[IL-CNM] birth centers/CPMs

Timothy Bannon bacombannon at sbcglobal.net
Sat May 19 17:24:32 CDT 2007

I am a reluctant email user but the dialogue regarding CPM's  is an excellent example of how it can work.  I support SB385 and the birth center bill.  I have worked with Cheri and the CPM community and supporters for years to advance the exchange of ideas and optimally support between these communities. As chapter chair we had two meetings that involved presentations by CPM supporters in order to educate the nurse-midwifery community.  
  As is often the case we don't know each other very well.  As a result of the political climate in Illinois there are few practising CPM's or direct entry midwives in Illinois.  They are likely to have a very low profile if they do practice.  I have had the opportunity to work with, learn from and teach many CPM's.  In our Alivio homebirth days we usually had a CNM and a CPM who couldn't officially catch but was a wonderful team member on our home births. Most had alot more homebirth experience than we did.  I learned the patience of normal labor without meds or pitocin from these women.I taught students from Seattle School of Midwifery and they were required to attend more births and comprehensive follow-up with families than any CNM student-- including myself.   They know labor, babies and breastfeeding in a way that is not taught in traditional university settings.  I was able help them be more comfortable with the medical conditions--ie borderline BP's as I had seen
 the full scope of that condition in a level 3 hospital.  It was a win-win for both parties and especially the families who benefited from the expertice of different midwives.
  Just as the Ob/MD communities argued against our qualifications without ever meeting or working with us I would love to have midwives of Illinois meet and learn from each other.
  That would go far to face fear and serve the women who seek our care in all kinds of settings. Midwives practicing underground without the benefit of easy consultation and transport is what is really potentially dangerous.
  One last comment--if we finally get birth centers in Illinois I can't think of that many midwives in Illinois with out of hospital experience. It is an art that would perfectly suited to working with our CPM collegues in a dynamo team to make our very visible "pilot program" successful.

thanks for your patience, Ceal
    I, too, have appreciated the interest and dialogue about this topic -- actually about THESE topics, as there are several that have become interwoven, with sometimes unfortunate implications.
  I am a huge supported of birth centers -- my husband and I were on the first state exploration committee with CNMs and OB/gyne docs at least 20 years ago.  We certainly would have moved our practice from hospital-based to birth center back then if we'd had that option.
  I am also passionate about a woman's right to choose and qualitifed provider to attend her birth at home;  and our practice provided "back-up" support for a home-birth CNM for many years.
  On the issue of licensing non-CNMs/CMs, I am less clear, perhaps without basis;  but I was sorry to see the two issues of birth centers and licensing of non-CNMs/CMs linked so closely.  I think that linkage has caused confusion and lost some of the birth center support.

I believe the combination of issues has negatively affected ISAPN -- it is my understanding that they were supportive of birth centers.  Their opposition has arisen from lack of support for licensing non-CNMs/CMs.  And to be honest, a number of CNMs as well as APNs in general do NOT support that part of the legislation.
  I also wish to add to Therese's comments to say that some of us have overlooked the positive results that have grown out of ISAPN's work, especially their paid lobbying efforts.  Their current work on updating the IL Nurse Practice act and legalizing APN prescriptive privileges for schedule II-V drugs will positively most of us.  Likewise, dropping the requirement for a collaborative agreement for credentialed and privileged APNs working in an accredited facility or affiliate will reduce a burdonsome current requirement that affects quite a few of us.  
Perhaps we need to take one step at a time.
  Nancy Fleming, CNM

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