Petition to Jane Cummings, Dame Sally Davies, Professor Gillian Leng CBE, Journalist, Celia Walden, Dr Ivor Cavill, Chief Executive Officer, Chief Executive Officer, Professor Cathy Warwick CBE, NICE National Institute ofClinical Excellence, Chief executive Officer
National Institute of Clinical Excellence : Implement Delayed Cord Clamping Immediately
As part of a growing global network, I would like to campaign to lobby the National Institute of Clinical Excellence to change the Current Guidelines which recommend Immediate Cord Clamping (NON evidence based practice, proven to be detrimental to babies and normally performed before baby has breathed) to recommend Delayed Cord Clamping for at least 3-5 minutes, but ideally until the cord stops pulsating. (Beneficial evidence based practice) NICE recommendations are based on the best available evidence of the most effective care. NICE have formally informed me that they won't publish new guidelines until November 2014, despite mounting evidence to prove that Immediate Cord Clamping can be deterimental to babies. Immediate Cord Clamping of the Umbilical Cord is practised in many hospitals. This has consequences. Research has shown that Immediate Cord Clamping deprives the baby of up to 40% of its intended blood supply. Reasearch by Farrar, Duley et al shows that leaving the cord intact leads to a weight gain of up to 210g in the five minutes following birth. The blood that the baby is deprived of contains Stem cells, Blood cells and other natural hormones, intended to complete the birth process. Immediate Cord Clamping is a major risk factor for anaemia in newborns. Research studies by Van Rheenan, Andersson/Brabin and Mercer have shown that Immediate Cord Clamping leads to long term anaemia which impedes learning and development. Hospitals throughout the Western world have been practising Immediate Cord Clamping for 40-50 years and are now well into second generation cord clamping. We lack the knowledge about the consequences of Immediate Cord Clamping, but there is NO evidence to support Immediate Cord Clamping as routine practice. Patience is the only thing that is needed to leave the cord intact. World Health Organisation, UNICEF, International Confederation of Midwives, Royal College of Obstetricians and Gynaecologists and Royal College of Midwives all support Delayed Cord Clamping. Immediate Cord Clamping needs stopping immediately. Common sense must prevail.
Petition to Mike Bloomberg, Health and Hospitals Corporation, Nirav R Shah, MD, MPH
Reopen Labor & Delivery Services at North Central Bronx Hospital
All women, babies and families have a fundamental human right to healthy, safe and respectful maternity care. On Monday, August 12, the Health and Hospitals Corporation (HHC) closed in-patient labor and delivery services at North Central Bronx Hospital (NCBH). The staff and community were only given three days’ notice of the closure, and no opportunity to have their voices heard. Closing labor and delivery services at NCBH will have dangerous repercussions for low-income women and families in the Bronx, including an unacceptable gap in access to safe and respectful obstetric services. Last year, there were 1,500 deliveries at NCBH. HHC has stated that they transfer these patients to the neighboring sister hospital, Jacobi Medical Center. However, Jacobi Hospital already has an overburdened labor and delivery unit. The reality is that the closure will result in unacceptable pressure on all neighboring Bronx hospitals. Low-income mothers and families will face the brunt of this negative impact. They will experience decreasing quality of services, will have to travel even further to give birth, and will lose vital community-based, women-centered care. There is further concern in the community that, as has been the case with recent hospital closures in Brooklyn, shutting labor and delivery services at NCBH is potentially the first step toward shutting down the entire facility. This is part of a larger pattern of a culture of disregard towards healthcare access for low-income communities. Sadly, this closure marks the end of an award-winning, midwife-led program that has served some of New York City’s most at-risk and underserved families for the last 36-years. In 2002, the midwifery program at NCBH received the American College of Nurse Midwives’ With Women for a Lifetime Commendation award for innovative and compassionate midwifery care practices. It has also been heralded as a national model for replication. Despite the positive impact of the midwifery services at NCBH, HHC has consistently undermined the program. In 2009, services were dramatically cut back, midwives were laid off and the midwifery model of continuity of care was completely disrupted. This resulted in an astonishing 90% increase in cesarean sections between 2008 (15.9% - the lowest in the city) and 2012 (30%). HHC sited safety concerns at Jacobi as their excuse for the closing. Rather than addressing staff shortages at Jacobi with new hires, leadership decided to end a thriving practice at NCB and transfer all staff to Jacobi. Tell Bloomberg, HHC and the NYS Department of Health that this closure is an outrage! Destroying a thriving program and leaving thousands of low-income families without easy and safe access to quality care is not the answer. HHC must reopen labor and delivery services at North Central Bronx Hospital!
Petition to Rebecca Hirt, R. August Kempf, Charles Pilcher, MD, Bob Malte, Kay Taylor, Jeannette Greenfield, Jeff Tomlin, MD, Al DeYoung
Evergreen Hospital: Protect Childbirth Options by Establishing a True Midwifery Practice.
There is no longer any true midwifery practice delivering babies at Evergreen Hospital. Until recently, women who give birth at Evergreen Hospital had the option to have a midwife from the Center for Women’s Health (CFWH) deliver their baby. Unfortunately, the CFWH (a private practice) has recently restructured. As of November 17th, there will only be two midwives who work in conjunction with obstetricians (OBs). A patient of the midwives is very likely to have an on-call OB deliver her baby. There is effectively no true midwifery option at Evergreen Hospital. In fact, this option is no longer truly available to most women on Seattle's Eastside. The only true midwifery practice remaining in this region is through Group Health. Unless a woman carries that insurance, she must effectively chose between having an OB deliver her baby in a hospital or having a midwife deliver her baby at home or in a birth center. This is unacceptable! Families on Seattle’s Eastside are accustomed to world-class healthcare and a wealth of childbirth options. Evergreen Hospital can maintain these options by establishing a true midwifery practice at the hospital. Midwives are a valuable alternative to giving birth with an OB. Giving birth with a midwife is a valuable alternative to giving birth with an OB. Midwives generally schedule more time for prenatal appointments. They are generally on call for urgent, but non-emergency, after-hours questions and concerns and spend a great deal more time with their patients during labor and delivery. Most importantly, midwives have a significantly lower rate of cesarean sections than OBs. According to the Center for Disease Control, the national rate of cesarean births in 2008 (the last year for which final data is available) is a startling 32%. Preliminary data for 2009 shows a 29.2% rate of cesarean births in Washington State. Midwives, on the other hand, have a cesarean rate approximately 30% to 50% below the national average (depending on the source of information). Before restructuring, the midwives at the CFWH reported a low 15% cesarean rate for the year to date. Fewer women will have the option to have a Vaginal Birth After Cesarean. What's more, the midwives at the CFWH were one of the very few practices on Seattle’s Eastside that consistently supported a woman who wanted to deliver her child vaginally after a previous cesarean section (VBAC). Midwives also report a much higher rate of successful VBACs than OBs generally. Without a true midwifery practice at Evergreen, it is not clear that VBACs will be consistently available to women who deliver at Evergreen. Evergreen Hospital can maintain our childbirth options. Evergreen Hospital can solve this problem by establishing a true midwifery practice at Evergreen Hospital. In fact, Evergreen made significant moves in that direction before the plan was suddenly and unexpectedly dropped. We must tell Evergreen Hospital that this community values having a wide range of childbirth options. Evergreen Hospital: Establish a true midwifery practice!