Report on the First Mfry
Council Meeting ~ March 9th, 2007
By Faith
Gibson, LM
As most of you probably already know, in
February 2007 I was appointed to the Midwifery Advisory Council
of the California Medical Board at the Division of Licensing
meeting, along with LM Carrie Sparravohn, Karen Ehrlich, Barbara
Yaroslavsky (MBC consumer member), and obstetricians Ruth
Haskins and Guillermo Valensuela. .
On Friday, March 9th, at the
first Council meeting, I was elected Chair of the Council and
Ruth Haskins elected Vice-Chair. I feel that she and I will be
able to provide dynamic leadership and am very happy to have
this unique opportunity. One of the responsibilities of all
Council members is to speak only for the consensus of the
Council, rather than any personal or professional opinion.
Another is to follow the rules laid out in the Keene-Bagley Act,
which govern public meetings.
As Chair, I am committed to fairly
representing all licensed midwives, to presenting a unified face
for the Council’s opinions, policies and activities and to do my
best, in conjunction with the other 5 members, to make the work
product of Midwifery Council be to the benefit of childbearing
women, the midwives who serve them and the agency that regulates
us. In that way, the Council will also serve the legislative
mission of the Medical Board, in regard to consumer safety, and
the goals of State of California, relative to improving access
to cost-effective maternity care for all California residents.
In order to be sure that everyone on the Council, regardless of
personal or professional background in the history and politics
of midwifery and medicine, I compiled an 3-ring informational
binder for each members of the Council, plus an archival
copy for Kathi Burns, in the MBC
office. Topics covered this time can be accessed by
clicking on
this link.
Other topics and documents will be added at subsequent meetings of
the Council.
Gary Qualset, director of the Division
of Licensing, suggested that topics which are felt by LMs
around the state to require the time and attention of the
Midwifery Council should be sent as a brief (but informative)
request to the DOL, to the attention of Kathi Burns. As time
permits, they will include them in the agenda at one of the four
Council meetings which will be scheduled each year.
The next Mfry Council meeting is
tentatively scheduled for April 17th in Sacramento at the
Medical Board’s Howe Ave facility. Starting time will be 11 am.
The main agenda item will be implementation of SB 1638 through
the development of a list of the reasons and complications for
each stage of midwifery care relative to transfer of care for
PHB clients. Preparatory information for this task will be on
the MBC web site and also the public notice of the meeting time
and agenda will be mailed out at least 10 days in advance of the
date.
Finally
– A Midwifery Council!
It’s been a long legal journey for
traditional midwifery since the 1976 Bowland Decision which
ruled, for the first time, that the practice of midwifery
without a state license was an illegal practice of
medicine. That California Supreme Court decision offered only a
‘legislative remedy’ i.e., passage of a new law, either to
exempt the practice of midwifery or to license it. It was the
consensus of practicing midwives, home birth parents and
California legislators that licensing was the preferred option.
Over the next 13 years (1977 to1993) there
were six legislative attempts to pass a midwifery licensing law
before the LMPA was signed into law in October of 1993. Since
1999, there have been three attempts – all unsuccessful -- to
replace the legally impossible mandate of physician supervision
with a consultation and collaboration relationship. However,
Senator Figueroa and Linda Whitney at the Medical Board helped
midwives legislatively amend the LMPA 5 times, to correct legal
problems and make it work better for us, for midwifery students,
and for the families we serve.
While the LMPA and its amendments have been
hugely successful in many ways, there still was an additional
problem, namely the Medical Board’s regulation of licensed
midwifery, without having any representation by licensed
midwives. In order to be appointed to the Medical Board’s
governing body, one must either be an MD or a “public member” –
defined as a person NOT licensed by the Medical Board. What that
meant was that LMs could never serve on the very Board that
regulated them.
Finally, ten years after the first midwife
was licensed, we have a process for representing ourselves in
the regulatory process. How did this wonderful thing come about?
I believe that mothers and midwives have
been able to make a positive impact on the century-long culture
of prejudice against normal birth and midwives, at least as
those beliefs are reflected in our licensing law, because we
relied on the same underlying principles in our political
efforts that are successful in regard to the successful biology
of spontaneous childbirth. In biology, this begins with a basic
trust in the normal physiology of labor and birth, patience with
nature, and the right use of gravity. In the political realm,
that can best be described as a fundamental respect for and
trust in the ‘system’ – the basic goodness of human nature and
the justice inherent in our democratic process.
In addition a fundamental sense of trust,
we also had the collective wisdom to accept the reality of the
situation at each step along the way and to do the best where
ever we found ourselves, with whatever we had at hand. Sometimes
it was nothing more that just the hope that eventually things
would get better.
Working
with the “labor” you have, instead of the one you wanted
As every mother and midwife knows, you have
to accept and work with the imperfect labor you get, not the
perfect fantasy labor you imagined. For us as birth activists
and advocates, this is an important concept. We are justifiably
outraged over the fundamental injustice of our situation.
However, whenever we let our sense of umbrage fuel our actions,
our energy is dissipated in raging against an unfortunate past,
rather than working for a better future. We have a really big
job ahead of us, both in relation to the regulation of
California licensed midwives and the core issue –the need to
rehabilitate our national maternity care policy for health women
with normal pregnancies.
Luckily for midwives, we have chosen to
work with the political “labor” handed to us by the Fates. This
meant having ‘patience with nature’ (both human and political!),
consistent persistence, a willingness to go with the flow and
the wisdom to honor the hard work of all the parties who shared
this journey with us, including consumer activist organizations,
State Legislators, Medical Board appointees and the hard working
staff of the State agency. A lot of people played a part -- some
big, some small -- but all were crucial absolutely to achieving
this worthy goal.
I believe that we have already righted many
of the wrongs of history and are part of a fundamental shift in
the nature of maternity care, to rehabilitating our national
maternity care policy, to bring about science-based care for
healthy childbearing women and to a harmonizing of the
relationship between the obstetrical profession, normal birth
and midwives.
Our time has come. As with any human
endeavor, we will lose our way from time to time, there will be
missteps, misunderstandings and sometimes we will have to
backtrack, we will get discouraged, but nonetheless, we will
prevail.
Warmest Regards,
Faith Gibson, LM, CPM
Executive Director, ACCM/California College of Midwives
Midwifery Advisory Council Member/Chair
