I got this info from a natural parenting group in my city, but I thought I'd pass it along to any other women here in Florida as well.
The rules governing birth centers are being reviewed and revised and some of the proposed changes could be detrimental to out-of-hospital births in Florida. In March, The Agency for Healthcare Administration (AHCA) held a public hearing designed to review changes and “clean-up” the language of the law. Since then, non-public meetings have been held and other changes to the laws have been proposed. One group that was consulted for proposed changes was the Board of Nursing, a group which has no authority over or expertise in licensed midwifery. (Asking the Board of Nursing to help create laws governing birth centers would be like asking Bright House to create laws governing Verizon Fios… Well, if Fios only served about 5% of the market and had a higher customer service rating.)
Some of the proposed changes to laws include:
1) Changes in screening for Group B streptococcus (GBS). Currently women are screened around 35 week, if tested positive they are offered intravenous antibiotics during their labor. If the proposed law changes passed, birth center midwives would be required to screen women on intake, mid-pregnancy and at 35 weeks. If the client tested GBS+ at any of these screenings, she would be risked out of the birth center. Also, if she ever tested positive with a previous pregnancy she would be risked out. This rule is not based on any scientific evidence and this rule alone would risk out at least 40% of women seeking birth centers.
2) Prohibiting birth center midwives use of lidocaine. Midwives are trained and licensed to use lidocaine. This is a local anesthetic used to numb the perineum should the client require stitches to repair a tear after the birth. If this law passed, if a women experienced a tear that needed stitches, she would have to choose between not having stitches even though they were recommended, transferring to a hospital for stitches, or getting stitches without a local anesthetic (as my friend Charlie said, she may have to “kick it old school with a bottle of whisky.”)
3) Requiring birth center midwives to transfer a woman to the hospital if her membranes have been ruptured for more than 8 hours (regardless of her stage of labor.) Current law states a mother must transfer if her membranes have been ruptures for more than 12 hours and she’s not in active labor.
The proposed rule changes would also continue to not allowing birth centers to accept clients with previous cesarean births. Any woman choosing a birth center has a risk-assessment done, with a previous c-section a physician’s sign off is required. Why are higher restrictions put in place? Currently women with previous c-sections are forced to choose between a hospital or a home birth. (There are a few more proposed changes from AHCA, see birthaction.org for more details.)
Furthermore, there was discussion by Florida's Council of Licensed Midwives to require licensed midwives to give vitamin K and eye ointment to all newborns without an option for parents to refuse. According to the discussion, if the parents refused after birth they would be required to transfer to a hospital. If this rule passed, parents planning to refuse vitamin K or eye ointment would not be able chose a LM as a care provider; this would apply to licensed homebirth midwives and licensed midwives at a birth center (but not to certified nurse midwives at a birth center or hospital.)
Birth centers are and important option for women because they offer more choices and create competition. Even parents planning a hospital birth benefit from having birth centers available because the competition causes hospitals to strive to make their policies and accommodations more humanistic. If the proposed rule changes were to pass, it would severally limit access to birth centers, likely causing many birth centers to lose business and be forced to close. And once laws are in place restricting licensed midwives practicing in birth centers, it’s possible the laws governing homebirth midwives would also be changed and restricted.
Please consider taking action on this important issue. There are a variety of things you can do and we need a response from a large number of individuals:
What Can You Do?
1) Below is a consumer letter template. Copy and paste it into an email. Put these emails in the ‘TO’ column: [email]Laura.MacLafferty@ahca.myflorida.com[/email]; [email]William.McCort@ahca.myflorida.com[/email] and put this one in the ‘CC’ column: [email]firstname.lastname@example.org[/email]