with no opposition! Thanks to all the midwives, midwifery students, and consumers that showed up for the hearing. It made a big difference. To those of you that could not make it, thank you for signing the petition, you were all there is spirit!
On January 23, several consumers and midwives met with lobbyists from organizations such as the Arizona Medical Association and the Nurses Association, among others. The lobbyists believed that the bill, without the amendment, did not allow enough time for public comment and did not provide a 3rd party review, both of which are present in the regular rule making process. After much deliberation, we agreed on an advisory committee and more opportunity for public input. Currently the advisory committee is made up of the following:
1. Two midwives who are licensed pursuant to title 36, chapter 6, and article 7, Arizona Revised Statutes. (2 Licensed Midwife)
2. Two public members who have used or who have significant experience with midwife services. (2 Consumers)
3. One physician who is licensed pursuant to title 32, chapter 13, Arizona Revised Statutes, and who has experience in obstetrics. (1 MD with OB experience)
4. One physician who is licensed pursuant to title 32, chapter 17, Arizona Revised Statutes, and who has experience in obstetrics. (1 Osteopath with OB experience)
5. One physician who is licensed pursuant to title 32, chapter 13 or 17, Arizona Revised Statutes, and who specializes in family medicine. (1 MD or Osteopath specializing family medicine)
6. One nurse midwife or nurse practitioner who is licensed and certified pursuant to title 32, chapter 15, Arizona Revised Statutes. (1 CNM or RN)
The original bill, without the amendment, would have resulted in ADHS opening up the rules. Will Humble, the Director, told us that he would task his medical directors (MD’s, OB-GYN’s, Family Dr’s) to come up with recommendations related to specifics around scope of practice. There would have been limited opportunity for midwives or consumers to present information. He would be getting his recommendations from medical directors, which would act as his advisory committee. This is the typical rule making process under the exemption. Without the amendment, there would be no place for midwives on Director Humble’s unofficial advisory committee.
With the amendment, midwives and consumers are given a formal avenue to request a scope change, and a way to present evidence to the Director. A committee, with equal representation from the medical community and midwives will comment and make recommendations to the Director. Before this amendment was created there was not equal representation.
This advisory committee is not permanent, as it is included in session law and NOT written into statute. It only applies to this specific rule revision and will not be used for future rule revisions. Midwives will be putting together a report in which they will state what rules they want changed and supporting evidence. The consumers will also be gathering information and research to add into this report regarding the changes we would like to enact. This report will be presented to Director Humble, who will then meet with his rules committee and create a draft of the proposed rules. The Director will publish the draft on his website. Within 60 days after being published, there will be a public meeting of the advisory committee to consider any public comments on the report. The advisory committee will be given the chance to make recommendations based off of the proposed draft of rules. The director will then consider everything that was said from the advisory committee and he will draft a final draft of the rule changes and will publish it on the website which will be open for public commentary and a public meeting.
The advisory committee can agree or disagree on certain things but ultimately Director Humble will make the final decision of the rule changes, which has always been his authority. Fortunately, we get to participate and make our suggestions.
There are some concerned with the advisory committee because licensed midwives are not in the majority. If we consider the LMs and the consumers as the voice for midwifery there is an equal representation for the medical community and the midwifery community, which is more than we had before. However, the concern that the equal balance may not be strong enough to allow for the changes we hope to make are valid. We are working with lobbyists to try to make changes in the advisory committee, making the midwifery community in the majority. As stated, steps are being taken to make changes. It must be understood that the changes may not be able to happen without destroying the support we have gained from the opposing lobbyists. Some may wonder why we need the support from the lobbyists. It is very simple, these lobbyists have a great deal of power. If they vote against our bill, they have the ability to destroy all of our work by have a simple conversation with a representative. That being said, we must be very careful in how we approach this issue.
There have been some calls to kill the bill. This is not a prudent course of action. The bill still has a bit of a process before it will be officially passed. We should use this time to work with lobbyists to modify the amendment.
There is absolutely no point in killing our bill. We have worked so hard to get to where we are right now in the process. The concerns that are being expressed are very real and we appreciate everyone’s concern. We do believe that we currently have a very strong bill and amendment. We believe that this bill will pass through the House and Senate without a problem. We believe that the bill, with the current amendment, will allow us to open up the rules and regulations and have great success in updating the rules. As consumers, we deserve to be cared for by midwives we are able to practice according to the current standard of practice. We will not sit back and wait. We will fight for it now!
2/1/12: The Health Committee of the House PASSED HB2247 UNANIMOUSLY today!!
1/12/12: We have come great lengths in our process to open and update the rules and regulations governing midwives here in the state of Arizona. A few months ago we met with Will Humble, the Director of Health Services. All attendees acknowledged and recognized that the rules and regulations are out of date and need updating. We left the meeting with our heads held high, smiles on our faces, our homebirth ralliers still down stairs supporting us, and some of our “next steps” in mind. We were so graciously given the opportunity to meet with Colby Bower, Chief Legislative Liasion at Arizona Department of Health Services. He gave us a quick overview of the legislative process which I have to say was extremely helpful. We left the meeting with a better understanding of the legislative process and a few people to contact in hopes to obtain someone to sponsor our bill. About a week later, we had a meeting with Senator Ash to explain our bill and our goals. The meeting went great, he is in support, and we secured him as our sponsor! Cecil Ash is the head of the Health Committee in the House, so having him as our sponsor means that:
1. He is in support of this bill
2. The bill has to be heard by the head of the Health committee before it can move on any further in this process
Our next step is to contact all of the Senators’ on the Health Committee in both the House and the Senate. Now that we have the support of the Head of the Health Committee in the House, we wanted to make sure the Head of the Health Committee in the Senate would be in favor of this bill as well. We had a meeting with Senator Nancy Barto, Head of the Health Committee of the Senate, and she was in total support of our bill. She thanked us for running this bill and taking our time to make this issue an important one, which it is!
We have a few meetings setup for the next couple of weeks. We hope for the same outcomes. Everyone we have spoken to has seemed genuinely interested in what we have presented them with. Our hearts, heads, and voice is strong as we continue this process.
~ We are currently hopping through the loops of legislation. We have found a Senator to sponsor our simple bill. We will need people’s voices like never before to tell your legislators to vote in favor of this bill.
~ The petition is closed. We gathered over 2000 signatures! Good Work!!
~ The surveys are still around. If you have not picked one up and filled it out please contact us and we will send you one electronically.
~ Letter writing will always be an activity that is needed. Your voice is powerful and the only way to be heard is through letters and phone calls. Direct your efforts to everyone on our “Where to Write” page.
~ Advocates try to meet once a month for planning and activities, such as writing letters. Keep checking in with this site or Facebook for the next meeting date and time.