Swine Flu Concerns Draw Attention to Need for Midwives, Sick Leave

By Rachel Walden — April 29, 2009

The swine flu news of recent days has sparked calls from advocacy organizations for attention to issues that a pandemic may exacerbate, such as the lack of paid sick leave and the lack of  of availability of licensed midwives to attend home births.

MomsRising, a campaign to bring “important motherhood and family issues to the forefront of the country’s awareness,” includes paid sick leave among the concerns it addresses. They note that advice from officials has been to stay home if sick, in order to avoid further transmission of the virus, but that:

This is easier said than done. In the U.S. today, nearly half of workers aren’t allowed to earn paid sick days (i.e. they don’t have a single paid sick day to take when illness strikes in order to keep our communities healthy and not spread illness). And more than half of the workforce does not have or cannot use paid sick days to care for sick children.

The group has further discussion here, including a link to a petition in support of paid sick leave.

Additionally, The Big Push for Midwives campaign issued a release (PDF) yesterday calling on policy makers to support and legalize Certified Professional Midwives (CPMs) for the provision of out-of-hospital birth in the scenario that hospitals are an undesirable place for otherwise healthy pregnant women. CPMs currently are “legally authorized to practice in just over half the states and are eligible for Medicaid reimbursement in fewer than a dozen states.”

Colette Bernhard, Vice President of Illinois Families for Midwifery, explained:

Hospitals filled to capacity with flu patients are unsafe and inaccessible places for healthy women to deliver their babies….legal and reimbursement barriers at the state and federal level prevent far too many Certified Professional Midwives, who already have the necessary training and equipment, to utilize their services to the fullest. Given the very real possibility of a flu pandemic, the need to fully incorporate CPMs into our health care system could not be more urgent.

Russ Fawcett of The National Birth Policy Coalition called for states “to get on board and license CPMs to practice legally” and argued that “it is every bit as critical that our federal policy makers require Homeland Security to include CPMs—who function as mobile primary care facilities for pregnant women—in disaster planning at local, regional, and national levels and as eligible providers for the National Health Service Corps.”

Relatedly, the CDC has issued “Interim Guidance—Pregnant Women and Swine Influenza: Considerations for Clinicians” – guidance addresses the presentation of the disease in pregnant women, prevention, treatment, and breastfeeding considerations.

For more information on swine flu generally, see the CDC website (with news and resources for both the general public and clinicians), CDCemergency on Twitter (you don’t need an account to follow the updates), and this consumer health page from MedlinePlus.

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