ACNM Region I Chapter 1

June Meeting Minutes

ACNM REGION 1 CHAPTER 1 MINUTES FOR  JUNE 12, 2002

 Contents

The meeting was convened by our chapter chair, Milree Keeling, in the offices of Harvard Vanguard near Kenmore Square (near Fenway Park) and during a Red Sox game.  Twenty-eight members eventually arrived.  Our hosts prepared a table of sandwich selections, chips, cold drinks, and some awesome cookies.

 Student Midwife Directed Study Presentations

The graduating class of 2002 from the Boston University School of Public Health Nurse- Midwifery Education Program presented their research projects.

                 Jean Kahn shared with us the results of her study on  “ The VBAC Rates in Maine” using data from 1998 to 2000. We saw the VBAC rate rise from a low of 3% to a high of 31% in 1996, but her research showed that the numbers are falling again. Small community hospitals have difficulty meeting the recent ACOG requirements for OB and Anesthesia to be “immediately available,” and the ominous language of the consent forms is intimidating the women.

                 Nu Rigby spoke on “The Barriers to Breastfeeding Among Vietnamese Women.”   Although these Asian Americans came from a culture that has always breastfed their infants, and although many of the young mothers were themselves breastfed, there is a dismaying trend in the short time this community has lived in the United States toward bottle-feeding.

                 Diane Roche’s topic  “Incorporating Cultural Competence into Nurse Midwifery Education” suggested how important it is to be aware of other cultures in the United States, and to function competently with diverse peoples.  She used the analogy of the quilt versus the melting pot.

                 Paula Eveleigh explored the lack of parity in insurance reimbursements for in home postpartum care vs. inpatient care in her “Proposal for Postpartum Maternity Care Choice.”  She argued for creating an option for postpartum home nursing visits, noting that this would be a good concept for midwife entrepreneurs.

                 Excellent work, graduates!

Toasts for the Hostesses

Biddy Fein, the director of the Harvard Vanguard Midwifery service , gave us the stats on what has to be the largest service in the Commonwealth, with 10.15 full time equivalents.  Theirs is a truly collaborative model where no patient requesting midwifery care risks out, unlike in many practices where as soon as a patient becomes other than low risk, she is managed by physicians. Their primary C – section rate is only 8 % for four years running.  Midwives attend almost 70% of all Harvard Vanguard births.  Their episiotomy rate is 1 to 3 %. Midwives attend forty percent of the ten thousand births at Brigham and Women’s.  Congratulations to your team--you show that you can still deliver true midwifery care while being big.

 And thank you for hosting the Chapter Meeting and the student presentations!

THE MEETING AGENDA

                The first motion was that future Harvard Vanguard meetings not be held on nights when the Red Sox are in town.  Unanimously approved. 

Reports: Membership

The chapter has 75 active members, four students, and 2 associate memberships.  

 Reports: Treasury 

We have  $4,017 in our checking account, and  $9,670 in savings. Our largest expenditure, as usual, will be $10,000 per year to our lobbyist ($6000 remains outstanding).

 Reports: Legislative Committee

Peggy Garland spoke on MA House Bill 1778, which is now in the Joint Ways and Means Committee, which will require managed care providers to contract with CNMs for reimbursement.  Right now, they don’t have to contract with CNM’s directly; we can bill under a group or physician contract– making midwifery work invisible to payers and to our employers.  The bill must come out of Ways and Means with a favorable report to go to the Senate floor for action.  IF IT DOES NOT COME TO THE FLOOR BY JULY 31, IT WILL DIE AND OUR EFFORT WILL HAVE TO START ALL OVER AGAIN!!! Anyone living OR CARING FOR PATIENTS WHO LIVE IN the Norwood, Medfield, and Walpole area PLEASE contact MaryAnn Hart at mahcamb@aol.com  to help her target Senator John Rogers, who is the legislator from that district and Chairman of Ways and Means. More broadly, any time a midwife delivers the baby or grandchild of a legislator, notify the legislative committee chair, in hopes of making friends and influencing people! 

