| 7 Jan 2006 @ 03:57, by Letecia Layson|
2118 Wilshire Blvd #377
Santa Monica CA 90403
December 26, 2005
This year has been a time of big transitions for the Hollywood Birth Center and me. On September 15, 2005 the Hollywood Birth Center officially closed its doors. I am currently facing disciplinary action with the California Medical Board that will affect not only my personal career as a midwife, but also midwifery in the State of California. I am writing to you to share with you the many factors leading up to this, to open the door for discussion with you and to urgently ask for your help.
When Tai and I started the Hollywood Birth Center back in 2000 we had a vision of creating a space where the families of Los Angeles could come to get complete prenatal care, birth their babies in a beautiful, nurturing space and be part of a community that supported them in their choices. Our commitment was to help individuals become empowered parents and to bring babies into the world in the most peaceful way possible. Despite many obstacles, in the 5 years we were open, we had the privilege of working with over 400 families.
Before opening HBC, I had completed 5 years of apprenticeship, had been a midwife for 3 years and had recently completed the California Challenge process, which was the only way for an experienced midwife to become licensed by the California Medical Board under recent midwifery legislation. Tai had been attending births as an apprentice for 5 years but still needed to complete the prescribed number of catches to go through the Challenge process and become licensed. Although Tai was my partner in the business, she was technically my apprentice and working under my supervision as her preceptor. Direct entry midwives have always received their training through apprenticeship although California law did not address it one way or another.
Tai, as many of you know, sat the challenge exam 3 times and was unable to pass part of the written section. 3 times was all that she was allowed and by not getting through the challenge process, she had no other way to become licensed except to go through an approved 3 year midwifery program. Her inability to pass the challenge exam created a huge dilemma for us because we had built the practice together and we were equal partners. We decided that she would mainly run the business and only attend births as a support person.
At some point the medical board became aware that she was an unlicensed partner and they began an investigation. The investigation was eventually dropped because no harm ever came to any clients and they could find no proof of Tai having practiced without me. The medical board, out of frustration, decided that because there wasn’t anything in the legislation about apprenticeship that they would interpret it as illegal. There was a notice sent out to all licensed midwives in California in fall of 2004 saying that we could not have apprentices. During this time I did not allow any of my apprentices do anything that could be considered ‘medical’. Many of you wrote letters to the medical board expressing outrage at this and the result was that apprenticeship was written into our legislation in January 2005.
In May, 2005 the medical board reopened their investigation and are charging me with “aiding and abetting in the illegal practice of midwifery” during the period 2001 through 2004. In other words, they want to discipline me for training and supervising midwives before the law specifically sanctioned such a practice. (It seems so unfair to have this happen when all of us who went through the challenge process were trained through apprenticeship long before the medical board was involved with us and they knew that). Since becoming licensed, I have trained many apprentices -4 who have passed their licensing exams and 1 who has finished her training and is sitting her exam in February. I have always been committed to training as many midwives as I could, believing that because the law did not specifically forbid it, and because I trained that way, it was legal.
During this stressful time I became ill with Fibromyalgia (an exhausting and painful immune disorder). I was unable to carry the load alone, so we hired other midwives to work with us, creating lots of financial strain. Finally, Tai and I decided that the best course of action was to sell the practice to other midwives who would carry on our vision for us. Unfortunately, Christine Anderson, the chiropractor who owns the building the birth center was in, was unwilling to lease the property to anyone we wanted to sell the practice to. Because neither Tai nor I had the energy to move the birth center in order to sell it, we chose to close the practice. We had clients who had paid in full due through October and our plan was to close at the end or October. Unfortunately we went bankrupt in July and had to close our doors on September 15th. Because Tai was unable to practice, she chose to leave at that time and move to Canada.
I continued to provide the care we had promised to our clients, with all of them choosing to birth in their homes. With the support of my apprentices, my family and many of our clients, we were able to create an amazing few months and had truly amazing births.
