SAFE BABY RESOLUTION
Legislative Research Study Questions
by Janel Martin-Miranda, MA, LPC, Safe Baby – Missouri, October 2006
The Safe Baby Resolution team asks our state legislators to form a Safe Baby Commission to be comprised of representatives from birthing women, doulas, midwives, physicians, therapists, psychologists, teachers, clergy, attorneys, representatives from women’s and children’s group (i.e., Shaken Baby, Domestic Violence, March of Dimes, Drug Prevention) and a legislative liaison to consider how to answer the following questions.
We are asking the state legislators to assign the commission (or appropriate department, such as Maternal Health and Child Wellness) with the objectives:
- Gather and study the current science that supports the resolution,
- Facilitate multi-disciplinary collaboration,
- Determine the feasibility of launching a major research project to look for long-term solutions, and
- Report the findings of the resolution study at the next legislative session.
1.
Develop Strategies for Implementing Findings. A proliferation of research about the primal period, including evidenced-based research about labor and birth practices exists but is not implemented, despite the trauma to the baby and mother. What are the strategies and technologies that could be: 1) examined, developed, and utilized to assist Missouri moms and babies to engage in aware conception, to be safe and supported throughout gestation, and to be responsible for her and her baby’s labor and birth experience, and 2) to have provided to them the opportunity to receive therapy to resolve the traumatic aspects of the birth, including her and her partner's (even home birth babies may need trauma resolution.)
2. Infuse New Research Findings into Traditional Professional Education. How can the Missouri legislature mandate changes in professional education to include the primal health information, brain research, Pre and Perinatal psychology, and trauma healing strategies to instruct all disciplines, but in particular in medicine, nursing, chiropractic, education, child care, and psychology/therapy?
3.
Study and Implement New Science-Based Technologies for Healing. How are the increasing rates of asthma, ADHD, and autism related to prenatal environment and care and the increased use of non-medically necessary drugs (induction and epidural), instruments, and surgical births; and how can the new understanding of therapeutic models in prenatal and birth trauma healing be implemented?
4.
Study the Rising Incidence of Post Partum Depression and Grief. What are Missouri legislators doing to provide funding and resources for hospitals to provide effective post-partum psychological treatment and medical care for women who experience cesarean section birth and/or the loss of their baby (death or adoption)? Post-partum depression among these women is rising at an alarming rate. Research, including from March of Dimes, is pointing at the increasing cesarean section rate as a contributor to depression (and prematurity). Prescription drugs are promoted as the choice of care for depressed post-partum women even though drug treatment is known to not be successful and to even have serious side effects. What is the effect of this on the long-term relationship of the mother and child, and what are the ramifications for society when mothers are not fully connected to their child?
5.
Homeland Disaster Preparedness – Include a plan for Pregnant, Laboring and Birthing Women, and Infants. How is the Missouri Home Land Security disaster plan prepared to care for pregnant and birthing women in MO in the event of a disaster? Currently, the practice of direct-entry midwifery is against the law in MO, and the CNM must be backed by a physician; therefore, out-of-hospital birth is rare and socially feared. In the event of a disaster hospitals will be focused on trauma patients and/or may be quarantined, and there will be zero options in Missouri for safe and quality care for pregnant and birthing women and babies outside of the hospital. What will they do?
6.
Increase Access to Quality Maternity and Early Infancy Care. Poor accessibility of legal maternal care in rural areas in Missouri is already a major contributor to highly medicalized birth (i.e., planned inductions and cesareans because they live hours from hospital). The prematurity and neonatal death rate has increased. In Missouri as in many states in the US, an exodus of obstetricians is leaving a lack of physicians in that specialty. What can Missouri legislators and citizens do to address the need to provide statewide, consistent, accessible, safe, affordable, quality maternity and pediatric health care for Missouri women and babies every day in rural areas, and during a disaster? What is the legislature doing to address the liability issue that drives obstetricians from their profession when it is well known that obstetricians practice defensive medicine and “malpractice avoidance.”
7.
Establish a Standard of Care and Accountability. How can Missouri lead in the United States in establishing a “standard of care” for the pregnant and birthing women and their babies? ACOG, is a professional group for obstetricians that supports them, and as such does not necessarily promote what is best for women and babies based on evidence-based science. ACOG is a lobbying group for physicians and leads in determining the social and political perspective that drives medicine and protocols - that are more ritual than science-based. The flimsy adherence to the science is evidenced by the widely varying protocols for medical care differ from state-to-state, hospital-to-hospital, doctor-to-doctor, and nurse-to-nurse. It is impossible for the wide variant of what is “normal” is science-based. Most often, it is personal choice and needs of the medical caregiver that dictates the care, not what is scientifically agreed upon. The profession of obstetrics is not accountable to anyone outside of obstetrics. What can the legislature to do to establish accountability for obstetricians?
8.
