Updated ~ Wednesday February 16, 2011 01:34
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Archive of CEO email updates
Email #1 May 25, 2004
The 2-minute explanation CEO // A_CEO
The Consortium for Evidence-based practice of Obstetrics (C.E.O.) // American College of Evidence-based Obstetrics (A-CEO) is up and running. Our official sponsor is the California Citizens for Health Freedom (CCfHF). We anticipate that a wide spectrum of organizations will join the Consortium in the next few weeks. There are no dues. The kick-off of our political strategy is web-based PR campaign targeting taxpayers, consumers, and concerned citizens dissatisfied with the status quo. Our goal is a 1,000 letters in a 100 days to California First Lady Maria Shriver.
The new web site, with all the info, is www.ScienceBasedBirth.com Check it out and pass it on person-to-person. Forward the website URL to your email groups.
A brief description of CEO's goals:
CEO is devoted to ending flat earth obstetrics, reforming our national maternity care policy and rehabilitating obstetrical practices for healthy women with normal pregnancies -- i.e., the 'social' model of childbirth services or 'mother-baby-father friendly' maternity care.
A-CEO is an alternative to A-COG for physicians who are tired of being "a cog" in the wheel of medicalized obstetrics (i.e., routine inductions & scheduled CS) and wish to re-establish the scientific foundation of their profession and reclaim their expertise in the use of physiological management for normal birth.
Physiological principles are "in accord with, or characteristic of, the normal functioning of a living organism" (1). This provide the safest and most cost-effective form of maternity care for a healthy population, regardless of the category of caregiver (doctor or midwife) , the educational status of the practitioner (OB, FP, CNM or LM.) or the location chosen by the parents (hospital, home or independent birth center). (1) Stedman’s Medical Dictionary definition of 'physiological'
A rehabilitated maternity care policy would integrate the classic principles of physiological management with the best advances in obstetrical medicine to create a single, evidence-based standard for all healthy women used by all maternity care providers -- GPs, family practice physicians, obstetricians, and professional midwives, and would apply in all birth settings. Management strategies would be determined by the health status of the childbearing woman and her unborn baby in conjunction with the mother’s stated preferences, rather than by the occupational status of the care provider (physician, obstetrician, midwife). At present, who the woman seeks care from (doctor vs. midwife) determines how she is cared for -- physiological versus medical management. This is inconsistent with scientific principles, which identifies physiological management as the foremost standard for providing safe care to healthy women.
A reformed maternity care policy would mandate that all hospital L&D units be staffed by professional midwives. It would require the medical profession to teach physiological management to medical students and also that practicing physicians learn and utilize physiological management. It would mandate that truly transparent informed consent be obtained before medicalized care (non-physiological management, immobilization in bed, anti-gravitational positions) and obstetrical interventions (for example IVs, continuous EFM, induction, off-label use of Cytotec, epidural, episiotomy, instruments and operative delivery) be recommended to healthy women.
CEO's relationship to the "midwife Problem"
Healthy childbearing families, hospital-based midwifery programs and professional midwives of all background face extremely serious problems under our current politicalized and deeply dysfunctional system. Cesarean section has become the 'pre-emptive' strike of choice; A-COG is shameless pushing the scheduled CS as the safest form of delivery. This promotes the fallacious notion that other options chosen by mothers and/or midwives equate to a criminal act of child abuse.
The historical 'midwife problem' has now become the midwife/mother/childbearing family problem. In additions to the usual suspects (the decades-long prosecution /persecution of midwives) new injustices arise almost daily. Hospital-based nurse-midwifery practices and training programs have been summarily closed, independent birth centers on the East Coast have put out of business en masse, court-ordered CS and reporting parents to child protective services are all on the rise. Criminal prosecutions (including homicide charges) are being filed against childbearing women who make medically-unpopular choices. Where will it end?