            MA Senate 569 is the Mass Coalition for Midwifery bill (reminder: this is ACNM, Massachusetts Friends of Midwives, and Massachusetts Midwives Alliance) to create a Board of Midwifery, so that we can separate from the Board of Registration in Nursing, become Licensed Independent Providers, and include and regulate practice of  non-nurse midwives, CM’s and CPM’s.   (The whole world is watching us on this one.)  Our bill’s lead sponsor is Sen. Richard T. Moore, chair of the Health Care Committee. His staff has issues with the language and form of the bill, and has suggested changes. Peggy feels  90% of these are unacceptable.  For example, they’d like a pharmacist and a medical doctor on our board, and wants to keep MD supervision of CNM prescriptive practice.  Of course, no midwives are on the medical and pharmacy boards, and we’d like to eliminate the “supervisory” concept.  So more work lies ahead. The Coalition will rework the draft of the bill with the Senator’s staff, and refile it in the fall. Milree added that any differences between the eastern and western MA chapters have been ironed out, but that it would be a good idea for the legislative committees to have a joint meeting, especially because many new people would like to become involved.

            The late breaking news is that the during the budget reconciliation, the legislature is looking at placing the Boards of Medicine, Pharmacy, and Nursing under the Department of Public Health, and have their budgets increased.  The Boston Globe recently ran a front-page series on the troubles within the BORN, such as the backlog of over 4,000 complaints filed that are unresolved. There is an opening on the BORN, and three midwives have expressed an interest :  Kathy Jones McWilliams and Fran Ventre (yes, she’s back!) of E. MA, and Liz Stevens of W. MA. The chapter will write letters of support for each of them. 

Advanced Practice Advisory Committee

Lisa Paine noted that, according to BORN regulations 244 CMR 6.04(2)(b) 3., anyone teaching nursing at the undergraduate level must have a Masters in Nursing, which eliminates all the CNMs with Masters or Doctorates in Public Health or other disciplines.  She believes this represents a conflict of interest with nurse educators pushing for Masters requirements, inasmuch as there is no research proving that a Masters degree provides safer practice.  This is important for midwifery education, since this eliminates many otherwise qualified teachers in nursing, many of whom are rural, ethnic and inner city aspirants.

Three of our members (Kathy Jones-McWilliams, Stella Chan-Flynn, and Kate O’Dell) have been regularly attending meetings of the Advanced Practice Advisory Committee of BORN. The issue that has revived this intermittently active committee has been, once again, a push to make the Master’s in nursing a requisite for licensure for APN’s in the state. Thanks to these three for actively opposing this suggested change.

 Peer Review         

A good number of the tools for peer-review of midwifery practice were distributed, but Biddy reports that none have been turned back in yet.  If there are questions or problems, please call Pam Ward. Also, service directors; please give her feedback on the process.

 ACNM Annual Meeting, Atlanta, GA

Milree reported that there were 1, 457 attendees, and that it was excellent educationally. Faculty from all three Massachusetts CNM schools and Rhode Island presented. 

The US House bill, CNM Medicare Services Act, (the 95% Medicare reimbursement bill) needs some Republican sponsors  (MA can’t help much there!) as well as more Democratic sponsors (as distinct from those who simply voice support).  There is only one sponsor from MA, Rep. McGovern.  According to Karen Fennell, Anthem, a BCBS group for eight states, plans to start reimbursing midwifery services only 65% of what they pay their physicians. If other plans were to follow suit, this would be an abject disaster, and put midwives totally out of business across the nation. As Mary Barger declared, “ the single most important act you can do since passing the boards…” is to contact your senators and reps in Washington and let them know that this bill MUST be passed. Anyone can write concerning this – you don’t need to be a midwife.  Get your relatives and friends to do it.  Go to the website http://www.midwife.org/ and follow the prompts to write a letter; click, click, cut and paste, and you did it! 

The Midwives of Color reception was well attended, with 80 people present.

The Bridge Club liaison between ACNM and the Midwives Alliance of North America (MANA) was reinstated by the membership in the business meetings, after the BOD, to save costs, had terminated it.  The national MANA convention is coming to Wakefield, MA, from October 24-27.  The chapter will be fund-raising and will be hosting an “event” to welcome midwives from across the continent. Contact Eva Wax or Milree Keeling if you’d like to help us welcome them.

