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	<title>Comments on: Midwives Call for Licensure</title>
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	<link>http://www.showmedaily.org/2008/07/midwives-call-for-licensure.html</link>
	<description>Advancing liberty with responsibility by promoting market solutions for Missouri public policy</description>
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		<title>By: Eric D. Dixon</title>
		<link>http://www.showmedaily.org/2008/07/midwives-call-for-licensure.html/comment-page-1#comment-599</link>
		<dc:creator>Eric D. Dixon</dc:creator>
		<pubDate>Fri, 19 Sep 2008 05:29:54 +0000</pubDate>
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		<description>David, while this sort of anecdote works well as a scare tactic, the plural of anecdote is not data. If you want to highlight worst-case scenarios for midwifery, you can&#039;t leave out the terrifying cases that have played out in hospitals. Adults should be able to choose their own level of tolerance for risk — and the statistics demonstrating favorable outcomes for midwife-attended births &lt;a href=&quot;http://showmeinstitute.org/publication/id.73/pub_detail.asp&quot; rel=&quot;nofollow&quot;&gt;speak for themselves&lt;/a&gt;.

Besides, regulatory oversight by government agencies is not necessarily the most effective means of ensuring quality in health care provision. It&#039;s almost ironic that you posted your comment here the day after the release of &lt;a href=&quot;http://www.cato.org/pub_display.php?pub_id=9640&quot; rel=&quot;nofollow&quot;&gt;a new study&lt;/a&gt; showing how &quot;Consumers would benefit were states to eliminate professional licensing in medicine and leave education, credentialing, and scope-of-practice decisions entirely to the private sector and the courts.&quot;

At any rate, you yourself &lt;a href=&quot;http://blogs.columbiatribune.com/politics/2007/08/midwifery_fight_hits_the_court.html&quot; rel=&quot;nofollow&quot;&gt;wrote last year&lt;/a&gt; that the issue with Missouri&#039;s new midwifery law wasn&#039;t about statistics, but constitutionality:

&quot;The matter before the court is the constitutionality of Senator Loudon&#039;s actions--it is not on Senator Graham, midwife statistics, or homebirth. All of the celebrities in the world will not change the basic facts before the court.&quot;

So, after the court found -- by a wide margin -- that your organization didn&#039;t have standing to challenge the law&#039;s constitutionality, you return to a strategy of bluster and scare tactics. I think people will see through it.</description>
		<content:encoded><![CDATA[<p>David, while this sort of anecdote works well as a scare tactic, the plural of anecdote is not data. If you want to highlight worst-case scenarios for midwifery, you can&#8217;t leave out the terrifying cases that have played out in hospitals. Adults should be able to choose their own level of tolerance for risk — and the statistics demonstrating favorable outcomes for midwife-attended births <a href="http://showmeinstitute.org/publication/id.73/pub_detail.asp" rel="nofollow">speak for themselves</a>.</p>
<p>Besides, regulatory oversight by government agencies is not necessarily the most effective means of ensuring quality in health care provision. It&#8217;s almost ironic that you posted your comment here the day after the release of <a href="http://www.cato.org/pub_display.php?pub_id=9640" rel="nofollow">a new study</a> showing how &#8220;Consumers would benefit were states to eliminate professional licensing in medicine and leave education, credentialing, and scope-of-practice decisions entirely to the private sector and the courts.&#8221;</p>
<p>At any rate, you yourself <a href="http://blogs.columbiatribune.com/politics/2007/08/midwifery_fight_hits_the_court.html" rel="nofollow">wrote last year</a> that the issue with Missouri&#8217;s new midwifery law wasn&#8217;t about statistics, but constitutionality:</p>
<p>&#8220;The matter before the court is the constitutionality of Senator Loudon&#8217;s actions&#8211;it is not on Senator Graham, midwife statistics, or homebirth. All of the celebrities in the world will not change the basic facts before the court.&#8221;</p>
<p>So, after the court found &#8212; by a wide margin &#8212; that your organization didn&#8217;t have standing to challenge the law&#8217;s constitutionality, you return to a strategy of bluster and scare tactics. I think people will see through it.</p>
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		<title>By: papsmear</title>
		<link>http://www.showmedaily.org/2008/07/midwives-call-for-licensure.html/comment-page-1#comment-598</link>
		<dc:creator>papsmear</dc:creator>
		<pubDate>Fri, 19 Sep 2008 03:15:37 +0000</pubDate>
		<guid isPermaLink="false">http://www.showmedaily.org/?p=1116#comment-598</guid>
		<description>Missouri Lay Midwives (CPMs) do not have any regulatory oversight.  In other words they have NO ACCOUNTABILITY.  Recently a &quot;new&quot; midwife counselled a patient with a previous C/S to labor and deliver at home.
The baby was emergently transported to a local hospital but only after severe neurologic damage had occurred.  

The American College of Obstetrician Gynecologists recommend that women with a prior C/S be cared for in a hospital where an immediately available physician and capability to perform Cesareans  can be done in a timely fashion.

The baby in this case will no doubt receive medical care at tax payer expense due to the lack of regulatory oversight in the statute.  No one thinks twice about licensing doctors----------if midwives want to practice medicine then they should be licensed, should have written emergency transfer agreements and collaborative practice agreements with physicians---the midwives vehemently refuse to do this in Missouri, let alone be responsible enough to carry professional liability coverage.</description>
		<content:encoded><![CDATA[<p>Missouri Lay Midwives (CPMs) do not have any regulatory oversight.  In other words they have NO ACCOUNTABILITY.  Recently a &#8220;new&#8221; midwife counselled a patient with a previous C/S to labor and deliver at home.<br />
The baby was emergently transported to a local hospital but only after severe neurologic damage had occurred.  </p>
<p>The American College of Obstetrician Gynecologists recommend that women with a prior C/S be cared for in a hospital where an immediately available physician and capability to perform Cesareans  can be done in a timely fashion.</p>
<p>The baby in this case will no doubt receive medical care at tax payer expense due to the lack of regulatory oversight in the statute.  No one thinks twice about licensing doctors&#8212;&#8212;&#8212;-if midwives want to practice medicine then they should be licensed, should have written emergency transfer agreements and collaborative practice agreements with physicians&#8212;the midwives vehemently refuse to do this in Missouri, let alone be responsible enough to carry professional liability coverage.</p>
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