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	pregnancy & birth midwives & doulas

What's A Mother To Do?

Kate Bauer, executive director of the National Association of Childbearing Centers (NACC), knows that simply having evidence that nurse-midwifery and birth centers provide more cost-effective and higher-quality care does not necessarily mean that legal barriers will be lifted. She suggests several ways that midwife- and birth-center proponents can help further their cause:

Write to your insurance company to say that you want the option of midwives and birth centers available. Insurance companies pay attention to what their clients want.

Talk or write to your employer's health-benefits coordinator, who often sits across the bargaining table from insurance carriers to develop the plan your employer offers.

Talk to your healthcare providers about nurse-midwives. Suggest they read Judith Pence Rooks's Midwifery and Childbirth in America (Temple University Press, 1999).
Help educate the public about the benefits of midwifery. Take an NACC video to a local Kiwanis meeting or make a presentation about nurse-midwifery to your PTA. Communities that are supportive of midwives and birth centers are educated communities; do your part to spread the word.

Go on-line and learn. Check out the websites for NACC (www.birthcenters.org), the Midwives Alliance of North America (MANA, www.mana.org), and the American College of Nurse Midwives (ACNM, www.midwife.org). ACNM's website has an extensive political-action section that includes information about current issues and priorities, including the CNM Medicare Services Act, a bill that would raise Medicare reimbursement for CNM care from the current 65 percent of ob-gyn rates to 95 percent.

Write your local, state, and federal government representatives and urge them to support the inclusion of midwives in maternity-care legislation. (The ACNM website offers sample letters.) Let them know their constituents support having the options of midwifery care, birth centers, and homebirths.

Currently, women are being denied their full range of choices when it comes to maternity care and childbirth. The issue is choice, whether you want to birth in a hospital, a birth center, or at home. "It's a right, just like a woman's right to have an epidural," Bauer says. "It's important that people realize you're not saying that every woman should birth in a birth center or with a midwife, but that every woman should have the choice."

Elissa Y. Sonnenberg, a freelance journalist based in Cincinnati, Ohio, specializes in issues of women, children, and families. She and her husband, Jim, have two sons, Nicholas (5) and Owen (3).