Other news      

Both Massachusetts ACNM chapters received a THRIVE (Teen Health Requires Interaction, Values, and Education) Grant, with MA DPH as our partner, from the ACNM-MCHB Providers Partnership grants. The local partners held their organizational meeting at DPH.  The eastern MA leader is Darcy Brewin, with Jenny Foster for western MA.  This is a grant to study the problems and issues of teen health.  The role of CNMs in adolescent health is key. 

The Preceptor Workshop at BU, “Midwifing the Student,” will be held Friday July 19, from 9 AM to 1 PM.   After lunch, from 2 PM to 4 PM will be Mirena training. The day will earn you .6 ACNM CEU.

 Next meeting

Mark your fall calendar for Wednesday September 11 (the 9 / 11 anniversary) for the next Chapter Meeting at the North Shore Medical Center-Salem Hospital, in Salem, MA. Directions: a map at http://208.149.104.90/direct/shdir.html, or

From Boston: Take Route 93 North to Route 95/128 North. Follow to exit 45 (left-hand exit, where Routes 95 and 128 split). Follow Route 128 North/Gloucester. Take exit 26 (Lowell Street) off 128N, and bear right onto Lowell Street. Follow straight through Peabody Center. Lowell Street becomes Main Street and, after crossing the Salem city line, becomes Boston Street. At the end of the street (marked by a traffic light and a large monument to the left of the intersection), turn right onto Essex Street, which immediately becomes Highland Avenue (Route 107). Approximately two city blocks after the first set of traffic lights the entrance to Salem Hospital and visitor parking is on the left at the second traffic light. (top of hill).

From Southern New England
Take Route 95/128 North to exit 45 (left- hand exit, where Routes 95 and 128 split). Follow directions above “From Boston.”

From Northern New England
Take Route 95 South to Route 128 North. Follow directions above “From Boston.” 

Have a wonderful summer!

Respectfully submitted,

Diane Peck, Chapter Secretary.

Job Notices

Jordan Hospital in Plymouth, MA, is looking for an experienced midwife for a full time, full scope position. Please contact Diane Peck, CNM at  (508) 746-5894 for information.          

Hi All!!
Hope you can help!! We are a three midwife private practice with four collaborating MDs in desperate need of an experienced midwife. Last year the CNM practice attended 220 births.  One of our CNMs is leaving due to family issues and another has broken her right arm and will be in a cast for 8 weeks. Liberty Tree Nurse-Midwives is located in a shoreline community about 20 miles north of Boston in Beverly, MA with births at Beverly Hospital . The hospital has approximately 2400 births per year, an experienced extremely midwife-friendly staff and a Level II nursery. Midwifery has been a part of Beverly Hospital since the opening of the North Shore Birth Center in 1980 and the philosophy reflects this influence.
Any and all interested CNMs should contact
Faye Doliber, RN, Business Manager
@ 978-927-2616
or
call Pat Young, CNM or Donna Doyle, CNM
@ 978-750-8300

Full Time Staff Midwife Opening: Cambridge Midwives/Cambridge Birth Center

We are looking for an experienced CNM to join our practice on a full time basis. New position available, seeking interviews for July 2002. We need an individual who can practice comfortable in a busy, Level 1 LDRP unit, as well as independently in our beautiful Birth Center, and in several multilingual ambulatory settings. Open-mindedness and flexibility within the work schedule are a must. We operate a seven-day, twenty-four-hour midwifery service for our patients who come from highly diverse backgrounds. Duties may include a combination of clinical time, labor and delivery unit coverage, and call for the Birth Center. Responsibilities include staff meetings, Ob-Gyn Department meetings, Grand Rounds, and other meetings as deemed appropriate by the Midwifery Director. Duties may include chart review, Quality Assurance, and/or other responsibilities. Applicants who are bilingual/bicultural encouraged to apply.

Contact: Ms. Connie Breece, CNM, Acting Director, Midwifery Service 617-665-1306 (voicemail); cbreece@challiance.org;

Or

Resumes may be mailed to: Connie Breece, Cambridge Birth Center, 1493 Cambridge St., Cambridge, MA  02139

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