Monday
Oct182010
A Tale of Two MOMS: ACOG Pulls a Fast One
Monday, October 18, 2010 at 6:48AM
Guest post by PushGirl Friday
A Tale of Two MOMS: ACOG Pulls a Fast One on Groundbreaking Maternity Care Legislation
As many readers here know, last summer Congresswoman Lucille Roybal-Allard introduced the MOMS (Maximizing Optimal Maternity Services) for the 21st Century Act, a groundbreaking piece of legislation that has the potential to revolutionize our maternity care system. The bill makes increasing access to evidence-based care, reducing racial and ethnic disparities in birth outcomes, and bringing down maternity care costs national priorities by promoting a number of common-sense, low-cost solutions to addressing the maternity care crisis in the US, such as:- Creating loan repayment programs to increase the numbers of family practice physicians, nurse-midwives, and certified professional midwives, all of whom provide low-cost, high-satisfaction alternatives to traditional obstetrical care
- Increasing access to culturally competent care and reducing disparities by taking measures to recruit more racially and ethnically diverse students into the maternity care workforce
- Launching a public awareness campaign to inform women of the benefits of increasing access to evidence-based maternity care and reducing over-reliance on often unnecessary interventions, such as labor induction, electronic fetal monitoring, episiotomy, and cesarean section
- Establishing an Interagency Coordinating Committee on the Promotion of Optimal Maternity Outcomes
The MOMS Act has attracted a broad-based coalition of advocacy and professional organizations, including Amnesty International, Childbirth Connection, The Big Push for Midwives Campaign, the American College of Nurse-Midwives, the National Association of Certified Professional Midwives, the American Association of Birth Centers, and the Midwives Alliance of North America, all of whom have been working together with Representative Roybal-Allard’s office to build support for the bill both within Congress and among the general public.
Notably absent from the list of MOMS Act supporters is the American Congress of Obstetricians and Gynecologists, which is already busy lobbying Congress about its own forthcoming legislation. Not to be confused with the MOMS Act, ACOG’S proposed Making Obstetrics and Maternity Safer bill, which in the interests of clarity has been dubbed—wait for it—the MOMS Initiative, will, as ACOG President Dr. Richard Waldman stated, “lead the way” in making maternity care safer by promoting research into the causes of premature birth, obesity, and racial disparities in outcomes. Because as we all know, the problem with maternity care in the US is with the women who receive it, not with the care they receive.
Perhaps a better title for ACOG’s MOMS legislation would be the Making Obstetricians More Satisfied Initiative, because the proposal contains absolutely no provisions that encourage obstetricians to abandon current practices in favor of evidence-based care or to give up an inch of turf in their ongoing battle to protect their virtual monopoly on the maternity care market in the US—a monopoly that is responsible for creating the need for the Real MOMS Act in the first place. ACOG laid the groundwork for its sabotage of the bill in a recent letter that has been circulating in DC, assuring Congress that the organization has already put many patient safety measures into place and that their own MOMS legislation “can lead to direct measurable improvements in patient safety and quality of care, and to healthier births.” No promises that the Misleading MOMS Act actually will lead to improvements, but hey—it’s a start, right?
As for the Real MOMS Act? According to Dr. Waldman it is unacceptable because a) it promotes “the wholesale adoption of delivery models that have not yet been proven safe and effective, including doula support, group prenatal care, and home-birth,” and b) it “questions ob-gyns’ ability, compared to certified nurse-midwives, family physicians, and certified professional midwives, to deliver care that supports physiologic birth.” In other words, the Real MOMS Act told the Emperor he has no clothes, he took offense, and now he’s busy knitting himself a new Naked Suit.
Watch this blog for further developments on the Real and Fake MOMS legislative front as we head into a new Congressional session in January. In the meantime, please spread the word about Congresswoman Roybal-Allard’s brave stance in support of real maternity care reform. We need more champions like her who are willing to speak up on behalf mothers and babies and who won’t be fooled by ACOG’s bait-and-switch tactics.
~PushGirl Friday
Notably absent from the list of MOMS Act supporters is the American Congress of Obstetricians and Gynecologists, which is already busy lobbying Congress about its own forthcoming legislation. Not to be confused with the MOMS Act, ACOG’S proposed Making Obstetrics and Maternity Safer bill, which in the interests of clarity has been dubbed—wait for it—the MOMS Initiative, will, as ACOG President Dr. Richard Waldman stated, “lead the way” in making maternity care safer by promoting research into the causes of premature birth, obesity, and racial disparities in outcomes. Because as we all know, the problem with maternity care in the US is with the women who receive it, not with the care they receive.
