The mothers will be heard!
The GORRC (Georgia Occupations Regulation Review Council) exists to determine whether an occupation should be licensed and whether doing so would harm Georgia consumers. October 30th, 2019, was our second committee meeting with them. The meeting ended up running long after an outburst from consumers present. The mothers demanded to be heard! Keep reading to the end for their fierce display of strength and love for their midwives!
GORRC stated that HB717 is currently a mess. (We agree.) The process for a bill is that it is drafted and submitted to legal review before being released and assigned an official bill number. Legal changed many aspects of our bill without consulting our legislative team. We are working on a lot of changes for the bill, but this GORRC ruling will be tied to HB717 in its current iteration. GORRC also estimates a high dollar cost to the state of Georgia to license CPMs based on the large number of CNM practicing. (There are currently just under 600 CNM, but only around 30 CPM.) There was also some discussion of the Evidence on Safety Briefing that we provided for the committee.
More than 700 letters requesting licensure for CPMs from mothers, fathers, EMTs, Chiropractors, Physicians, NICU nurses, L&D Nurses, grandparents, and more…
Our chapter president, Missi Burgess, CPM, gave a 20-minute detailed overview of the rigorous education and specialized skills training that Certified Professional Midwives (CPM) undergo to achieve the national credential we hold. You can read a lot of this information for yourself here.
Following our presentation, multiple medical associations were allowed to read their position statements on licensing CPMs for out of hospital deliveries in Georgia. Spoiler alert: they all said they didn’t approve.
Bethany Sherrer, legal counsel of the Medical Association of Georgia (MAG), presented first. MAG exists to “protect physicians on issues that matter". Sherrer stated that women should always plan to go to a hospital. Concerns with licensing CPMs were listed as:
lack of sufficient evidence
evidence points to hospital birth being safer
lack of physician oversight
and lack of control over “what is happening in in a woman’s home” by the state
suggests that access to care issues in rural areas can better be solved by sending more physicians there and utilizing telemedicine rather than community midwives.
Dennis Troughton of the Georgia Drugs and Narcotics Association stated that their job is enforcement for the Georgia Board of Pharmacology. They have broad authority throughout the state to investigate how drugs are obtained and what is done with them. His concerns about our bill are:
Currently, no other providers can order or prescribe medications without physician oversight
Questions regarding: Who is responsible for the drugs? -and- What substances are we talking about?
A key discussion happening is that without licensure, CPMs in Georgia are unable to legally obtain antihemorrhagic drugs that are standard for the emergent care of a woman who is bleeding after delivery. It is within the scope of practice and education of a midwife to use these medications (Pitocin and Misoprostol) safely. It is one of the reasons why NOT licensing CPMs is putting Georgia mothers in harm’s way. Georgia has laws currently on the books that would prevent even a licensed CPM from carrying these drugs. Other states that license CPMs have a formulary that consists of these drugs and the midwife can order and use them without a physician. This is similar to how law enforcement agencies can carry and use Narcan without physician oversight. Georgia could train and permit a police officer to administer a drug but not a midwife who is already trained?
Dr. Al Scott, OBGYN presented on behalf of the Georgia OBGYN Society as President of the Board. Interestingly, their mission statement includes the goal “to cooperate with all agencies and organizations who seek to improve obstetrical and gynecological care in our state”. Dr. Scott practices in Decatur, GA at Dekalb Women’s Specialists. His concerns with HB717 are:
liability insurance should be required of CPM
CPM can terminate services and OBs cannot
no required physician oversight
CPMs are not able to do cesareans
rural care issues
“OBGYNs are the experts and are not included in the bill”
the Georgia OBGYN Society supports the training of “college prepared CNM” to safely provide care to rural Georgia
they do not support HB717
Finally, Dr. Harbin of the Composite Medical Board of Georgia spoke. The mission of the Georgia Composite Medical Board is to protect the health of Georgians through the proper licensing of physicians and certain members of the healing arts and through the objective enforcement of the Medical Practice Act. The Medical Board opposes HB717 in its current form because:
lack of supervision
lack of birth assistant training requirement
no formal training requirement
possession of medications
rendering of medical care by unqualified individuals
feels midwifery is medicine
liability concerns
no documentation of relationship with physician or hospital.
At this point, the microphone was available to members of the audience that had signed up to speak. 19 women had enlisted and were given 3 minutes each. As the first mother took the floor, baby on hip, the medical associations stood to walk out. Surprisingly, they were called out! The mother’s voices echoed around the room: “Hey! You don’t listen to mothers?!” and “We listened to you, now sit back down and listen to us!” What else can you do when you’ve made a mother angry but obey? It was a chilling display of what is actually happening in Georgia right now: the mothers are crying out and the medical professionals are not hearing their cries.
Mother after mother after mother declared that she was capable of reading the research herself and deciding where she would have her baby. Testimonies of the excellent care given by CPMs were read, including one mother who claimed that her midwife saved her baby’s life by recognizing a rare condition that was not presenting textbook.
A direct quote from one mother is definitely going to be available on a t-shirt soon: “my human rights trump policy”. Thank you so much to everyone that came out to show support!
We will be meeting again to hear GORRC ruling on Wednesday, November 6th from 11-noon.
Currently we are working with our Lobbyist to begin re-writing the bill.
Fundraising efforts are underway including an auction!!! Email HB717Auction@gmail.com if you have items or services to donate for auction. The auction will take place December 7-14 on Bidding Owl.