Wednesday, November 4, 2009

Missouri Natural Birth Center Announces Closing

The Columbia Community Birth Center has announced that it will close its doors at the end of the year. According to media reports, medical director, Elizabeth Allemann, M.D., is leaving the practice and the center is unable to find a replacement physician. Without a physician, the birth center is unable to accept insurance reimbursement.

Click here to read newspaper story.

Other media reports claim that the community and legal acceptance of homebirth , midwives also made it difficult for the birth center to continue.

Columbia Community Birth Center was opened three years and delivered 175 babies.

I do not have first hand information into the closing of the center other than what I have eread in the press, although I have had conversations with Dr. Allemann in the past.

A commentary on the closing of this Missouri birth center is actually quite difficult , because of the mutual distrust in Missouri, between midwives and physicians. Allow me to give a brief history from memory, and my apologies if I get it wrong.

In Missouri it was a felony to act as a midwife without a nursing license. Missouri did not recognize the CPM. A committee chairman in the Missouri legislature put wording into a bill that decriminalized midwifery. The wording was in such archaic language, that the word midwife was not used, (I believe even the terms labor and birth were not used) and no one objected until after the bill was passed. The governor refused to veto the bill after the midwifery clause became publicly known, not because the governor wanted to legalize midwifery, but rather he needed the rest of the bill and would not veto the entire bill. The physicians brought a court case to overturn the new law and were eventually rebuffed at the Missouri Supreme Court, due to "lack of standing."

If one were to look at this as an outsider, you would see everyone did what they needed to do. The homebirth advocates got very creative and found a legislative supporter to push the bill through. The physicians attempted to protect their turf by fighting against it (although they claimed that they were fighting on behalf of moms and babies, which is not their mandate and which the court called them on, when throwing out their case)

My question is: are you surprised that based on the above stated scenario that it would be difficult for the birth center to find physicians who want to work with it?

Yesterday, when discussing agendas,. I talked about battle plans. The problem in political and legal battles, is when the battle is over (although the war may continue) you may actually have to work with your enemy or your friend who is on the other side. It's why in sports it's bad form to run up the score.

When you win your battle, keep an open door to your opponent. You never know when you need them.


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