Perhaps a better title for ACOG’s MOMS legislation would be the Making Obstetricians More Satisfied Initiative, because the proposal contains absolutely no provisions that encourage obstetricians to abandon current practices in favor of evidence-based care or to give up an inch of turf in their ongoing battle to protect their virtual monopoly on the maternity care market in the US—a monopoly that is responsible for creating the need for the Real MOMS Act in the first place. ACOG laid the groundwork for its sabotage of the bill in a recent letter that has been circulating in DC, assuring Congress that the organization has already put many patient safety measures into place and that their own MOMS legislation “can lead to direct measurable improvements in patient safety and quality of care, and to healthier births.” No promises that the Misleading MOMS Act actually will lead to improvements, but hey—it’s a start, right?
As for the Real MOMS Act? According to Dr. Waldman it is unacceptable because a) it promotes “the wholesale adoption of delivery models that have not yet been proven safe and effective, including doula support, group prenatal care, and home-birth,” and b) it “questions ob-gyns’ ability, compared to certified nurse-midwives, family physicians, and certified professional midwives, to deliver care that supports physiologic birth.” In other words, the Real MOMS Act told the Emperor he has no clothes, he took offense, and now he’s busy knitting himself a new Naked Suit.
Watch this blog for further developments on the Real and Fake MOMS legislative front as we head into a new Congressional session in January. In the meantime, please spread the word about Congresswoman Roybal-Allard’s brave stance in support of real maternity care reform. We need more champions like her who are willing to speak up on behalf mothers and babies and who won’t be fooled by ACOG’s bait-and-switch tactics.
~PushGirl Friday
Reader Comments (23)
GRRRR! What can we do to get some awareness about this?
It is the American COLLEGE of Obstetricians & Gynecologists, not the American CONGRESS. I believe in homebirth and midwives and evidence based care and accurate reporting that reflects our intelligence.
Anita, go to http://www.acog.org. Look at the top left corner of the page.
@Anita - actually, PushGirl is correct in referring to it as "Congress" rather than "College" - they recently changed the name of the organization (http://www.acog.org/) :)
So my question is, what can grassroots organizations and other folk do to advocate for and push through the MOMS Act? In NY, we recently succeeded in pushing through the "Midwifery Modernization Act" which removed a requirement from NY midwifery law that stated midwives have to get the signature of a collaborating physician to practice. ACOG tried to block that too, but failed - due, in no small way, to the perseverance of consumers hammering their representatives with phone calls and emails telling them that the MMA was something that constituents wanted.
Yes, please let us know how to be active on this. Thanks for posting.
Lest we succumb to what was described by Maxine Hong Kingston as "breaking women with their own tongues" I think we need to rename the fake ACOG MOMS bill and fast. Anyone have any clever spin? Launch it here!
Ann Sweeney
Mass Friends of Midwives
www.mfom.org
The bill needs more co-sponsors in the House, especially Republicans. Take a few minutes to call your member of Congress and ask them to please sign on as a co-sponsor for HR 5807, the MOMS Act for the 21st Century.
To find the contact information for your member of Congress go to:
http://clerk.house.gov/ and click on “Member Information”
OR
Call the Clerk’s Office:
(202) 225-7000
You will need to know all nine numbers of your zip code to find out who your Congressional Representative is. The last four digits of your zip code can be found on any recent bills you have received.
All of us in the birth advocacy movement are aware of the crisis in maternal health, but for many members of Congress, this issue is barely on their radar screen. Improving maternity care and the health of mothers and babies is a bipartisan issue that everyone can support!
I love this little gem from the ACOG bill:
"Pregnancy and childbirth is a joyous and safe experience for the majority of mothers in the United States, and ob-gyns play the leading role in delivering this care. Yet the US lags behind other industrialized nations in healthy births, and we know very little about why."
Umm, hey ACOG, read the first sentence again and you'll know a bit more about why.
RJ, I have been thinking along similar lines. As co-organizer of FreeOurMidwives we learned a lot about how to make the consumer voice undeniable and social media played a big role. We need ONE place that captures all supporters so that as the legislation rolls along we can access consumers again and again. If anyone is currently working on this project or wants to I would be happy to join in on the efforts.
The double name take is frustrating. It seems like now we'll have to make an extra effort to say, "No, not THAT MOMs legislation....the other one."
Side note here: Something funky is up with the comments. I'm not sure if anyone else is having problems. I'm working on it.
Edit: I think I might have messed it up more. I'm really sorry. If your comment comes in as a duplicate of the previous comment, please let me know. You get 15 minutes to edit your comment, so check after you hit "submit" that it's what you wrote.