In August 2005, the medical board offered me a settlement where I would have to pay all the costs of the investigations plus 5 years of probation, 1 year of community service, an ethics class and only being able to practice under the direct supervision of an obstetrician. In effect this is a set up to not being able to practice anymore. I was ready to settle and move out of state, when I learned that the medical board intends to use my case to set a precedent to enforce ‘obstetric supervision’ with every licensed midwife in California.
California midwifery legislation says that all midwives must practice under the supervision of an obstetrician, but none of us can do that because the obstetricians who are willing to support us are threatened with losing their malpractice insurance if they supervise us. It also makes them liable for what we do, which isn’t fair to them. In reality we are all unable to comply with the law. The medical board is aware of this, but so far has not attempted to enforce the supervision issue.
What we have are collaborative relationships with obstetricians. This means that if we have a concern about one of our clients we can consult with, or refer our clients to see the obstetrician. Then, together we decide the best plan for care. If one of our clients develops a complication in labor, the obstetrician is on call for us and we can transfer into their care in the hospital. This works well for all of us. There is work being done by our state midwifery organization to change the ‘supervision’ wording in our legislation to ‘collaborative’, but it hasn’t happened yet.
The purpose of the medical board is to protect the public and ensure quality medical care, yet it seems that they are protecting the interests of the American College of Obstetrics and Gynecology (ACOG), who let us know at every medical board meeting that they do not want us to be able to practice. Regardless of the fact that we have better outcomes or maybe because that threatens them, they continue to try to get rid of us. I am not the only midwife in our area that is facing this type of disciplinary action, and some have had their license’s revoked.
So, in essence, what I thought was to be a personal loss may turn out to be a loss for every California licensed midwife. (Although I believe the biggest loss of all is to the future generations of mothers, fathers and babies who might not have the choice to receive the one-on-one attention that midwifery care provides).
In the end, this is not a personal or a professional issue. It is a women’s rights issue, and it affects all of us. This is not something I can fight alone. But I know that with the support of those of you who believe in the midwifery model of care, we can be a powerful voice for change. Only together can we create:
A world where all children are nurtured in tenderness and respect. All people thrive in their relationship with each other and the world. All of life flourishes.
My hearing with the medical board is scheduled for the week of January 23rd, 2006, only a few weeks away. If you are willing to help, here are some of the ways you can:
1) Call, write, fax or e-mail our local senators and assembly members letting them know how you feel about this situation. Calling or writing is the best way to get their attention.
email@example.com Assembly Member Karen Bass Senator Sheila Kohl 5750 Wilshire Blvd suite #565 10951 W Pico Blvd suite #202 Los Angeles, CA. 90036 Los Angeles, CA. 90064 (323) 937-3466 office (310) 441-9084 office (323) 937-3466 fax (310) 441-0724 fax
senator.Bowen@sen.ca.gov firstname.lastname@example.org Senator Debra Bowen Assembly Member Fran Pavley 2512 Artesia Blvd suite #200 6355 Topanga Canyon Blvd suite #205 Redondo Beach, CA. 90278 Woodland Hills, CA. 91367 (310) 318-6994 office (818) 596-4141 office (310) 318-6733 fax (818) 596-4150 fax
Senator Kevin Murray 600 Corporate Point suite #1020 Culver City, CA. 90230 (310) 641-4394 office (310) 641-4395 fax
2) Write letters of support for me that I can take to the medical board. email@example.com Constance Rock 2118 Wilshire Blvd #377 Santa Monica, CA 90403 (310) 836-4200 home (818) 324-2678 cell
3) Contact Senator Figueroa. She has been the champion of the California midwives, passing many bills that have affected the profession of midwifery in a very positive way. She has a lot of clout with the medical board. Figueroa@sen.ca.gov Liz Figueroa 43801 Mission Blvd #103 Fremont, CA. 94539 (510) 413-5960 office (510) 413-5965 fax
4) Join or donate to Citizens for Health Freedom. Visit their web site for more information. www.citizenshealth.org
5) Finally, I need support with financial contributions to pay for my attorneys fees. We are anticipating that it will cost over $15,000. A legal fund has been set up for me by my sister, who can be contacted at: firstname.lastname@example.org Suzanne Rock 6526 Zelzah Ave Reseda, CA. 91335 (818) 344-4714