She'd also been kicking around the idea of becoming a lawyer, thanks in part to a psychic friend of her brother's who predicted she'd go to law school. Since she was going to be in Boulder for the conference anyway, she made plans to sit in on a law school class at the University of Colorado. She liked the class, and when she returned to the conference that afternoon, she attended a session in which one midwife was lamenting Colorado's laws. What we need, she said, is "a hot-shot legal team."

"I said, 'I think I'm going to go to law school to become that hot-shot legal team,'" Indra says. "And everybody was like, 'Yeah! You go!' So that really inspired me." On the drive home that night, she cried. "I felt a sense of purpose and like I made sense, and my skills and interests were coming together in a way that could make a difference."

Indra hurried to take the LSAT and apply to law school. She was accepted to the University of Denver in 2006, and, after being offered a scholarship, quit her teaching job and enrolled in the law school's night program.

Indra Lusero is putting her law degree to work for midwives.
anthony camera
Indra Lusero is putting her law degree to work for midwives.
Indra Lusero in a family photo, shortly after giving birth to Eliot Indigo.
anthony camera
Indra Lusero in a family photo, shortly after giving birth to Eliot Indigo.

In school, Indra pored over the midwifery law and wrote several papers on the history of natural birth in Colorado. She developed a reputation and started getting phone calls about birth-related law questions. Midwives asked her for help when a complaint was filed against them. One midwife consulted her on how to fill out the birth certificate for a baby born to a transgender couple. She was contacted by a pregnant attorney who wanted to know if it was legal for her to refuse to walk through a metal detector for fear it would harm her baby.

Indra graduated from law school in December, and plans to take the bar this summer. In the meantime, she's concentrating on other projects, including Delivering Natural Care for Families. The coalition isn't just Indra: Seth Donovan, a community organizer and reproductive-justice advocate, has been helping for months. Indra also recruited Jacinta Montoya Price, who recently left her job as director of COLOR to give birth to her son. Montoya Price had wanted to have a home birth, but her health insurance didn't cover it.

Together they developed a list of changes they'd like made to the midwifery law. Some are the same as the DORA recommendations, and thus supported by the CMA.

But a few go further; for instance, they're pushing for allowing midwives to administer local anesthetics and IV fluids, and to be able to suture women who experience tears during childbirth. Several midwives say they already do so, regardless of the legality. But Indra and others want it on the books. They're also asking to add language that encourages more collaboration between midwives, nurses and doctors.

"Right now, the law literally says that even though we're going to regulate home-birth midwifery, we don't feel good about it," Indra said to a group of home-birthing moms gathered in a funky Fort Collins coffee shop one recent Saturday afternoon. "We need to wipe the slate clean and then we can build from there."

Meetings like the one in Fort Collins are part of the strategy, too. For the past two months, Indra and Seth have been holding workshops. Though their numbers are still small, outside experts who are keeping tabs on the midwifery sunset review, such as David Swankin of the Citizen Advocacy Center in Washington, D.C., predict their mere presence will make a difference. "The idea that they're organized, even if they're small, is important," he says.

******

It appears that they're already making a difference. On January 19, the Senate Health and Human Services Committee held the first hearing to decide which recommendations will make it into the first draft of the bill. Representatives of the CMA, the obstetricians, the pediatricians, the certified nurse-midwives and the Colorado Nurses Association all took the microphone to oppose or support the changes.

As expected, the doctors, nurses and nurse-midwives testified against granting midwives "limited prescriptive authority" to obtain and administer certain drugs.

"To simply allow them to write prescriptions," said Steve Holt, an obstetrician and president of the Colorado chapter of ACOG, "that just is not appropriate."

Mary Ciambelli of the Colorado Nurses Association agreed. Direct-entry midwives, she told the committee, "don't have the appropriate training or skills in pharmacology."

Instead, the doctors and nurses wondered if there was another way to allow midwives access to certain drugs without handing them a blank prescription pad. "We'd be happy to discuss some different terms that could be utilized" other than "limited prescriptive authority," said Jessica Anderson of the American College of Nurse-Midwives.

Their opposition prompted questions from lawmakers and caused Senator Shawn Mitchell, a Broomfield Republican, to wonder whether the disagreement was "a fight over the symbolic high ground" rather than a concern over the drugs in question.

The Colorado Nurses Association also opposed allowing nurses to simultaneously register as nurses and direct-entry midwives. Dual licensure, Ciambelli said, would "cause even more confusion than there is today" about the difference between nurses, midwives and nurse-midwives. "We need to protect the title of nurse," she said.