The issues are plain and straightforward -- the independent practice of midwifery, science-based maternity care and the constitutional rights of competent adult women to have control over the manner and circumstances of their normal birth. However, these issues cannot be resolved from within this same dysfunctional system. "More of what's not working, won't work either". A hundred years of failed efforts have amply demonstrated this impossibility. Politically-speaking, we do not have the elements of success under the present circumstance. We must change public perception in order to change the politics. We must win in the court of public opinion.
Story with a happy ending...
The only way that mothers and midwives can be repatriated to their constitutionally appropriate status is to fix the real problem -- the uncritical acceptance of an unscientific premise or interventionist obstetrics for health women. This hundred-years old failed medical experiment must be replaced with an evidence-based and cost-effective model of mother-baby-father friendly maternity care. After that is done, the so-called 'midwife problem' will resolve itself on its own merits. Nothing else will work.
So i urge midwives, students and midwifery clients to join CEO in its effort to end flat earth obstetrics. Write a letter to First Lady Maria Shirver today. Tell everyone else to write and ask your favorite organization, church group, etc., to join our Consortium. Let Donna Russell of CCfHF know that you are out there and you wanted to be counted as a warrior for the rights of women, babies and a compassionate, cost-effective healthcare system.
New web site with all the info is www.ScienceBasedBirth.com Check it out and pass it on. Stay tuned for late breaking news. ^O^
Email #2 June 22, 2004
Dear Midwives, Mothers and Other Supporters,
I have an update on the Consortium for the Evidence-based practice of Obstetrics (CEO) and our new web site -- www.ScienceBasedBirth.com.
I am please to report that the Index page has been reorganized with help from my Stanford class (i recently took a course in rhetoric and effective use of images).
As a result of several requests for a message that is "easier to understand", I added a new link called "The Bottom Line ~ 5-minute short-cut for busy people". It is 3rd on the navigational list on the top left side of the Index page.
Based on suggestions from my professor and classmates, i also added printer-friendly PDF files for the membership info and application and a short version of the instructions/address for Mothers Day letters to Maria Shriver. I'm working on transposing other files to PDF but so far, only the White Paper PFD is finished. Others will slowly follow.
Last but not least, I added a new 3-part statement on the basic purpose of the Mothers Day letters to California First Lady Maria Shriver. A FYI copy is included at the bottom of this email.
I hope you have written a Mothers'Day Letter to First Lady Maria Shriver. If so, email me a copy directly to post on the CEO web site archive.
If you haven't already registered with Citizens for Health Freedom, please forward your email to Donna@citizenshealth.org so she can add you to their large email list. Note that the membership info and application are one of the documents that are "printer-friendly" PDFs -- easier to read and take action.
I do want to encourage people to write a letter soon -- so far i have only received a tiny handful of letters for the archive. If we can't forge an effective political response to the ever-encroaching effects of Flat Earth Obstetrics, we are all in danger of having to change our names and enter the witness protection program .
warm regards, faith ^^O^^
A Plan for all reasons ...
The purpose of the Mothers' Day letter-writing campaign is three-fold:
1. To create a cohesive, broad-based and effective constituency made up of consumers, taxpayers, childbirth and public health professionals committed to reforming our national maternity care policy, which includes a recognition of the ethical and constitutional rights of competent adult women to have control over the manner and circumstances of pregnancy and normal birth and the care of their newborn.
2. To bring about legislative hearings on the issues identified in the CEO White Paper, including the off-label use of Cytotec for labor induction, the ever-climbing cesarean section and maternal mortality rate, the danger in promoting the maternal choice cesarean as the so-called "ideal' form of childbirth and the physically damaging effects on the pelvic floor and pelvic organs associated with medical management of vaginal birth
3. To facilitate passage of legislation mandating that physicians obtain truly informed consent before substituting medical and surgical interventions in place of the safer, evidence-based principles of physiological management and provide full information about the risks of medical or surgical intervention they recommend
This would include medical interventions such as:
- the off-label use of Cytotec and use of other 'cervical ripening' agents
- non-medical inductions or inductions based post-dates or "big baby"
- routine use of IVs and continuous electronic fetal monitoring
- other procedures or policies that keep a laboring woman confined to bed
- the use of artificial hormones to stimulate or accelerate labor,
- narcotics and epidural anesthesia
- requiring the mother to labor or push in anti-gravitational positions
- episiotomy, operative delivery (forceps or vacuum extraction or Cesarean)
- the medically unnecessary, 'elective' or 'maternal choice CS
Email #3 June 29, 2004
CEO ~ Eyes on the Prize ~ 65 days & 995 to go 45 days and 5 letters down -- 65 days and 995 letters to go
Dear CEO members, mothers, midwives and other supporters,
I’m currently arranging for the CEO web site to have its own email address. Within the next few days (week at the outside) email@example.com will become the new email contact address. Just check bottom of the Index page.
