Proposed changes for birth centers in Florida
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Thread: Proposed changes for birth centers in Florida

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    Mega Poster Sandradee84's Avatar
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    Default Proposed changes for birth centers in Florida

    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: Laura.MacLafferty@ahca.myflorida.com; William.McCort@ahca.myflorida.com and put this one in the ‘CC’ column: director@birthaction.org
    Sandra
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  2. #2
    Mega Poster Sandradee84's Avatar
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    Consumer letter (from Birthaction.org)

    Laura MacLafferty, Unit Manager
    Hospital & Outpatient Services Unit
    Bureau of Health Facility Regulation
    2727 Mahan Drive, Mail Stop #31
    Tallahassee, Florida 32308

    Bill McCort, Health Facility Regulation
    Hospital & Outpatient Services Unit
    Bureau of Health Facility Regulation
    2727 Mahan Drive, Mail Stop #31
    Tallahassee, Florida 32308

    Dear Ms. MacLafferty and Mr McCort,

    Recent proposed rule changes regarding Licensed Birth Centers in the State of Florida have been brought to my attention by other interested parties. These changes have been proposed in various ways without a chance for rebuttal or more information by affected parties, including the birth centers or licensed midwives involved with the day to day application of the rules.
    At this time, I would like to lodge my objection to any rule changes being done outside of the hearings and without a chance to question or rebut those proposing the changes, per Florida policy regarding rule change proposals. Specifically:

    a) Any proposed changes to remove the option for vaginal birth after cesarean (VBAC), which was included in the law to continue offering the option for vaginal birth in a state of declining access through hospital birth. The risk score process allows for VBACs to be screened for and given informed consent about any risks pursuant to vaginal birth. The recent American Congress of Obstetricians and Gynecologists’ (ACOG) statement regarding a woman’s right to autonomy in choosing VBAC backs up the ability of the woman to make care decisions after being given informed consent.

    b) Any proposed changes to increase mandatory testing for mothers or infants without an option to offer rather than impose testing without recourse. Any such proposal is in direct violation

    c) Any risk scoring criteria that would force mothers into being removed from birth center care for Group Beta Strep positive status without other risk criteria.

    d) Any criteria that would remove the ability of midwives to administer lidocaine. The current protocols for licensed midwives include a process by which they are qualified to provide such services.

    e) Any criteria that would restrict the ability of multiparous women to be given informed consent of the risks of multi-parity and then make autonomous choices for location of birth and provider.

    f) Any criteria that will restrict a licensed midwife or other care provider, including certified nurse midwives, family practitioners or obstetricians from practicing as they would in a hospital or homebirth setting, including physicals, risk score criteria or other criteria that binds them under their own practice regulations.

    At this time, I would also like to specifically be kept abreast of any further proposed changes or discussions regarding Rule 59-A, in writing or via email.



    Contact Information for Laura MacLafferty and Bill McCort at AHCA:

    Laura MacLafferty, Unit Manager
    Hospital & Outpatient Services Unit
    Bureau of Health Facility Regulation
    2727 Mahan Drive, Mail Stop #31
    Tallahassee, Florida 32308

    Telephone: (850) 412-4549
    Fax: (850) 922-4351
    Email: Laura.MacLafferty@ahca.myflorida.com

    Bill McCort, Health Facility Regulation
    Hospital & Outpatient Services Unit
    Bureau of Health Facility Regulation
    2727 Mahan Drive, Mail Stop #31
    Tallahassee, Florida 32308

    Telephone: (850) 412-4341
    Email: William.McCort@ahca.myflorida.com.
    Sandra
    married 10/17/09



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    Mega Poster Singfourever's Avatar
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    wow. Why are they spending so much energy on this? They should be looking at hospital births not birth center births. What is wrong with people?
    The second one is especially frustrating. What good does this do, really?
    Sarah
    Owen Michael 4/05 Grey Neil 5/07 Alice Katherine 4/6/11

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    Posting Addict Amber_daisy's Avatar
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    Quote Originally Posted by Singfourever View Post
    wow. Why are they spending so much energy on this? They should be looking at hospital births not birth center births. What is wrong with people?
    The second one is especially frustrating. What good does this do, really?
    Money is behind it. If you risk out 80-90% of the population, birth centers are going to go under. Plain and simple.

    This is so effed up.
    ~Amber~
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    Mega Poster Sandradee84's Avatar
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    It hasnt been opened up for public meetings yet, but if they are having any in my area, you can be damn sure I'll be going.
    Sandra
    married 10/17/09



    Andrew - born 12/21/2010 5 weeks early!

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    Mega Poster Singfourever's Avatar
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    Quote Originally Posted by Amber_daisy View Post
    Money is behind it. If you risk out 80-90% of the population, birth centers are going to go under. Plain and simple.

    This is so effed up.
    That is so wrong. I really hate the health care industry in this country.
    Sarah
    Owen Michael 4/05 Grey Neil 5/07 Alice Katherine 4/6/11

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    Posting Addict TiggersMommy's Avatar
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    Thanks for passing this along. I don't live in FL but I have some "activist" family members that do so I passed it along to them.

    Their motives are so clear. Hospitals want to make more money slicing women open so they need to pressure the government to pass legislation to push 100% of pregnant women their way. Plain, simple, and totally wrong.
    Erin
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  8. #8
    smoochietigger
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    Hi ya'll -- Thank you so much for posting this...I live in Central Florida and will begin working on finding out more on this situation.... I'm 6 weeks pregnant...so this is extremely important to me.

    Thanks for the heads up and please forward any more info you may recieve or reserach. I'll do the same.

    Jen

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    Posting Addict jooniper's Avatar
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    Blarg! Stuff like this makes my blood boil. I'd LOVE to see the scientific reasoning behind any of these changes.
    -Jenn -
    my family blog--my pics--
    Married to Kenny Aug '06


  10. #10
    Mega Poster Sandradee84's Avatar
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    Quote Originally Posted by jooniper View Post
    Blarg! Stuff like this makes my blood boil. I'd LOVE to see the scientific reasoning behind any of these changes.
    Science?! people dont believe in that down here
    Sandra
    married 10/17/09



    Andrew - born 12/21/2010 5 weeks early!

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