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27 comments
Dlmakamartha
Dlmakamartha

Women and babies suffer at the hands of doctors and nurses way more than midwives....unnecessary interventions leading to major abdominal surgery.....I am so sorry for every mother/family that has suffered at the hands of any provider....but it is no reason to throw the baby out with the bath water! Tragedies happen in all stages of pregnancy and delivery and the right people need to be held responsible. But it's not a good reason to ban all midwifery or to issue a blanket statement that women should only have their babies in the hospital. Do you research people and make an informed choice for you and your baby....instead of following blindly like sheep.

I've had a baby in the hospital and one at home....I will forever have the rest of my children at one....

Liz
Liz

I have suffered tremendous injuries from a Colorado DEM. They aren't required any formal education. My midwife is currently under investigation for negligence. She tried to offer someone else's prescription to induce my labor because I was post due. She was gravely uneducated in GBS protocol. She wanted to "sterilize" her instruments in a baking pan in my oven. She tried to "PowerBirth" me without my consent (I wasn't dilated completely when she told me to start pushing.) She forcibly broke my water with her finger. She yelled at me to push every ten seconds, that I was wasting my contractions, wasn't working hard enough, didn't want my baby enough. She kept saying she could see the head, but I didn't feel it. After 3 hours of pushing, I was weak. She put oxygen on me because I was going to pass out, but she forgot to turn it on and left me alone in my room. When I transferred to the hospital, she did not take me to the hospital in our emergency plan, but to a hospital farther away because she had a "better relationship with them." She refused to transfer my medical records to the on call OB. I was so swollen from pushing before being dilated that it took over a half an hour, two L&D nurses, and many, many tries to even insert a catheter. The "head" she saw was a blood clot that had formed on my bladder- I was only 6 cm dilated. "Oh, she must have undilated when we got to the hospital," was her response to the OB. After my csection, my surgeon said he had to literally pick my bladder up and put it back where it belonged, I was pushing so hard before complete dilation. My child almost died from her incompetence. He had to be recuisitated at birth. I suffered uterine trauma, a severe prolapse, and I'll be lucky to sustain another pregnancy. My body will never be able to vaginally birth a baby. Dare to call me an "uninformed skeptic?"

LindaRosaRN
LindaRosaRN

Families who have been injured by midwife care are beginning to tell their stories at "Hurt by Homebirth" (http://hurtbyhomebirth.blogspo.... These are horrific stories of gross incompetence resulting in needless deaths and injuries.

On this site, note "Zen's Story" about a Colorado "direct-entry midwife" (DEM) who apparently couldn't tell the difference between a blood clot and crowning of the infant's head (and had a woman pushing for three hours when her cervix was only partially dilated). This DEM also prescribed garlic as vaginal suppositories for Group B Strep infections, etc.

I urge families who have been injured by DEMs to come to the Capitol in Denver on Tuesday, April 19th to speak to the House Judiciary Committee (hearing starts 1:30pm in Room 107) on SB-088, a bill that seeks to expand the midwives' scope of practice.

"Regulation" of midwives has done nothing to protect the public, but only dupe the public that DEMs have the State's blessing to provide what is really alarmingly substandard care.

If you have suffered a loss or injury at the hands of a Colorado direct-entry midwife, please contact me: contact*at*childrenintherapy*dot*org

john
john

Grace S and other closed-minded, uninformed skeptics, please check out the documentary, and website, The Business of Being Born.

Grace S
Grace S

It just AMAZES me that people can be so self-absorbed and egotistical that they would take ANY risk with the birth of their baby, as if it's all about *them* and not their baby. And now these unprofessional midwives want to be able to "play doctor" by using medications and suturing in people's homes!? Why don't they just become OBGYN doctorsi if they REALLY want to help moms deliver their babies? It BOGGLES the mind!

Njcronk
Njcronk

Grace, I think you have never been at a midwifery birth. If you had, you would see the huge difference in quality of care -- by midwives. Here is my story. I've had both. A birth with a midwife and a birth with OBs. I would pick the midwife birth every time if I could.

http://www.huffingtonpost.com/...

Westword W. Westword
Westword W. Westword

If you would like your comment considered for our Letters to the Editor section, please e-mail me with your name and town (we don't print e-mail addresses)at patricia.calhoun@westword.com.

Leanna14369
Leanna14369

I pray for you and your family and hope this all happens in the best way. I want a midwife, so good luck!!

Karen Robinson, CPM, RM
Karen Robinson, CPM, RM

Because of the way the Department of Regulatory Agencies has collected information regarding homebirths in Colorado, information about perinatal demises is sketchy at best. Some midwives report first trimester miscarriages as perinatal deaths. DORA does not collect details on the surveys midwives complete, so we have no way to know what happened with the demises that have been reported. The Colorado Department of Vital Records also tracks homebirths and their reported demise rate for planned homebirth is less than 3 per 1000--which is what one would expect in the low risk population direct-entry midwives serve.

