Midwives

Women would have easier access to nurse midwives under a bill that passed the Senate in Annapolis yesterday. Senators voted 46-1 to require health plans and HMOs to let their members go directly to certified nurse midwives for obstetric and gynecological care. The House of Delegates has overwhelmingly approved a similar measure. The two chambers must work out differences between the bills before the General Assembly session ends April 10. Alice J. Neily, lobbyist for the state's 200 nurse midwives, said the legislation would provide "very significant" health care benefits for women.

 The obstetrics unit at Maryland General will close June 30th displacing 10 to 15 doctors and midwives. The news was first reported in the Baltimore Business Journal. The University of Maryland Medical System, which owns Maryland General, made the decision to stop the services because of a declining number of deliveries at the hospital, said spokeswoman Mary Lynn Carver. The hospital delivered about 1,200 babies annually five years ago and now delivers about 400 each year.

On New Year's Eve, Gloria Forgash was not celebrating like most holiday revelers.Instead, the veteran nurse midwife was helping deliver a baby boy during the last exhausting stint of a prolonged labor.Hours later, nurse midwife Ellen M. Ray arrived at the hospital for another marathon labor, resulting in the birth of a baby girl ninehours later.For Howard County's nurse midwives, it was out with the old and in with the new -- nurse midwives here delivered the lastbaby of 1990 and the first of 1991.

Supporters of home births are trying to convince legislators to create a pilot program that could  eventually lead to the licensing of midwives without nursing degrees. The three-year pilot would allow certified professional midwives to deliver babies in a home setting without worry of arrest or prosecution. Certified professional midwives are trained in midwifery and meet standards set by the North American Registry of Midwives. Under the pilot progam, midwives would share their birth outcomes with the state Department of Health and Mental Hygiene.

Monique Cleary of Columbus, Ga., doesn't like pain. She gets light-headed during routine blood tests. So it's surprising to hear that she's aiming for a natural childbirth with no pain killers. "I am so ready," said Cleary, whose due date is imminent. "At first I was scared, but I'm not anymore. I think I know everything there is to know, and I'm ready for it." Cleary attributes her confidence to the care she's received during her pregnancy. Like a growing number of women, she chose to have her baby with the help of a nurse-midwife.

A pregnant woman has nine months to get used to the idea of being a mother and expand her knowledge of birth and baby care.Building a bridge from her early confusion to comfortable understanding usually falls upon a medical professional. But it doesn't have to be an obstetrician/gynecologist who answers the questions and gives the treatment.It could be a certified nurse midwife.At the Eldersburg practice of Drs. Esposito, Mayer, Hogan & Associates, P.A., three certified nurse midwives -- Ellen M. Ray, Jackie Notes and Lauren E. Pohler -- practice side by side with six doctors.

A Pennsylvania midwife who has delivered about 45 babies in Maryland pleaded guilty yesterday in Carroll County Circuit Court to practicing midwifery here and was ordered to perform 100 hours of community service counseling pregnant women in Pennsylvania."

Judie Ray Pradier's trial on charges of illegally delivering babies turned into a testimonial of sorts yesterday when scores of parents packed a Howard County courtroom to support her and lay midwifery.More than 150 supporters, including many children delivered by midwives, were gathered at the District Court in Ellicott City to defend the right to enlist lay midwives to deliver babies at homes.The case ended with a surprise victory for Ms. Pradier, a 38-year-old Adelphi resident who estimates that she has delivered 400 babies in the past nine years.

Unable to attract and keep nurse-midwives, Columbia Medical Plan's Howard County operation is putting the popular service on hold, effective Jan. 1.The move will force HMO members to have their babies delivered by physicians or private nurse-midwives, while plan officials consider whether to revive the program.The decision could affect up to 300 women a year who typically would choose to have their babies delivered through the Blue Cross and Blue Shield of Maryland subsidiary's nurse-midwiferyprogram.

When Jessica Mitford wrote an expose of the funeral industry in "The American Way of Death," Time magazine called her "Queen of the Muckrakers." Now she has investigated the industry surrounding the other most vulnerable moment in a person's (read: woman's) life, besides the death of a loved one -- childbirth.This topic has the added dimension of male (since most obstetricians are men) exploitation of women (since all mothers and midwives are women). Ms. Mitford addresses that, but she also ties her topic into the economic inequalities in the U.S. health care system.