Getting this campaign off the ground had been challenging. Everybody I talk to is excited, supportive and anxious to help. People like the information on the CEO web site. I’ve even gotten enthusiastic letters from Europe. However, people in California are having a hard time getting that high level of interest and energy turned into actual letters to California First Lady Maria Shriver.
But things seem to be warming up now. I have received two more email letters in the last 24 hours from people who wanted feedback before mailing hard copies. “Keep those cards and letters coming”-- we only have 65 days left to meet our goal of a thousand letters in a hundred days. And if we can’t figure out how to energize a constituency for childbearing issues, well, there still is the witness protection program.
All kidding aside, I believe that against all odds fundamental change is not only possible but to be expected. I am old enough to have already seen really big social changes come to fruition and to believe that if it can be done once, it can be done twice. As a teenager, I lived in the Dark Ages of the Deep South, that is to say, a deeply segregated society that was not shy about enforcing a harsh system of total separation and frequently used violence to preserve a decadent and demeaning way of life.
I lived in a segregated world, attended segregated schools and provided maternity care in a segregated hospital. Indeed it was a system that was decadent for white and demeaning for blacks. However, what I remember as particularly repugnant was the experience I had many times when we stopped to use the restroom at a gas station on the way to the East Coast beaches. Instead of the usual arrangement of one mens' and one womens' restroom, it had three bathrooms -- ‘White Ladies’, ‘White Gentleman’ and ‘Colored’. One need only to think about that for a minute or two to get the dehumanizing aspect of this southern convention.
It was wrong, it needed to be changed and it was. Not only are the restrooms on the highway to Cape Canaveral Florida no longer segregated, but every other institution of modern life is as well, so much so that we don't even think about it. Younger people can't believe it was ever any other way. Someday, the social prejudice against us will be eliminated and those same humane principles of "integration" will apply to maternity care.
Right does win out if one is willing to believe in it with all one’s heart, work for it with all one’s abilities and wait expectantly for the process to come to fruition. And yes, some of us are called upon to work awfully hard and even suffer in the process but then, heavy labor always hurts yet, its always worth it. If as midwives we can expect the laboring women we serve to work hard and tolerate the pain, then surely we can take our own advice.
Warm Regards, faith ^^O^^
I continue to get emails asking me "where's the generic or "form" letter???"
So here is the latest post on the CEO site, regarding the topic. It can be accessed from
www.sciencebasedbirth.com // sub-directory "Bottom Line -- 5 minute short cut for busy people".
Click on the link "Next Generation Form Letter".
I'm be paying attention to see if people actually print up and mail the form letter to Maria Shriver (and notifiy CEO via email) or the form letter conversation is a more elegant stalling technique. Chow, faith ^O^
READ ME FIRST :
Many have asked for a simple form letter that could just be printed out, signed and mailed. The bad news is that legislators pay little attention to three type of political activism -- petitions, emails and form letters -- they consider them a type of "junk mail" that does not represents a passionately committed and informed constituency.
So I'm posting a 'next generation' form letter -- a 'Chinese menu' template with two or three choices for each category so that people can cut and paste one-of-a-kind form letter. Writers may also go to the Letter Archive, read the correspondence already sent, use any of those ideas or cut and paste text from those sources to their own unique letter. (There are links to example of this build-your-own template technique on the web page).
