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Open Letter to President-Elect Obama

Dear Mr. President-Elect,




Congratulations are in order for me, too. For the first time in over a decade, I feel hopeful about my country’s future. I am compelled help in the ways I can, driven to create the new world you speak about; I am here with energy and heart.


I know you have an endless list of tasks to tackle right off the bat, but I thought I would ask one more thing of my new president. It’s actually a symbiotic request since, if it were initiated, would help so many of those that need help... those who live with and around us.


You already know what a distressing state health care is in our country. We seriously need to find a way to give more care while keeping costs to a minimum. One low-cost, effective and humane way to bring quality care to pregnant women is to embrace and endorse midwives licensed by the North American Registry of Midwives in the United States. Individual states have been in charge of the licensing and regulation of non-nurse midwives, but it would bring a new level of legitimacy if our new president found it important enough to advocate and support national regulation and implementation.


Licensed midwives cost thousands of dollars less than nurse midwifery care and can cost tens of thousands less than physician care. Research into the safety and efficacy of homebirth midwives continues growing, but at this time, the statistics are positive – could be better, but your endorsement can make that happen.


One statistic that isn’t in question is midwives have a far, far lower rate of cesarean sections than physicians. Millions, if not billions, can be saved every year by lowering the cesarean rate.


With legalization in all states and territories, with regulation and standardization, the largest obstacle between the best of midwifery care and what exists now would fall by the wayside: physician collaboration. If physicians were required by law to collaborate with midwives, the care we offer would improve, the safety of mothers and babies would increase and the women and their fetuses or newborns would exquisitely benefit. As it stands now, women seeking midwifery care are left without the safety net of obstetricians should any deviation from the norm appear.


Most Licensed Midwives around the country also operate without malpractice insurance because there is no requirement for insurance companies to do so. If the government legitimized midwifery and physicians were required to collaborate with us, insurance companies could also be required to offer a basic need of midwives and families – insurance.


Probably the largest benefit for women and our country is that midwives would finally be able to attend women on Medicaid! The rate of pay for a vaginal birth is low, but midwives would be honored to be the care providers for the poorest of the poor. And if we are lowering the rate of cesareans, significant cost-savings for the government will, once again, come into play.


Please, Mr. President-Elect, please elevate midwifery and establish national licensing standards and incorporate us into the national solution for improved healthcare for pregnant women and their babies. We are a resource just waiting to be tapped into!


Bring the midwives along with you, dear Sir. We are eager to serve our country with you as leader.


Congratulations again... and thank you for everything. 


Barbara E. Herrera, LM, CPM

San Diego, CA

Reader Comments (10)

You're really going to send this right? Because I think we should all send something similar. Thanks for sharing! :)

November 6, 2008 | Unregistered CommenterMicki


November 6, 2008 | Unregistered CommenterGail

Well, Open Letters aren't sent... they are found and read. I put it in my FaceBook Notes, too. Let's hope the right people read it!

November 6, 2008 | Registered CommenterNavelgazing Midwife

While it is true that open letters are not typically sent, perhaps this is one that should truly be passed on. We run the chance that maybe the administration will hear this from enough people, lawmakers and constituents, and it will come into consideration when the president-elect is working more on his health plan for the nation.

I urge you, like previous posters, to please send it, and for us all to draft our own, similar letters. It is powerful, beautifully written, and a very important subject that needs to be discussed by many. It also may be beneficial to the cause to redraft this as a form letter for readers to send to their own lawmakers.

November 6, 2008 | Unregistered CommenterKendra


November 6, 2008 | Registered CommenterNavelgazing Midwife

Isn't it great to have a president (elect) where you feel like he or his staff will actually read and consider a letter that is sent to him? I think that is why so many people feel hope about this president, because he has given the impression that he will listen and work with us. It feels like there is room to advocate, and like it may actually make a difference. I hope you send it, and I hope others send many that are similar.

November 7, 2008 | Unregistered CommenterJennifer (mama blogess)

I'm working on a template letter and should have it up in a few hours. I will make it so it can be printed (put on my Ama Mama Midwifery site).

Thank you all for encouraging me to do this. I think it's a wonderful idea and I am thrilled to begin its implementation!

November 7, 2008 | Registered CommenterNavelgazing Midwife

You really should submit this to Mr. Obama's transition team website Change.gov where he specifically asks for input from the American people.

November 7, 2008 | Unregistered CommenterAnonypilgrim

I shall. Please see the next post up... and YOU, TOO, send a letter out to a dozen places. :)

November 7, 2008 | Registered CommenterNavelgazing Midwife

I am not an Obama voter...but I do agree he's going to be my president. I am praying for him, and for our nation just as I have prayed for past leaders. Just to state that up front.

I am impressed with your letter, and feel that this IS the time for such change in health care. Cost effective methods are hard to come by, and your suggestions appeal to this. But secondly, they also address the issue of choice for women in birth. If a woman's risk is low enough, she has a choice. If a woman has an issue, she has a safety net. This is an amazing well thought out letter, Barb, and I for one support you on this. So much money is spent in the hospital for birth...charges for each little thing. This is a way for women to be responsible for their decisions. I can also forsee a safer situation for mothers in late term crisis pregnancy like teens, who may not want to go to a hospital but could call a midwife. Rather than secret delivery at home alone, they could have midwives. If midwives were part of our communities, such as in church congregations, parents on the PTA, or in other ways involved, women and teen moms could easily seek them out for care. If county health departments contracted midwives, much care in the homes could occur that might not now. Postpartum depression could be handled, with midwives popping in for care during the critical time after a baby is born. This seems like a perfect situation to solve a lot of problems...

November 13, 2008 | Unregistered CommenterDawn

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