x-sender: governor.haley@sc.lmhostediq.com x-receiver: governor.haley@sc.lmhostediq.com Received: from mail pickup service by sc.lmhostediq.com with Microsoft SMTPSVC; Tue, 8 Dec 2015 23:25:15 -0500 thread-index: AdEyOZpO2Nm9b+XPQYWLwE+hwgerQg== Thread-Topic: DHEC Board Meeting on 12/10/15 From: To: Subject: DHEC Board Meeting on 12/10/15 Date: Tue, 8 Dec 2015 23:25:15 -0500 Message-ID: <17C4C5128F8F4F9A97F86AEEE4E0D8FD@IQ12> MIME-Version: 1.0 Content-Type: text/plain; charset="iso-8859-1" Content-Transfer-Encoding: 7bit X-Mailer: Microsoft CDO for Windows 2000 Content-Class: urn:content-classes:message Importance: normal Priority: normal X-MimeOLE: Produced By Microsoft MimeOLE V6.1.7601.17609 X-OriginalArrivalTime: 09 Dec 2015 04:25:15.0587 (UTC) FILETIME=[9A6DD930:01D13239] CUSTOM Mrs. Kristyn Leonard 266 Ambling circle Columbia SC 29210 kristynleonard@gmail.com HEAL DHEC Board Meeting on 12/10/15 108.70.13.226 Gov. Haley, There is a DHEC board meeting this week regarding the midwifery regulations. These are my thoughts I sent to them. Dear Mrs. Longshore, Your email address is the one provided as the clerk for the upcoming DHEC board meeting. And it's probably overflowing right now. If it's not, you might want to check your spam folder. In addition to the petition I created, (https://www.change.org/p/keep-midwives-in-south-carolina) which currently has over 3000 signatures since it's inception on Saturday, I would like to add a few words to be shared with the board. I have been told that the public will likely not have a chance to speak at this meeting, and that's what I am. The public. A consumer. A citizen. A voter. Not a midwife. The outcome of this meeting doesn't impact my job or my household income, it impacts my choices and those of my children. And what I have to say is important, lest the government forget that they answer to me. Not the other way around. The time is far past for everyone involved with these regulations to put their egos aside. THIS IS NOT ABOUT YOU. This is about making sure the mothers and babies of South Carolina have choices in birth and access to safe, evidence based care. Regardless of what that means for any one individual's pride, the bottom line is these women MUST be put first. I could go through point by point with links and articles about how the proposed regulations are far from evidence based, however, I am certain that would be a waste of my time. No one would read those articles, and since I'm a consumer no one would take my word for it. So I won't. I will leave that to the MAC, after all, that's what they're there for. So why isn't the board listening to them? Let me put this in terms that might be better understood by the board members. The current behavior of the board to put forth regulations surrounding a topic on which they have no expertise and ignoring the advice of those who do is the equivalent of me saying: I built my children's playground. Therefore, I am qualified to perform a safety inspection on your construction site and potentially shut you down, Mr. Amsler. I manage my household. Therefore, I am qualified to manage a medical practice, just like you Mr. Lutz. I've been to the dentist. Therefore, I am qualified to set protocol for your dental procedures, Dr. Kirol. I have had a job in sales. Therefore, I am qualified to run your company, Mr. Wells. I really love physics. I didn't take it in college, but I had a great teacher in high school. Therefore, I am qualified for a job at your company, Mr. Joye. I began my college career as a chemistry major. Therefore, I must be as good at chemical engineering as you are Mr. Batts. I have a heart. It's still beating. Therefore, I must know something about cardiology, right Dr. Hutto? I own a home. Therefore, I am qualified to sell houses for your firm, Mr. Hewitt. Clearly, these claims are beyond absurd and are borderline offensive. You have all put years, decades even, into your careers and are regarded as experts in your respective fields. The problem is, your field is not birth. Not one of you. And this is exactly what you are saying to the midwives. It doesn't matter that you may have taken a childbirth class, or that you have children, and let's not ignore the elephant in the room, only one of you on the board is even physically capable of bearing children and having any appreciation for what that process entails! It is time for you to work together with the MAC who do have the expertise in out of hospital birth. That is what they are there for. Dr. Hutto and Dr. Kirol: as the medical professionals on the board it is your responsibility to ensure that the principles of biomedical ethics are being adhered to. For those on the board that are not aware, these principles include: Autonomy: the patients right to make their own choices, regardless of what the medical professional thinks of it. The medical professional's job is to provide information, not coerce a particular decision. Veracity: an understanding of complete honesty between patient and provider. Beneficence: an obligation of the provider to promote good outcomes and prevent harm. Nonmaleficience: the active avoidance of harm to the patient. Confidentiality: the provider must not release any private information without consent. Justice: patients must be treated fairly and care should be accessible to anyone. The current regulations are completely unethical. And now you all know it. The only principle left intact, that I am aware of, is confidentiality. My autonomy, my choice, is being stripped away from me with these regulations because of my history of cesarean, without anyone even looking at any other risk factors. When the evidence clearly shows that a history of cesarean alone does not make me a high risk patient. Veracity is violated when mothers feel forced to lie about their condition or gestation for fear of loosing their care or being transferred unnecessarily. Beneficence and nonmaleficience are absolutely blown apart by these regulations. There is overwhelming evidence that midwifery care has positive outcomes and prevents negative ones. Look at our mortality rates against the rest of the world. Bosnia, Croatia, and Kuwait all have better maternal mortality rates than we do. This information is not hard to find. A quick google search will do it. Poland has the lowest rate in the world. Let's follow that example. We are not a different species because we have a different culture. And finally, justice. There is no justice here, there is no fairness. There is no equal distribution of or access to care when you are effectively shutting down midwives across the state. And before I forget, regardless of what is actually happening, there is a strong appearance of conflict of interest when one of your board members, Mr. Lutz, works for an OB office and therefore potentially stands to gain financially from the loss of midwives and the influx of those patients into the OB practice. To get back to my original point, it's time for all involved to drop any remaining ego. Myself included. I will be the first to admit to you, I am new in this politically charged birth world. I don't know the whole story here of what is going on between DHEC and the MAC and why you two seem incapable of working together. There are always two sides and more to the story than is put out to the public. I consider myself a reasonable person and I believe in kindness, humility, compassion, and being teachable. I think that is how we mend bridges between these two organizations that as an outsider look like they are fighting with each other when they are supposed to be working together. It's time to bury the hatchet, raise the white flag, and call a truce. The women of South Carolina, and our daughters, are depending on it. Sincerely, Kristyn Leonard