FORM LETTER However, for those who just don't have the time for the build-your-own version, click the link below for a real, sure-enough form letter. Be sure to delete the heading (red type) and add your name before printing.
================================TEXT for form letter ============================================
FORM LETTER -- add date and your name & address before printing
Office of the First Lady
State Capital Building
Sacramento, CA 95814
Mothers Day 2004
Dear First Lady,
I am writing on behalf of the Consortium for the Evidence-based practice of Obstetrics (CEO). The medically-interventive, obstetrical model used routinely on healthy women causes major problems. Obstetrical intervention for healthy women is not scientifically-based. We need public dialog to bring about appropriate changes in our national maternity care policy and the reform these potentially harmful obstetrical practices.
Physiological management provides the safest and most cost-effective form of maternity care and is associated with the lowest rate of maternal and perinatal mortality and the greatest wellbeing of mother and baby. Science-based or ‘physiological’ model of childbirth should be the universal standard for healthy women with normal pregnancies for healthy populations.
Legislative hearings are necessary so childbearing families who have had negative experiences with the current system can testify on problems such as:
(1) off-label use of Cytotec for labor induction & increasing percentage of non-medical induction
(2) the ever-climbing cesarean section and maternal mortality rate that is 30th in the developed world
(3) the danger in promoting the maternal choice cesarean as an idealized form of childbirth
(4) the physically damaging effects on the pelvic floor and pelvic organs associated with medical management of vaginal birth --
Examples include: procedures or policies that keep a laboring woman confined to bed such as continuous electronic fetal monitoring, the use of artificial hormones to stimulate or accelerate labor, narcotics, epidural anesthesia, requiring the mother to labor or push in anti-gradational positions, prolonged-breathe holding, episiotomy, operative delivery, etc
The need for a new law requiring physicians to provide full information about the risks of each significant medical or surgical intervention and to obtain truly informed consent before substituting medical and surgical interventions in place of the safer, evidence-based principles of physiological management.
Thanking you in advance,
Put your name & address here
CEO’s Post Independence Day Message ~
Declaring Peace on the normal biology of childbearing women
The idea of declaring war seems to be very appealing to the American psyche the war on drugs, the war on poverty and a constant stream of mini-wars on cholesterol, failing schools, single mothers, and gay marriage. There must be a better, less violent way to work for social justice.
So in honor of our recent 4thof July holiday, I declare our independence from this battlefield mentality by making a Declaration of Peace on the normal biology of childbearing women. Instead of making war, we can commit ourselves to making peace on healthy women and normal biology. In recognition of the vitriolic tone and recriminating nature of the ancient conflict between the medical and midwifery traditions, we can also declare peace on maternity care providers of every educational background, whatever their ideology. Instead of offering ourselves up as soldiers willing to die for our country, we can live in the expectation that one day, some day soon, people everywhere will wonder what the big deal was and why would anyone object to the science-based use of physiological management.
The Action Plan du jour ~ I'd like to have some idea of who and how many of you are really interested in pursuing the goals of the CEO & A_CEO. Our most immediate goal is national maternity care policy reform that would end the routine use of potentially-harmful obstetrical practices and establish a single, science-based or ‘physiological’ model of childbirth as the universal standard for all practitioners providing care to healthy women with normal pregnancies. If accomplishing those goals seem important and you are personally willing to work for them under the umbrella of the Consortium, then please email me at the CEO firstname.lastname@example.org. Also i would like to know if any of you are distributing the CEO messages du jour on to other email lists so i can judge the level of response, based on the size of the group.
UPDATEAt present the letter-writing seems to be stalled. While there may be more letter sent to First Lady Maria Shriver, CEO has only received (and posted) 13 letters. However, the 100 days is not up yet and so we'll keep on keeping on till then.
Hope to get lots of emails from people who believe that we can "declare peace" on normal birth and help to rehabilitate the harmful practices so often used by contemporary obstetrics on perfectly healthy women.
warm regards, faith ^O^