Working the System 6

The BackgroundFighters

Working the system can be challenging! I recently shared in my last post about the founding of the Colorado Birth Center Coalition (CBCC) in order to make the Colorado Department of Public Health and Environment (CDPHE) open our state birth center regulations. (Please be sure to check out that post for the background to this journey) I plan to post monthly updates from here on out about how the process is going and this is my first of these update posts.

As a heads up, I am very worked up in this moment and the following rant will reflect that. I feel the need for a disclaimer about physicians; in general I respect them as colleagues and I value my relationships with the physicians that I consult with. I am blessed to have many wonderful physician consultants available and perhaps this is why I am so shocked by what happened today. I am too used to being treated with respect and I have forgotten how it can be…..

The Low Down…

We have been meeting monthly. Each month, there has been a core group of attendees and some who are new and different. So far, the meetings have been very productive and positive. We have been able to make some great potential changes to the regulations and update them to current practices. These changes are still subject to a final review and voting process but none the less they have been going smoothly. CDPHE has been very open to our input and had acknowledged the birth center teams as the experts in our care model. Then, the December meeting took place and I felt slapped in the face with reality.

Prior to today I had been lulled into a false sense of calm and happiness about how easily everything was going, I was becoming too comfortable. Well today that changed and I am definitely awake again! A new physician stakeholder was present and I had to sit and listen to how his opinion suddenly became the most valued in the room. Despite the fact that he has zero experience with out of hospital birth. How could it be assumed that providers who know nothing of our model should be the ones to determine what is safe practice for us?!? The Patriarchy was alive and well, the classic paradigm of “doctors always know best”in full force. Honestly, I am so full of anger and disbelief in this moment that I can hardly think straight. As time as passed from the meeting my frustration has only grown and become more pronounced. I won’t go into the details of the questions raised as, to be frank, they were too convoluted and clearly not based in knowledge to make sense. Instead, I will lay out some facts about birth center care that should be recognized:

  • True Informed Consent is a hallmark of birth center and midwifery care. Each and every client is given extremely detailed informed consent about all procedures. This process happens, from the beginning of care to the very end and all throughout. In addition, this process happens when clients are not pressured or in the “thick” of labor and can reasonably ask questions and make thoughtful decisions.
  • Clients are Partners in their care, not recipients. They are fully informed of all practices related to care decisions, transfer protocols, education, discharge planning and postpartum care.
  • Birth Center Midwives practice under a nationally recognized Scope of Practice as defined by our professional organizations. In the state of CO, Certified Nurse Midwives are recognized as independent providers who are capable of ordering and reviewing lab tests and ultrasounds and have prescriptive authority. We are highly trained providers who have been registered and licensed by both state and national entities as safe and competent.
  • The birth center model focuses on the family as the epicenter. In the postpartum period, this means that families are kept together, the baby never leaves the sight of one of the parents. There is no nursery or centralized location for the baby to go to, they are kept skin to skin with their parents. In the event of a transport the baby is always with a parent or other predesignated care giver.
  • Birth centers provide comprehensive care. Prenatal care, labor and birth care, postpartum and newborn care and well woman/gyn care. We are experts in our field and are experts in out of hospital birthing.

These points serve to draw attention to many of the ill informed and condescending questions and assumptions that were made today. After today, I am awake, I will remain awake and I will continue to be present to fight this fight for our families and all families!

Now I would like to focus on the faces in the picture that was taken at the meeting, this a part of the dedicated group that is working so diligently to make sure that families in our state have access to safe, quality and evidence driven care through the free standing birth center model. Pictured are representatives from Mountain Midwifery Center, The Birth Center of Boulder, The Denver Center for Birth and Wellness, the Colorado Midwives Association and the CO Chapter of NACPM. Not pictured but present are representatives from Elephant Circle and  Bloomin’ Babies Birth Center. These are your Warriors and we will continue to fight for you.

If you would like to become involved in our cause, please contact Elephant Circle to learn how at

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