Practice Issues – Safety & Cost

Link to HEALTH EVIDENCE REVIEW COMMISSION (HERC) COVERAGE GUIDANCE: PLANNED OUT-OF-HOSPITAL BIRTH Approved 11/12/15 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 […],%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 Introduction: Cesarean section is the single most frequently performed major surgery in the world today. The CS rate in the US, which is […]

Background info to support re-adoption of the Criteria for Client Selection from our previous Standard of Care/current MBC Practice Guidelines for Ca LMs: Recent and definitive info on national birth certificate reporting of NNM in the Linked Birth/Death Data set AND the NNM rate averaged for the last 4 years of LMAR data (over 10,000 […]


Below is a very lengthy excerpt of my letter to MBC staff Curt Worden, providing crucial background information for the August 7th “Interested Parties” meeting. @@@ Unfortunately, I am unable to attend the scheduled Interested Parties meeting scheduled later this week.  I expect someday professionals and members of the public will be able to provide […]


CLIA means the Clinical Laboratory Improvement Amendments of 1988 CLIA INFORMATION IS AVAILABLE ON THE INTERNET AT 12-17-2002 Number 7 on list of glossary terms and definitions: Facilities only collecting or preparing specimens (or both) or only serving as a mailing service and not performing testing are NOT considered laboratories. [emphasis added] GOOD LABORATORY […]