Saturday, October 31, 2009

My Guest Column in Today's Herald Tribune

On Sunday, the Sarasota community has an opportunity to improve the health of our pregnant women. "Maternal Health Care in the 21st Century: Sarasota and Beyond" is a free discussion featuring leaders in the fields of obstetrics, midwifery, public health and public policy. This balanced panel will create a forum for much-needed dialogue about the state of maternity care in Sarasota.

The distinguished panelists for Sunday's program are Dr. Washington Hill, M.D., FACOG, medical director of labor and delivery at Sarasota Memorial Hospital; Ina May Gaskin, CPM, founder and director of The Farm Midwifery Center; Jennifer Highland, executive director of the Healthy Start Coalition of Sarasota County; and Rep. Keith Fitzgerald, District 69, Florida House of Representatives. The discussion will be moderated by Sarasota Vice Mayor Kelly Kirschner.

Each speaker will offer his or her unique expertise with regard to the current condition of maternal health care and what we can do to improve it. Attendees will have the opportunity to ask the panelists questions immediately following the discussion. There will also be several guests in attendance with expertise in different areas of maternal health care, to whom questions can be directed as well.

The American obstetric model is being replicated worldwide, yet we are failing our pregnant women. According to a World Health Organization report released this July, America ranks 35th in maternal mortality and 33rd in infant mortality, two widely recognized barometers of public health.

We cannot improve America's maternal and child health status without making changes in our own community that ensure that prenatal care is available for all of our women and families, and that modern medicine and technology are being used appropriately.

While obstetric interventions like labor induction and cesarean section surgery are absolutely necessary and even lifesaving for some, they can be detrimental and life-threatening for others, and are extremely costly for taxpayers (Medicaid covers about half of all births).

It is our responsibility as maternity-care consumers to become educated about all options available to us. This education is a key objective for the planners of "Maternal Health Care in the 21st Century: Sarasota and Beyond." Each attendee will leave the program with a resource guide outlining available prenatal and maternity-care services in Sarasota, a glossary of terms and explanations of different models of care.

One possible way to improve outcomes for mothers and babies is to increase access to, and education about, midwifery care for low-risk, healthy pregnant women, and to encourage a collaborative model of care, whereby midwives and obstetricians work together to give each woman the most appropriate care for her specific set of risk factors.

Pregnant women in our community are very fortunate to have options within both the obstetric and midwifery models of care. Sarasota is home to two free-standing birth centers, four licensed midwives, several certified nurse midwives, many obstetricians, perinatologists and a hospital with the only Level III intensive- care nursery in this four-county region. There are options for low-income and uninsured families to receive quality prenatal, childbirth and postpartum care, regardless of income.

Improving Sarasota's maternal health care will take a collaborative effort by individuals and organizations in many disciplines working together to provide affordable care based on the best evidence available.

However, no advances can be made without the effort and participation of concerned and informed consumers. By attending "Maternal Health Care in the 21st Century: Sarasota and Beyond," Sarasota's women, families and maternity-care practitioners will be on their way to positive change in our community.

Laura Gilkey, vice president of Florida Friends of Midwives, is co-planning "Maternal Health Care in the 21st Century: Sarasota and Beyond" with Sonia Pressman Fuentes, co-founder of the National Organization for Women.

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