21st Century Healthcare in US

Link to HEALTH EVIDENCE REVIEW COMMISSION (HERC) COVERAGE GUIDANCE: PLANNED OUT-OF-HOSPITAL BIRTH Approved 11/12/15 http://www.oregon.gov/oha/herc/CoverageGuidances/Planned-out-of-hospital-birth-11-12-15.pdf Oregon-collected data on planned out-of-hospital birth –> pages 33 & 34 In 2011, the Oregon Legislature passed House Bill 2380, which required the Oregon Public Health Division to add two questions to the Oregon Birth Certificate to determine planned place of birth […]

https://www.aap.org/en-us/advocacy-and-policy/state-advocacy/Documents/2013%20CCHD%20Newborn%20Screening%20Bills,%20Regulations,%20and%20Executive%20Orders%20-%20AAP%20Division%20of%20State%20Govt%20Affairs.pdf Assembly Bill No. 1731 CHAPTER 336 An act to add Article 6.6 (commencing with Section 124121) to Chapter 3 of Part 2 of Division 106 of the Health and Safety Code, relating to public health. [Approved by Governor September 15, 2012. Filed with Secretary of State September 15, 2012.] legislative counsel’s digest AB 1731, […]

A Better Way ~ opportunities to improve the maternity care & the VBAC situation in California: What society needs is a rational system for providing ‘mother-baby-father-friendly’ maternity care, one that functions logically for childbearing families by meeting their practical as well as biological needs. The goal is nothing less than affordable, accessible, women-centered, mother-baby friendly […]

Work-n-Progress ~ last edit Aug 18, 2015  The Magnitude of the Post-Cesarean Problem in California and its affect on childbearing women and their midwives Over 600,000 babies are born in California every year. With a 33% Cesarean section rate, around 200,000 women are added to the post-Cesarean/potential VBAC pool each year. Not all of them […]

Part 3: Ethical, Economic, and Personal Costs of a high-Cesarean/low-VBAC rate As fully described in Part 2, the multiple serious complications caused by placenta previa and/or and placenta accreta-precreta are not routine childbirth problems that are prevented by new obstetrical technologies or easily solved by modern obstetrical techniques. Instead they are extremely serious, often life-threatening […]

Part 2: Risk of Primary and Repeat Cesareans and the Unintended Consequences of VBAC bans by hospitals and obstetrical groups As discussed in part 1, hospitals and obstetricians attribute policies banning VBAC to their concerns over possible lawsuits. Viewed from this perspective, there may be a legitimate economic reasons for hospitals and obstetrical practices to […]

 The VBAC Controversy and Ca LMs Part 1 ~ VBAC in California ~ Access-to-Care & Denial-of-Service Issues Adapted and expanded upon from Jan Kemal’s VBAC article posted on the Science & Sensibility website http://www.scienceandsensibility.org/?s=vbac Introduction: Cesarean section is the single most frequently performed major surgery in the world today. The CS rate in the US, which is […]

Part 3 ~ Part 2 chronicled the the history of how Twilight Sleep drugs, episiotomy, forceps, manual removal of the placenta and other interventions became the standard for normal childbirth services in the US from 1910 to 1980. The relationship of the obstetrical model to normal childbirth has changed very little since obstetrics was standardized in […]

Click here to read Part 1 ~ How the maternity care system (care for healthy childbearing women) in the US originally became illogical  Part 2 ~ Obstetrical management of normal childbirth ~ 1910-1980 By 1910, the ‘standard of care’ for normal childbirth as defined by the new surgical discipline of obstetrics and gynecology was (no surprise!) an […]

This is a preamble to the California College of Midwives’ formal statement on VBAC. The high-profile need for VBAC services is a direct result of the high CS rate in the United States. VBAC has become particularly controversial because 50% of California hospitals ban VBACs; a large proportion of obstetrical practices refuse to provide obstetrical care for a normal vaginal birth after a […]