Midwives, Moms Say State Harassed|and Investigated Them in Bad Faith

EUGENE, Ore. (CN) – Nineteen midwives and pregnant women claim a state licensing agency bullied the moms to keep them from having home births and ran investigations on trumped-up charges in at attempt to shut down Oregon’s largest midwifery center. Andaluz Waterbirth Center and Alma Midwifery joined the women as plaintiffs in the federal class action.

     Midwives in Oregon may preside over home births, including difficult deliveries of breech babies, twins and babies born after their mothers have had a Caesarean section, according to the complaint.
     But lead plaintiff Jennifer Gallardo, owner of Andaluz Waterbirth Center, Oregon’s largest midwifery center, says employees of an unnamed Portland hospital publicly announced the intention of “top officials” to shut Andaluz down unless its midwives stop delivering breech babies and twins outside of hospitals.
     Gallardo and the other midwives declined to name the hospital in the complaint, saying the parties are involved in mediation.
     Gallardo claims the Oregon Health Licensing Agency played along with the campaign, initiating “bad faith” investigations and filing baseless complaints against Andaluz.
     Gallardo says the agency is targeting Andaluz not because of any actual violations, but merely because midwives there are practicing their profession. She says the false charges have scared mothers away from the center.
     The moms and midwives claim that the Licensing Agency’s Director Randy Everitt’s actions “have been geared towards punishing midwives who perform these births,” despite their legal right to do so.
     While conducting the bad-faith investigations, the agency harassed pregnant women who sought to give birth at home or at a midwife-centered birthing center, according to the complaint.
     Agency investigators Tim Molloy and Janet Bartel allegedly demanded the women’s medical and birthing records, in violation of the Health Insurance Portability and Accountability Act. Both investigators are named as defendants.
     Gallardo claims the investigators, who have no knowledge or training in midwifery, forced the women to describe “the most intimate details of one of the most personal of life experiences to state investigators who they know to be antagonistic toward their midwives.”
     Gallardo claims the investigators intended to harass the women into having their babies at hospitals “and to make it nearly impossible for birthing mothers to find a midwife willing to attend their birth.”
     Seven plaintiff-mothers seek class action status on civil rights claims, asserting their right to give birth attended by a midwife and to protect their medical privacy.
     Midwives provide prenatal and postpartum care. In Oregon, midwives may deliver babies without a license. In 1994, midwives lobbied to create a licensing board, to increase their credibility with mainstream doctors and to get coverage from clients’ insurance policies.
     “The medical community in Oregon lobbied against the bill to establish the Board of Direct Entry Midwifery. They did so in large part to protect their economic interests in having a monopoly on health care in the state of Oregon,” according to the complaint.
     The doctors say that deliveries of twins and breech babies should be done only through expensive Caesarean section, according to the complaint. It adds that obstetricians often claim that births outside of a hospital are unsafe.
     But Gallardo says that “breech and twin homebirths have been the current and virtually only method for delivering babies for centuries and, in this country, are a part of its rich history. Obstetrics is not a part of that history, but is a new medical model ground in allopathic medicine and surgery.
     “Experienced midwives consider breech births and delivery of twins as natural birthing events. Under most circumstances, trained midwives are fully capable of performing such births.”
     In the event of complications, midwives take mothers to the nearest hospital.
     Medical doctors treat births of breech babies, twins and births after mothers have had Caesarean operations “as medical problems,” Gallardo says, and “routinely turn to invasive procedures such as Caesarean operations.”
     Caesareans are the most common operation performed in U.S. hospitals, Gallardo says, citing a study published by Amnesty International.
     She says they account for 32 percent of all births, despite a World Health Organization recommendation to keep the average between 10 and 15 percent of births.
     Caesareans triple the risk of maternal death and put both mother and child at risk during future pregnancies, Gallardo says. She claims that 40 other countries, including “nearly all” industrialized countries, have lower maternal death rates than the United States.
     Half of the women who undergo Caesareans experience complications, including “infection, blood loss and hemorrhage, hysterectomy, transfusions, bladder and bowel injury, incisional endometriosis, heart and lung complications, blood clots in the legs, anesthesia complications [and] re-hospitalization due to surgical complications,” the midwives claim. They add that “chronic complications from scar tissue adhesions include pelvic pain, bowel problems and pain during sexual intercourse.”
     Not only is the procedure dangerous, expensive and too heavily relied upon, Gallardo claims, midwives have the expertise to safely perform vaginal births “that would otherwise result in a Caesarean operation.”
     And that, they claim, is “an economic threat to the medical community.”
     The women seek declaratory judgment and injunctions on constitutional claims, including free speech, free association, due process, equal protection, and freedom from searches and seizures. They also alleged intentional interference with economic relations. And they want the state agency restrained from filing “‘bad faith’ complaints that do not factually allege midwifery practice violations,” and ordered to expunge records of bad faith investigations of midwives. Plaintiffs are represented by Roy Haber of Eugene and Michael Rose of Portland.

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