KANSAS CITY, Mo. -- On the surface, nothing about last month's picture-perfect delivery of Linda Kerr seemed amiss. Her mother needed no pain medication. The labor was quick. Excited family members gathered nearby to welcome the newborn into the world. But in Missouri, where the Kerr baby was born in a carefully planned home birth, the experienced midwife hired to oversee the delivery was committing a Class C felony. "Can you imagine that?" asked Jessica Kerr, the mother of the healthy newborn.

KABUL, Afghanistan - The pregnant woman was bleeding and in trouble. So Mullah Abdul, 42, helped load his terrified young cousin into a jitney van and sent her on the six-hour ride from her isolated village to the nearest hospital, in a town called Pul-e-Kumri. Three hours later, in the midst of the journey across the Hindu Kush mountains, the woman died. So did her child, struggling to be born. The driver turned around and drove them home to be buried. The young woman might have been saved by medicines that control bleeding and that are available in every delivery room in the United States.

It's not the bombs falling from U.S. warplanes or the years of drought or the shortage of doctors and medicine to treat disease that is killing the women in Afghanistan. They are courting death by giving life. Childbirth is the leading cause of death for Afghan women, many of whom have not seen the inside of a school or a hospital for years and who have a life expectancy of just 46 years. About 90 percent of women have their babies at home on their own. It can take days to reach a hospital, which is often not worth the trip.

Monique Cleary of Columbus, Ga., doesn't like pain. She gets light-headed during routine blood tests. So it's surprising to hear that she's aiming for a natural childbirth with no pain killers. "I am so ready," said Cleary, whose due date is imminent. "At first I was scared, but I'm not anymore. I think I know everything there is to know, and I'm ready for it." Cleary attributes her confidence to the care she's received during her pregnancy. Like a growing number of women, she chose to have her baby with the help of a nurse-midwife.

Women would have easier access to nurse midwives under a bill that passed the Senate in Annapolis yesterday. Senators voted 46-1 to require health plans and HMOs to let their members go directly to certified nurse midwives for obstetric and gynecological care. The House of Delegates has overwhelmingly approved a similar measure. The two chambers must work out differences between the bills before the General Assembly session ends April 10. Alice J. Neily, lobbyist for the state's 200 nurse midwives, said the legislation would provide "very significant" health care benefits for women.

When Special Beginnings Birth and Women's Center opens this week in Arnold, it will be the first facility in Anne Arundel County where women can deliver babies with the assistance of certified nurse midwives, but with no doctors nearby.The American College of Obstetricians and Gynecologists has discouraged such freestanding alternative birth centers except when geographical isolation forces reliance on them -- a position that Special Beginnings staffers disagree with.The center in the 1400 block of Baltimore Annapolis Blvd.

 The obstetrics unit at Maryland General will close June 30th displacing 10 to 15 doctors and midwives. The news was first reported in the Baltimore Business Journal. The University of Maryland Medical System, which owns Maryland General, made the decision to stop the services because of a declining number of deliveries at the hospital, said spokeswoman Mary Lynn Carver. The hospital delivered about 1,200 babies annually five years ago and now delivers about 400 each year.

The Court of Special Appeals has upheld the 1995 conviction of a Glenarm midwife who attended the stillbirth of a Sykesville couple's son in December 1994.The appeal stemmed from a Carroll County Circuit Court case against Karen Hunter, 35, who received a suspended six-month sentence for practicing nursing without a license and was ordered to stop practicing midwifery unless she becomes a certified midwife.Hunter said last year that she had been a lay midwife for eight years and had delivered about 145 babies before attending the birth of Cynthia and Johnny Morgan's 13-pound son, Jonathan Caleb Morgan.

A Baltimore County midwife who delivered a stillborn child to a Sykesville couple last winter was found guilty yesterday of practicing midwifery without a license.Circuit Court Judge Raymond E. Beck Sr. found Karen Hunter, 34, of Glenarm guilty of the misdemeanor and suspended a six-month sentence.Ms. Hunter was ordered to serve three years supervised probation and not to practice midwifery unless she becomes certified as a nurse-midwife.Ms. Hunter and Sally Cromwell, her attorney, said they intend to appeal the decision.