Karen Robinson, CPM, RMPresidentColorado Midwives Association

LindaRosaRN
LindaRosaRN

About that 3 deaths per 1000 births. Shame on Ms. Robinson for presenting this very misleading statistic.

I called Vital Statistics. The Colorado Department of Health Environment has data on direct-entry midwives for 2007-2009: For midwives, the department does not collect data on deaths for the usual perinatal period (i.e. week 20 of pregnancy through 28 days after birth), but only deaths in the neonate period (i.e. first 28 days of life). Then only deaths that occur at home go on the midwives' record. Any distressed infants transferred to a hospital and die there (or are declared dead there) are not added to midwives' kill rate.

And actually, infant deaths with low risk pregnancies should be more like 1 death per 1,000 births. An obstetrician may only see one such death in his whole career.

DORA's data also under-reports midwife-related deaths in a number of ways.

So much for midwives being "experts at normal deliveries." As someone said, "That's like being a pilot who is an expert at flying in good weather."

Linda Rosa, RN
Linda Rosa, RN

Ms Robinson's statement does not seem to jive with the data provided by DORA:

http://www.dora.state.co.us/mi...

Where are those first trimester miscarriages of which you speak? I presume the demises are here, reported as required by Colorado law of register midwives.

Regarding the statistics by the Colorado Department of Vital Records: that rate must be largely for unassisted-by-midwife, spontaneous births. But DORA's data clearly shows that having a registered midwife assist at a home birth puts the death rate over three times that amount (11.3 deaths per 1,000 births).

And look at the huge number of transfers to hospital care. Presumably those are emergencies where lives and staving off injury are dependent on STAT care.

What is sketchy is the number and type of injuries suffered by newborns who survive home deliveries. DORA should be collecting that data as well.

I also note on websites of Colorado midwives that they generally state that home birth is "safe" and even imply that it is safer than hospital care. That is misleading the public.

I agree that adults should be allowed to risk their own fool necks, but putting infants at needless risk is another matter. Seriously, what is more important: having the best possible outcome for an infant or having a pasta party with friends after a delivery?

2AlbertaA
2AlbertaA

32 yrs ago, my daughter had a home birth with a midwife, nurse studying midwifery and a physician who approved of such and me holding a mirror so she could watch...important since I had been given that choice when she was born. It was wonderfull and within an hour we all sat around the table and ate lasagnia and toasted the great experience and new grandchild. Since then Ive had five grands waterbirths and a greatgrandson by 32 yr old gd.All have been happy and no problem events. New mexico and Colorado are with it....from a believer.

Linda Rosa, RN
Linda Rosa, RN

One thing more...

When things go wrong with lay midwives and home births, there is now a new website for families to tell their tragic stories:

Hurt by Homebirthhttp://hurtbyhomebirth.blogspo...

These heart-rending accounts are a far cry from the hot-tub-poetry-drumming-birth-as-theater sort of event described in this Westword article.

Linda Rosa, RN
Linda Rosa, RN

What I don't see in the Sunset Review or this Westword article is a comparison of death rates -- the bottom line on issue of direct-entry midwives.

The incidence of death of newborns at the hands of direct-entry midwives is appalling high in Colorado, and climbing. The last figures put it at 11.3 deaths per 1000 births. That is DOUBLE the rate of the rest of the state. Also consider that the direct-entry midwives are not involved in high-risk pregnancies, premature births, etc.

For more info, see comments by Amy Tuteur, MD:http://skepticalob.blogspot.co...

Linda Rosa, RNLoveland, CO

Bbcatcher
Bbcatcher

Linda, I am trying to research these statistics. Can you give me your source for this number, as I've not been able to verify it? Thanks,Janelle Komorowski, CNMGreeley CO

Guest
Guest

Seriously, you're quoting Dr. Amy??? The woman actually believes the Wax Paper is good science!

inkintheveins
inkintheveins

I heard Indra speak during the Senate hearing and she was absolutely amazing. I spoke too, but got too choked up a couple of times talking about how important home birth is for those of us who choose it. Here is the written version of my testimony: http://www.facebook.com/note.p...

Guest
Guest

"Home birth has long been a controversial issue. Doctors and nurses say it's unnecessarily risky, and they criticize the midwives who deliver babies at home as amateur and insufficiently trained." ------- How absurd! Women have been giving birth how long compared to the "Medical Profession" which has been established how long?

A great book on this is - Witches, Midwives, and Nurses, A History of Women Healers by Barbara Ehrenreich and Deirdre English- original publishing 1973 Feminist Press. It is only 48 pages and well researched and referenced.

Marvelousbobchestnut
Marvelousbobchestnut

The baby on the cover doesn't have nipples or a belly button. Is this because of anti-obscenity laws?

 
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