Title: Innovations in Maternity Care Committee Report
Author:
Section/SPIG: Maternal and Child Health
Issue Date:
Focusing on the issues before us has been difficult over the past several weeks. The epic proportions of the ongoing disasters in the Gulf Coast make it difficult to relate to the agenda for the fall meeting. We want to express our sympathy to those who have lost loved ones and our concern for all those who have lost everything. The daily recognition of the needs of the survivors and evacuees complicates our communication.
In addition, we as individual providers have been dealing with massive cuts of public health programs. In Tennessee, where two of the co-chairs reside, the population of the state is facing the loss of publicly funded health insurance for more than 300,000 people. This will not directly affect pregnant women or children under 21, but has a serious impact on women’s health.
The mission of the Innovations Committee is to raise the “hard” questions in childbirth. Why do we do this? Is it necessary? Is it mother and child friendly? Does it help better outcomes? The continued growth of technology has caused loss of control by childbearing families of their birth options.
At this time, however, the basic fabric of childbirth may be threatened as the number of actual providers shrinks in the face of staggering increases in malpractice insurance. This year’s Annual Meeting program is planned to highlight the issues in malpractice coverage. The almost five-fold increase in malpractice is closing birth centers and forcing both low-risk and high-risk providers to reevaluate what they are doing.
“Who’s Left to Deliver the Baby?” will be held on Monday, Dec. 12, 2005 from 4:30 – 6:30 p.m. Charles Mahan has agreed to be the moderator for this session. We have several presenters looking at the issues of who is delivering and what the barriers exist to receiving adequate maternity care. The business meeting for the committee, which will follow this session, is a great time for input into what the group is doing. We are looking for increased participation from the committee, as both committee chairs have other section responsibilities within APHA for the next two years. The committee is also scheduled to have a poster session
There is a need to establish a national conversation on malpractice for essential providers. Recently Senator Frist (R-Tenn.) visited a birth center in eastern Tennessee which is a nurse midwifery practice. The visit is covered on the ACNM Web site as well as <www.BirthCenters.org> and the Senator’s own Web site. Check out our news coverage at <http://dpa.xtn.net/> and <http://mca.xtn.net/>. The birth center and other rural obstetrical providers whose practices include over 50 percent Medicaid patients are requesting Federal Tort Claim coverage for their services. However, the proposal for legislation has been somewhat put aside by the immediate needs of Katrina.
Beyond the topic for the Annual Meeting, these issues regarding access to and quality of maternity services will need to be addressed. The committee will be working with the overall Section to plan a strategic approach to these overwhelming concerns. An online survey of access problems as well as malpractice insurance increases is being considered. The loss of federal Maternal and Child Health Funding will only make these problems more difficult in each state.
Comments, questions, concerns….please email Barb Levin at <BarbL11@aol.com> or Carole Nelson at <cpmcnel@usit.net>. Thanks for the time and the effort. We look forward to seeing you at the rescheduled meeting in Philadelphia.
(Editor’s note: The problem of malpractice coverage is, of course, not limited to rural health care delivery settings – see the news story below on the D.C. Family Health and Birth Center.)