What about the use of a petition? I'm not sure for what position exactly, but thepetitionsite.com was the one used to slow down the FDA taking a certain breast cancer drug off the market, so it does work.
As PushGirl responded above, the best and strongest action to take is to contact your U.S. congressman/woman and your two U.S. Senators and tell them that you want them to become a co-sponsor of H.R. 5807, the MOMS for the 21st Century Act, which was introduced by Congresswoman Roybal-Allard (D., CA). The more co-sponsors the bill has, the better, and the stronger the bill will be to resist ACOG's gamesmanship. The bill needs lots more co-sponsors in the House, Republicans as well as Democrats, and it needs someone to introduce it in the Senate -- either or both parties. Better care for women and babies is a bi-partisan issue. Also note that Congress pays more attention to phone calls (not emails, but phone calls) from constituents than it does to petitions.
Let's beat back ACOG's "Stepford-MOMS" bill by building up a huge groundswell of consumer support for the real MOMS bill.
Wow, Anita...just Wow.
I am hoping that this is the beginning of a call to action that will be repeated after elections. SInce many of our reps are currently busy trying to keep or wrap up their jobs, it won't do much good today. In 4 weeks, when elections are over, offices are populated again and reps are gearing up for the next session it will be a great time to contact them. What can we do in the meantime to prepare?
Not surprisingly, the original bill includes ACTION initiatives (loan programs, awareness campaigns, etc) and the opposition bill is essentially all RESEARCH initiatives. And ACOG suggests that they be responsible for a large chunk of the research, because we all know they'd be inclusive and open minded to any and all maternity models that might improve care. There are certain aspects of "common" maternity care that even ACOG suggests OBs step away from, yet there is no impetus for anyone to do so unless they want to. Why do we need more research, again??
@ Larissa,
Interesting, excellent observations. More research is needed because it keeps the money OUT OF the communities that most need it and funnels it back to the researchers/government who already knows what the real problem is---the practitioners. Have you ever investigated how many millions go into research. Try this hhs.tags.gove (I think) and look up your favorite universities, organizations and programs. ACOG can research the fuck out of EVERYTHING and change NOTHING.
I have not read through all of the comments so I apologize if I am saying something similar to a previous poster. This statement by ACOG about their own MOMS legislation: “can lead to direct measurable improvements in patient safety and quality of care, and to healthier births.” says to me they are admitting that what they are currently doing is not as safe as it should be, is of questionable quality and is negatively impacting births. Seems to me their attempt at trying to make the bill's acronym the same is actually shooting themselves in the foot. Making Obstetric and Maternity Safer again sounds to me like they are admitting that obstetrics (specifically!) and maternity care in this country IS NOT SAFE! And who cares for ~90% of women utilizing maternity care in this country? Oh yes it is OB's (hopefully congress can read between the lines and make the connection - not that it matters - lobbying power and $$ are what matters).
Another excerpt: According to Dr. Waldman it is unacceptable because a) it promotes “the wholesale adoption of delivery models that have not yet been proven safe and effective, including doula support, group prenatal care, and home-birth,” and b) it “questions ob-gyns’ ability, compared to certified nurse-midwives, family physicians, and certified professional midwives, to deliver care that supports physiologic birth.” We all know that A is an inaccurate statement and B, well my response to B is DUH!! Yup that is exactly what we're doing questioning the ob-gyn's ability to support physiologic birth - sadly I think that they truly think they can support physiologic birth but honestly they have no idea what that means. How can they? Have they ever been to a home birth?
I appreciate what OB's do for the 5-15% of women and babies that truly need them, but as for interfering with the other 70 - 85% of women and as for their organization - UGH.
Very interesting on the "name change", I am hanging my head in shame, forgive me, I knew nothing about it (is that a good thing?). I suppose it goes right along with stealing others' acronyms. In deeper investigation, it does appear that the name didn't *change*, as ACOG is still the "College", but another entity added as a "brother" organization is the "Congress." The Congress is the one that created this bastardization of the original MOMS bill, but it is still the College that creates policy. It appears Goliath has an eviler twin.
@ Lisa~
Exactly. Good OBs actually acknowledge that their training is *not* suited to 'support physiological birth' -- namely, sitting on their hands and watching labor. As directly opposed to midwives (of all stripes) who are trained to intervene when complications *actually* occur.
It does not mean that an OB *must* be an interventionist, or that some aren't more handsy than others, but their roles are specifically geared towards 'doing something.'
Great piece.
Great idea, Ann!
How about
Making Obstetricians' Money Safer Act?
Robin Hutson
Foundation for the Advancement of Midwifery