Legislate of State-wide Maternity Care Protocols that are Evidence-Based Science. If the increasing premature birth and infant mortality rate in Missouri, as has been suggested, is partially related to the increased practices of inductions and cesarean section, what are doctors and legislators doing to regulate the misuse of technology? And, if the current research indicates the non-medically necessary medical interventions are associated with emotional and psychological conditions, how can the legislature ensure that appropriate, consistent, evidence-based, medical protocols be implemented? What mandatory, consistent doctor-to-doctor, hospital-to-hospital, and nurse-to-nurse protocols can the (Missouri) legislature create in the care of laboring and birthing women and babies that are consistent from doctor to CNM to CPM? The use of non-medically necessary inducing and interventions during labor and birth as well as the “in case” approach to harsh, invasive interventions, resuscitation, and cleaning of newborn are not based in science. Decades of research, new findings, and new understandings tell us these are damaging; and yet, obstetric and pediatric professionals are allowed to continue these practices on babies even when we know the first hour of life is a time research shows is crucial attachment time?
9.
Establish Adequate, Consistent, Accountability and Statistic Gathering. The reporting of maternal and newborn trauma and loss of life is underreported and misreported. Hospital risk-management takes precedence over maternal and baby-risk management. What format and structures can be established and enforced by the (Missouri) state legislature for full-disclosure, reporting, and structures that mandate evidenced-based practices and consistent reporting and documentation of labor and birth experience by the birth caregivers?
10.
Create Partnerships to Support Pregnancy, Birth, and Early Infancy. How can Missouri legislators create reporting and accountability structures that mandate and support doctors, midwives, doulas, and birth trauma therapists to work in harmonious partnership with the goal of creating available, safe, and gentle birth and post-partum continuity of care for the health and well-being of our babies?
11.
Introduce an Agenda of “The Baby’s Rights” that Looks at a Human Baby’s Rights as Well As A Women’s Right to Her Body. While reproductive rights are personal and beyond legislation, what do the citizens of Missouri believe is the right of a human being to expect to be born to parents who are healthy, welcoming, and functional, and who are prepared to protect and provide for him or her in a community and society that is safe and harmonious? A human baby will live his lifetime with the results of his mother’s choices and experiences. Society pays for this in multiple ways. This critical, primal, foundational period of development BUILDS the body and brain that IS that person; therefore, a social and political will to protect the human being from conception forward is critical. Birth is the BABY’S experience. Only that human being will have to live with the consequences.
Respecting a mother’s individual human right to reproduce, how can the legislature and society members support, fund, and ensure the healthy, conscious, safe prenatal behavior of the mother? And so,
11. a
Study the Combined Effects of Alcohol, Drugs (illegal and prescription narcotics, psycho-tropic meds), Trauma, Mother-Baby Separation and the High Rates of Child Abuse, Addiction, ADHD, Methamphetamine Use and Addiction. In Missouri where the methamphetamine addiction rate is number two in the US, what can the Missouri legislature, MO citizens, doctors, and epidemiologists do research the connection to the predominant use of narcotics during labor and birth? Is there a relationship between gestation and narcotics during labor and birth contributing to the incidence of methamphetamine addiction?
11. b.
High Rates of Smoking. What can the Missouri legislature and citizens do to address the high rate of pregnant women who smoke in Missouri, especially when we know smoking is a contributing factor to lifelong health issues (that the child must live with and society must pay for?)
12.
Support and Fund Parenting Preparedness (Conscious Conception) as both Prevention and CREATING Harmonious Humans from the Developmental Time. Consciousness and awareness is about beginning before conception to prepare for pregnancy and parenting. How can we as a society create the will to look at how to address and fund responsible parenting and individual and couple preparedness for conception and parenting? What is the connection between random conception, poor nutrition, a lack of family or emotional support, stress, and violence during gestation and the need for extreme medical intervention during labor and birth? And, do they correlate to life long issues with violence, health issues, and poor self-esteem? The research indicates so. While the majority of adult Missourians (Americans) give little thought to the primal period of development (and so accept that the laboring and birthing baby are not affected by induction and narcotics), are teen programs, abstinence programs, and health curriculums addressing the role of aware/conscious conception?
13.
Address Adoption and NICU Issues. Referring again to the social and political disregard of the impact of the conception experience, gestation, labor and birth, and hospital stay on the BABY, the impact of these life experiences for the newly born human are tragically ignored. Knowing that the conception, gestation, labor and birth create one long critical period of development for the ability of the baby to feel wanted, valued, and attached, how can we incorporate these new techniques to support a baby to transfer from the biological mother to the adoptive mother? And/or, how can we better support baby and mother dyads in separation and reunification during NICU care and protective services.
14.
Address Role of Nutrition and Primal Programming of Health. With the recent news frenzy regarding the "obesity crisis" in the US and Missouri, and the primal health research indicating that obesity (as well as heart, stroke, and diabetes) is established in utero, and the common understanding that obesity is a factor in diabetes, heart disease, etc., what system supports and interventions can be implemented? How are the high rates of obesity in Missouri being related to poor prenatal nutrition to be addressed?
15.
Evaluating the Long-Term Physical and Psychological Impact of the Use of Drugs and Technology in Labor and Birth. I have long wanted to do this research. In a longitudinal study of at least five years, would Missouri babies born at home (naturally, surrounded by familiar faces and sounds, in their own germ field, and nil interventions) have better health, developmental, educational, social, academic, and behavioral outcomes as compared to babies born induced, with narcotic epidural, and surgical birth? As multitudes of money go to research and services to address a myriad of issues through the human lifetime, medicine, psychology, and religion all ignore the primal period as foundational and they ignore the collective scientific evidence is suggesting is related to maternal and neonatal mortality, prematurity, asthma, autism, violence, and addiction?