Kansas CNM being investigated for attending an out of hospital VBAC

[lorijds]

I just received this in my email box; please lend Kirsten your support. The implications of this decision could be far reaching. I don't know if our Birth Center could continue to attend VBACs if this is decided against Kirsten. I don't know if this would limit lay midwives as well, as they are not covered under the nurse practice act, naturally. However, my concern would be that attending an out of hospital VBAC will be labled as practicing medicine without a license, which would then have implications for the direct entry midwives of Kansas

I would also like to add that we are seeing a huge shift in the state of Kansas in regards to VBAC policy. To my knowledge, on the hospital in Lawrence, the hospitals in Wichita, and the hospitals in KC are attending VBACs; for the rest of the state, once a section, always a section. This is terrible, and it looks like it is going to get worse before it gets better. Please, lend us in Kansas your support. We need it!

Thank you, ladies. I know I can always count on you!

Lori Strecker
www.topekabirthcenter.com

If you have any questions, you can contact me at [e-mail]

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Kirsten Miller wrote:


The first person I told about this, via email,*was Eva Gavin.* At that time I asked her to keep it to herself until I was ready, if ever, to "go public".* I am glad that ICAN knew of the situation as I appreciate their support.* I am glad that my need for privacy was honored in that my name was not used.

*

At this point, 3 weeks later, I am ready for it to go public, as I think there is much to be gained and/or lost for the women of Kansas who have ever had a cesarean section.* My attorney is a Christian man who is of the mind that the board of nursing may choose to set a precedent in their decision in this case.* And I'm thinking, even if they don't know it, IT WILL set a precedent, whichever way they decide.* I don't mind if this information is distributed to the midwifery community because I think it is important for women to take action.

*

The Board of Nursing is responsible for investigating any complaints they receive about a nurse licensed in the state of Kansas.* They received a complaint that I attended an out of hospital trial of labor after cesarean section (TOLAC).* I did.* The letter I received stated that the BON had received information that I "may have violated the Kansas Nurse Practice Act" by attending the attempted out of hospital VBAC.*This is not illegal as CNMs may practice in the home setting, as long as they are practicing in collaboration with a physician who has, with the CNM,*mutually adopted practice guidelines.* These requirements were met.

However, our local hospitals don't offer VBAC.* At issue is" Should a CNM be allowed to do so out of hospital?* I think this is a turf war.* Or perhaps the complaint was filed to scare me.

*

The BON has the responsibility to collect all pertinent information to the case and make a decision about what, if any, discipline will be administered to the nurse. (me)

*

I would like to ask for support from the ICAN and midwifery community.* If anyone is so inclined, they may contact the primary investigator to respectfully give their opinion about how the case should be decided.* I believe that the decision to have an out of hospital VBAC should be made between a woman and her health care provider.* If the BON decides that CNMs may no longer attend out of hospital VBACs, it severely limits patients choices.* It takes away their right to have a midwife who has hospital privileges and who can continue to provide care for them if a transfer becomes necessary.* I don't think out of hospital VBAC is a good idea for every woman, but I do think the decision should be made on an individual basis, depending on many factors.* I would hate to see it become impossible for a woman in Topeka*to choose vaginal birth in a safe environment.* The only reason I offer it to carefully selected women is because the only hospital choice Topeka women currently have is repeat cesarean, a major surgery with inherent risks.

*

I would appreciate your prayers for me personally as well as the outcome of the investigation.

*

The investigator's name is Karen Peschka, RN.* She can be contacted at:

[e-mail]

785-296-2696

*

My only 2 requests are this:

*

1.* If any of the contents of this email are forwarded or discussed, please forward my*entire email message so that it doesn't turn into rumor.

*

2.* If anyone contacts Ms. Peschka, please be respectful.* I don't want an outpouring of support to get nasty and sour their opinion of midwifery.

*

Thanks,

*

Kirsten Miller, RN, MSN
Certified Nurse Midwife
keeping birth normal
www.topekamidwife.com
785-845-4328

[Kiki Runs]

I am so saddened to read this.....for a while early on in this pregnancy (which WILL end in a VBAC), I was considering staying at my mom's house (western KS) and having a homebirth there. I didn't get far enough along on that "plan" to even start checking the (#*% "legalities" (and it so pi$$es me off that there could even BE legalities for MY birth).

You've got me thinking, though. I am not sure of the hospital's policy on VBACs in my hometown. I know both the docs who would be attending personally (family practice - only ONE in town, lol) and I know that as PEOPLE, they would both be supportive and understanding of my wishes, I just didn't get far enough along in my planning to check on the hospital's "official" policy on VBAC. However, being as isolated as the town is, even if the hospital was HUGELY supportive of VBACs, it wouldn't really help many Kansas mamas, KWIM? But also b/c of how isolated it is, as long as I was fairly far along in labor before I showed up at the hospital, there wouldn't be much they could do about stopping a VBAC (and I don't believe they would truly do much past stating a token "official policy says no", before they just went ahead and attended).

The closest hospital that's probably as "safe" as the ACOG recommends :eyeroll is an hour and a half away... Honestly, knowing these two docs, if a mom was set on a VBAC (and didn't rush to the hospital the instant she thought she was in labor), she'd probably get it.


That said.....I don't believe there probably is much demand for (or even knowledge OF) VBACs in my hometown. I couldn't tell you one mama who's VBACed. Obviously, I don't know the reproductive history of every woman in town, but when I was back this summer, I was VERY outspoken about VBACing this time, and I did not ever hear "Oh, so-and-so did that". I believe that the WOMEN of my hometown are of the "once a c/s, always a c/s" mindset, not necessarily the docs. I couldn't tell you if the docs offer VBAC as an option or not, but I would bet there just isn't much interest. People were SHOCKED when I told them I would VBAC - I'm talking dropping jaws, fumbling for words, "isn't that dangerous?" SHOCK. I'm betting that once a mama in that town has had a c/s, the only thing she's interested in with subsequent pregnancies is when the r/c/s will be scheduled.


Sorry, I'm just rambling on.... I think I'll have my mom ask the docs next time she sees one if they "allow" VBACs at the hospital. I'm really wondering if the hospital has even established an official policy about it, b/c it's probably a non-issue! Hmmm.....

Anyway, Lori, I am so worried about this. I will be sending positive energy toward the situation and hoping the BON will make the right decision for VBACing mamas and VBAC-attending midwives.



Is the future going to be scheduled c/s for ALL mamas? This is so frustrating!!

Kinsey

[Kiki Runs]

Lori, do you have any updates on this? I've been thinking positive thoughts....

Kinsey