Mama's Got a Plan:

Maternity Care, Health Insurance, and Reproductive Justice


Michigan’s 9-part CPM licensure odyssey: part 2

The Fellowship of the Bill – Part 2

This is the continuing story of Michigan’s nine-year journey toward a law to license Certified Professional Midwives. The first installment of the story is HERE.

Part 2

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About this panel

Back in Michigan – or, if you will, Lothlórien – the midwives began the work of convincing their colleagues, including one who had been arrested in the 1980s for the unauthorized practice of medicine (Frame 2). Other midwives were also beginning to feel uneasy, suspecting they were under scrutiny by law enforcement. A senior midwife (Bilbo Baggins – see Page 3) had a personal connection to Jean Doss, a wizard of a lobbyist experienced in licensure initiatives (Frame 3). However, that very experience made her reluctant to launch herself into another licensure fight. She warned the midwives that such legislation took at least 20 years to enact. Nevertheless, her determination and savvy were key ingredients in the quest.

It was all very well to speak of legislation, but a bill required a sponsor (Frame 4). The tall order faced by the midwives and their lobbyist was to identify a legislator of the majority party (Republican), who was not near to being termed out, who had some knowledge and sympathy for midwifery care, and who was not indebted to any medical professional groups. The group wooed and won freshman representative Ed McBroom, a dairy farmer from Michigan’s rural and remote Upper Peninsula. Not only had a midwife attended the home births of his (then) three children, but he himself had also been born at home. As were his cows (Frame 5).

And what were Michigan families – the “consumers” – up to during this time? Around the year 2000 Pamela Pilch, a Michigan mother, lawyer, opera singer, and all-around good egg, founded the Friends of Michigan Midwives, an organization intended to provide services to busy midwives. Although Pam left the state several years after, FoMM was later revitalized in order to support the licensure effort. For whatever reason, FoMM attracted many volunteers named Melissa: Melissa Hale and Melissa Ryba are both past presidents. Melissa Furlette, now a CNM, also served on the board. The hive metaphor was chosen because “Melissa” means “bee” in Greek, as does “Deborah” in Hebrew, as remarked by Deborah Fisch, another FoMM board member. The current president of FoMM is Elizabeth Hawver, whose name was left out of this frame because it unfortunately does not fit in with the bee naming scheme. Sorry, Beth! In every other way, you are the perfect leader!

 

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Michigan’s 9-part CPM licensure odyssey: part 1

The Fellowship of the Bill

Series introduction

Michigan’s nine-year journey toward a law to license Certified Professional Midwives was nothing less than a heroic quest. How better to portray it than through the story of The Lord of the Rings? The first book in Tolkien’s trilogy, The Fellowship of the Ring, seemed an appropriate choice to describe the hopes and strivings of the merry band of sisters that – slowly, excruciatingly – pushed legislation from opposition to enactment. Material in this cartoon was taken from Tolkien’s books and Peter Jackson’s films.

Many liberties were taken with both Tolkien’s story and Michigan legislative history. Events portrayed did not necessarily occur exactly as shown. Objects in mirror are closer than they appear. Onwards!

Part 1

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The immediate inspiration for this cartoon was a tableau created by Cardboard Box Office. That worthy website is the brainchild of a family that recreates scenes from famous movies using only the materials already present in their home, with cardboard boxes playing a large role. Their Facebook link to “The Lord of the Teething Ring” was subtitled “One does not simply crawl into Mordor.” It refers, of course, to the warning given by Boromir in one of the early scenes of the movie:

One does not simply walk into Mordor. Its black gates are guarded by more than just orcs. There is evil there that does not sleep. The great eye is ever watchful. It is a barren wasteland, riddled with fire, ash, and dust. The very air you breathe is a poisonous fume. Not with ten thousand men could you do this. It is folly.

In our cartoon, Mordor is represented by Lansing; make of this comparison what you will. The capitol building is shown in Frame 2 foregrounded against a very angry-looking Mount Doom. The Michigan Legislature badge pinned to the building is worn by every legislator in this cartoon. Watch for it!

Drives to Lansing, while not perhaps as heroic as journeys on horse or on foot with staff and backpack, were nevertheless fraught with the unforeseen (Frame 3). A great number of the Fellowship were midwives and parents; illness, childcare problems, women in labor, last-minute texts, and typical midwife-style driving featured frequently.

Midwives are not usually called to births by eagles (Frame 4), but fantasy permits us this fiction. Fantasy extended to the legal position of Michigan midwives pre-licensure. Some opponents of licensure believed the practice of home birth midwifery to be legal on the basis of Michigan v. Hildy, a 1939 judicial decision itself based on a much earlier Attorney General’s opinion. Supporters of licensure, however, pointed out that the enactment of the 1978 Public Health Code superseded the old decision because of its overhaul of health care professional licensure. In addition, even should a midwife succeed in fighting off a criminal conviction by citing Hildy, a licensure act in and of itself would alert the judiciary and prosecutors alike that out-of-hospital midwifery was regulated, and therefore not a crime.

Several Michigan midwives who doubted the need for licensure attended a 2007 Chicago summit offered by The Big Push for Midwives, a national advocacy group formed to support and coordinate state CPM licensure efforts (Frame 5). The midwives underwent a conversion experience, driven in part by warnings of plans underway by the American Medical Association to further restrict midwifery scope of practice with its “Scope of Practice Partnership” initiative. The Big Push urged states to initiate licensure legislation in order to forestall the AMA’s plans, which were cleverly portrayed by Pushers as “SoPPzilla” (Frame 6, and see next page). Strider, a.k.a. Aragorn, is revealed here to be Katie Hemple, a member of The Big Push Steering Committee.

 

Part 2 →

 


Ginger Vee goes to the movies

In the early 1990s, the video rental industry flourished. Nevertheless, as is shown here, people still went to the movies.

Just as media formats change yet produce the same effect (consumption!), plots may change yet reflect the same underlying ethos (consumption!).

Take a walk down memory lane with Ginger Vee, her chum Marla, and stick figure screen stars who exist uneasily in their three-dimensional garments.

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Movie: Madonna: Truth or Dare (1991).

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