Director Humble,

As part of these discussions, it is imperative to remember the rights of individuals to make decisions based upon their own risk-benefit analysis. No doctor, of any profession, is allowed to force their wishes of care upon a person. The health care provider, instead, is obligated to give informed consent to the individual directly in their care, and must step back to allow the individual freedom of choice. Mothers birthing children should NOT be subject to any other conditions or requirements-it is their SOLE decision, and they must live with the outcomes of their choices as anyone else is expected to.

A doctor who is interested in forcing their way of care onto a patient, I would argue, has ulterior motives, financial or otherwise, and their bias must be considered. A mother should have her freedom of choice in healthcare options and that right should be unequivocally protected by law, regardless of her birthing circumstances. By placing undue restrictions on mothers, they are left with poor choices and can not seek proper care.

I am a mother of two, middle- to upper-income, college educated, who birthed my first, and will birth my second at home in March. Please do not allow me to be classified as a “dirty”, “uneducated”, “poor” woman who must be saved from herself. I assure you my choice of home birth was a well-educated decision. Please, Director Humble, protect my rights to make these decisions for myself in the future!

Thank you for your time and consideration.

Dear Director Humble,

Having watched the video of meeting #3 and attended meeting #4, I came away feeling disappointed at the tone that some members of the committee seem to have toward homebirth midwifery. It seems there is a perception of hospital-based professionals as being the primary bearers of knowledge and skills for birthing, and that obstetrical doctors are merely allowing midwives to attend births out of the hospital.

In reality, midwives have been shepherdesses of the birth process for the vast majority of births throughout human history, as well as around the world today. No one on the committee would be there if not for midwives assisting their ancestors during homebirth. There is a rich tradition of knowledge and experience in the midwifery field, as is evidenced by the collaborative practices in other western nations.

Why is the committee not starting from this perspective of honoring a long-standing and effective model of care, and *then* moving on to discuss details about meeting consumers demands for safe and supported VBAC/breech/twins at home? In the *fourth* meeting, why is there even discussion about how many degrees which care provider has, or seeking approval from OBs, or notifying hospitals for all homebirths? These are not statements that come from a cohesive acceptance of midwifery being a time-honored and effective methodology for serving birthing mothers.

It seems that the homebirth midwives and their supporters are having to expend quite a bit of energy on defending an already-proven and well-honed profession, rather than brainstorming ideas for creating a successful continuum of care for a mother who is planning a HBAC/breech/twin birth, in the possible (yet statistically unlikely) event that she should need to transfer. Time is being wasted that could be spent creating real, innovative, and consumer-honored solutions.

To that point, there are already midwives legally assisting in HBAC deliveries (CPMs). Perhaps the committee could invite a presentation from these midwives to share their current experiences in providing informed consent, providing prenatal support to these women, experiences during labor and birth, experiences with transport if needed, etc. I hear discussion about the VBAC experience in the hospital, but I don’t hear the committee discussing what is currently and legally happening during a midwife-assisted VBAC at home.

I encourage the members of the committee and the AZDHS staff to reorient themselves toward the understanding that the profession of homebirth midwifery is long-standing in its own right, has been serving Arizonans very well, and is not in need of hand-holding or additional restriction from another profession. Midwifery is not a sub-set of obstetrics and midwives exist by the demand of consumers, not by the permission of obstetricians.

Please focus the discussion on creatively addressing the consumer demands for homebirth in the cases of VBAC, breech, and twins, and spend the committee’s energy on developing strategies to make these births incredibly successful experiences for the families, in the location of their choice.

Thank you so much for all of the time and energy you and your staff have put in, and continue to devote, to this important cause.

Warmly,
Rachel Davis

Oliver Wendell Holmes wrote:“I detest a man who knows that he knows.” Exchange man, for woman, and I suspect the persons contributing to the continuing of midwifery licensing may have a tendency towards these types of thoughts as well. Women KNOW birth.
I know that I know birth.

The discussion here should not be safety and statistics. Those are, perhaps, debatable and interpreted differently and often times denied and ignored. What IS NOT debatable-what SHOULD NOT be up for debate EVER-Is the issue of the authority and responsibility that only a woman can have for her unborn baby and for her birth.

We will not achieve freedom through pragmatism and oppression of parental rights and responsibility. The picking and choosing of what pregnant women will be “allowed” to do is deviant and despicable on the part of people making and supporting these decisions.

As a woman in this state, I DO NOT CONSENT to these licensing laws that diminish my freedoms.

The state does not belong in a position to make decisions about the way women are carrying babies and giving birth. Defining terms of position, times for placentas, impossible requirements for vbac – is appalling (not to mention NOT supported by evidence of normal birth). We may as well be regulating the beating of the heart, the function of the eyes, or the timing for digestion. It is the epitome of self-indulged arrogance.

Some may feel non-regulation is dangerous. Fine! That is an opinion. What is not acceptable, what is criminal, is the invasive laws placed on families, on women, when people presume to be qualified in defining parameters for birth. Only the woman is qualified to determine these parameters.

All midwifery law should be abolished. Insurance reimbursement be ******. Midwifery should not be requesting MEDICAL insurance for NON MEDICAL life events in the fist place. There is only one sentence that is needed, to rightfully govern and PROTECT women and babies and families “ “Women have complete jurisdiction in their births; giving birth where, how and with anyone (or no one), of their choosing.”

As a mother of 5 and one that chooses to birth privately, without a midwife or doctor, I am incredibly disturbed and disgusted by the tyranny, in the guise of humanism, that is being played out in this discussion of midwives and their rights. There are no midwifery rights without mother’s giving them those rights; the decision belongs not to the state or midwife, but to the mother. I can guarantee that women will awaken and realize they have been sold for a bowl of soup. Then, they will seek out those that serve – not those with divided interest between state and self-preservation -but those that serve them wholeheartedly and selflessly.

No two women are the same in their birthing needs. There MUST be provision made for this. I want acknowledgment, in the law, that women have the inborn, inalienable right to give birth where, how and with anyone that they choose. Including non-licensed midwives.

Director,
I agree a women can choose to have anyone present at her birth that she wishes. However, some women would like to choose to have a licensed professional present who is supportive of normal, non-interventive birth, yet is capable of detecting potential complications and refers to EMERGENCY care as appropriate without having a physician dictate any form of control in the matter. That is exactly where a licensed midwife fits into the picture. The fact is, OB’s have a toolbox full of interventions to assist in rare birthing circumstances and/or complications, however, in today’s practice, these interventions are being implemented far too often as “control” measures because of fear. This is perpetuated in the way the current draft rules are written by requiring a midwife to have a back-up physician sign for her license. This is equivalent to requiring an individual who wishes to get a driver’s license to have an ER physician agree to take care of them in the event of a car crash! PLEASE ensure that those requirements are REMOVED in their ENTIRETY to preserve women’s freedom to have whom she wishes to be present at her birth, as you assert a woman has.
Thank you.

Director Will Humble:
I would like to continue to have access to homebirth midwifery in Arizona…
Therefore, the proposed section on requiring a backup physician in the proposed rules/regulations MUST be struck!!
Please do not make midwifery illegal by maintaining that requirement!
Thank you.