Jennifer Crook Moore of Birmingham is a midwife. 

She is, in fact, a Certified Professional Midwife (CPM), trained to assist women in that most primal act, the birth of a child, and to do so in the mother’s home rather than in a hospital.
 
Moore and other CPMs follow a protocol called the Midwives Model of Care. According to the MMOC, the midwife should be aware of the expectant mother’s psychological as well as physical wellbeing, and provide her with prenatal care, assistance during labor and delivery and postpartum support, as well as individualized counseling in such areas as nutrition.  

Jennifer Crook Moore. Photo by Wes Frazer.

Moore and other midwives believe that most healthy women with low-risk pregancies should have the choice to have their baby at home, the natural way, without an excess of drugs and technological interventions.

However, midwifery is, for all practical purposes, illegal in many states, Alabama included.

This means that Moore must drive to Tennessee, where she is licensed, in order to serve as the primary caregiver for a pregnant woman or attend an at-home birth. 

“It’s not illegal to birth at home in Alabama,” Moore says. “But it is illegal for a midwife to attend that birth.”  

Photo courtesy Jane Peterson.

In recent years, Moore and others have attempted unsuccessfully to get the Alabama legislature to legalize CPMs. Moore is the legislative co-chair of the Alabama Birth Coalition (ABC) and serves on the educational committee of the Alabama Midwives Alliance (ALMA).  

Despite their previous disappointments, Moore and her fellow advocates in Alabama continue the fight, and they are now getting a boost from the national Big Push for Midwives campaign. The Big Push will hold its second-ever national conference, called the PushSummit 2009, at the Highland Conference Center in Birmingham from July 12-15. The first PushSummit was held in Chicago in 2008.

Midwifery activists from at least 13 states will gather to discuss their efforts to increase access to out-of-hospital maternity care and the CPMs who are trained to provide it. Attendees will share tips on how to advance the cause in their states, both in terms of legislation and public education. 

The Alabama Birth Coalition is serving as the co-host of the event, and the kick-off for the Push Summit will be “Free the Midwives,” a musical benefit for the Alabama Birth Coalition, to be held Sunday, July 12, at 4 p.m. at Bottletree Café. Admission is $10. The performers are Vulture Whale, 13ghosts, Duquette Johnston, John Jeremiah Sullivan and Kate Taylor.  The ABC’s Susan Petrus and Stacy Walker will be at the event with information about the movement. 

According to Moore, she came up with the name of the benefit at the time the Alabama legislature passed the Free the Hops bill that legalized so-called high gravity beers in the state after a long grassroots effort. “If we can free some beer, surely we can free the midwives, ” she says. 

The money raised at “Free the Midwives” will assist ABC and ALMA in attempting to get a bill legalizing CPMs through the Alabama legislature when the new session begins in January 2010, according to ABC co-founder and president Lisa Clark of Huntsville.  “The ABC, in coalition with ALMA, have formed a three-member legislative committee,” Clark says. “We need to have at least two members in Montgomery every day of the legislative session. Money will help make this possible.” 

According to Clark, funds raised at “Free the Midwives” will also help defray the expenses incurred in hosting the Push Summit and help pay for the ABC’s efforts to educate the public regarding the benefits of legalizing CPMs.

I asked Clark if she is optimistic about getting a favorable bill passed by the Alabama legislature. “I’ve been working on legislation for 13 years and I approach each legislative session with new optimism,” she says. “I have to or I couldn’t have hung in there this long. The more I learn about Alabama politics, the more discouraged I become about private citizens being able to go to Montgomery and have their concerns addressed. But I believe in the need for this bill and I believe eventually it will get passed.” 

The ABC achieved one success in the legislature in 2009, according to Clark. The state house and senate established a joint committee to discuss the midwifery issue this summer and fall between legislative sessions. Two resolutions were passed to make this possible, a house resolution sponsored by Rep. Laura Hall of Huntsville and a senate resolution sponsored by Sen. Linda Coleman of Birmingham. 

“We have submitted bills before, but we will wait until the study committee meets to draft legislation,”  Clark says. “Hopefully we will get the results soon enough to take their findings into account in drafting the bill.”

Steff Hedenkamp sympathizes with the struggles of  Moore, Clark and others to seek positive change through the legislative process. Hendekamp is a public relations professional in Kansas City, Missouri, who helped launch the Big Push for Midwives Campaign in 2008. “I have four children, two that I gave birth to at home in the water with midwives,” Hedenkamp says.

“What our state advocates are facing in their respective statehouses are these nearly surreal David vs. Goliath situations,” Hedenkamp says. “We’re talking about moms and dads wearing their tires bald driving hours and hours to the capitols and home again in order to do advocacy with policymakers on even less than a shoestring.” 

On the other side, she says, are well-funded lobbies such as the American Medical Association (AMA). “Since the Big Push for Midwives Campaign began, we have organizing the grassroots together in order to stand up to these very well-financed opposition forces,” Hedenkamp says. She is able to cite at least a few states where the midwifery movement has had some success, including Idaho, where a bill was passed this spring to legalize CPMs.  

According to Hedenkamp, the Big Push wants to make sure that midwifery advocates make their voices heard as the Obama administration seeks to reform health care. “With U.S. maternity care in crisis and with the opportunity to save more than $9 billion annually while also improving birth outcomes, we have quite a bit of good news to share with Washington,” she says. 

The figure of $9 billion she cites comes from David Anderson, a professor of economics at Center College who, according to the Big Push web site, calculates that increasing the use of CPMs and out-of-hospital medical care by less than 10 percent would result in savings of $9.1 billion annually while actually improving care. 

To support her assertion that maternity care in America is in crisis, Hedenkamp says that the U.S. has the second worst newborn death rate in the developed world, one of the highest maternal mortality rates among all industrialized countries, a rising rate of cesarean surgery, and widening racial and ethnic disparities in birth outcomes. 

The PushSummit will feature a discussion of those racial disparities, including those found in the state of Alabama. Representatives of the Alabama Poverty Project will attend, according to Hedenkamp. There will be a presentation by Nadiyah Seeraj of the International Center for Traditional Childbearing (www.blackmidwives.org) in Portland, Oregon, which was created to support black women who wish to become midwives. There will also be a screening of Bringin’ in Da Spirit, a documentary film about midwives narrated by Phylicia Rashad and directed by Rhonda L. Haynes.  “This is significant because of our urgent need in Alabama and beyond to grow the number of African American midwives to help address racial disparities in birth outcomes and infant/maternal mortality and morbidity rates,” Hedenkamp says.

For more information about the Big Push, visit www.thebigpushformidwives.org. To learn about the ABC or “Free the Midwives,” go to www.alabamabirthcoalition.org.  To learn about ALMA, visit www.alabamamidwivesalliance.org.