ALAMO, Texas (AP) — The citizenship of hundreds, possibly thousands, of people who insist they are Americans is being called into question because they were delivered by midwives near the U.S.-Mexico border. The federal government's doubts have arisen as many people in the border region try to meet a June 1 deadline to obtain U.S. passports so they can freely cross from one country to the other.
The people delivered by midwives have documents such as birth certificates and medical records. But the agency that grants passports is challenging the credibility of those papers, citing a history of some midwives fraudulently registering Mexican-born babies as American.
The passport applications being questioned include those of children of Mexican women who crossed the border to give birth in the United States, and even employees of the U.S. Customs and Border Protection agency who were born on the border and now work to protect it.
The government has "effectively reduced to second-class citizenship status an entire swath of passport applicants based solely on their being of Mexican or Latino descent and having been delivered by midwives in nonhospital settings in Southwestern border states," according to a federal lawsuit against the State Department filed last year in the border town of McAllen, about 120 miles south of Corpus Christi.
Immigration attorneys and the American Civil Liberties Union hope to have the case certified as a class action because they believe thousands of people could be affected, with most still living near the border.
Since 1960, 75 Texas midwives have been convicted of fraudulently registering Mexican-born babies as American. At one point, the government assembled a list of nearly 250 "suspicious" midwives but never explained what made them suspicious.
State Department spokesman Andy Laine declined to comment because of the litigation. The agency also declined to release statistics on passport application refusals.
After June 1, anyone re-entering the United States from Mexico or Canada will have to show a passport, not just a driver's license and birth certificate, which are the only current requirements.
For families who have lived in the area for generations, the border is just a river in the middle of one community. Many people live on one side of the border and work on the other.
"Going back and forth is as natural for them ... as going across town is for the rest of us," said Lisa Graybill, legal director for the ACLU in Texas.
If the lawsuit is not resolved before June 1, families "will have to choose if you're going to live in Mexico or you're going to live in the U.S. You won't be able to cross," said Lisa Brodyaga, the immigration attorney who filed the lawsuit against the State Department.
Anna Karen Ramirez had to sue the State Department to get her passport, even though she had a birth certificate, medical records and receipts from her 1989 birth at a clinic in Hidalgo, just south of McAllen. She also had signatures of two police officers who witnessed the event.
Ramirez's parents lived in Mexico and raised their daughter there. But they decided to have their child in the United States.
With the deadline looming, and the State Department suspicious of her citizenship, the family met several times with U.S. consular officials to obtain a passport, but their request was refused.
Ramirez's father, Narciso, drives a taxi back and forth across the border every day. He said he was warned that the family's dogged pursuit of the matter could threaten the visa that allowed him to operate his cab.
Anna Ramirez sued, and while waiting, voted unchallenged in the U.S. presidential election. A month later, she received her passport but never got a clear statement of citizenship.
"Every 10 years she's going to have to prove she's a U.S. citizen" to renew her passport, said her attorney, Naomi Jiyoung Bang.
The State Department practices are "a holdover from an older, less-regulated world," said Mark Krikorian, executive director of the Center for Immigration Studies, which advocates for more restrictive immigration laws. "It's what happens when modern standards collide with old country practices."
Krikorian said the government cannot just believe everyone, nor can it turn down everyone delivered by a midwife.
Because Ramirez is young, her parents were able to find documents the government requested. The midwife who delivered her was still alive and able to testify. They could also afford to hire an attorney to help.
David Hernandez had a harder time locating evidence.
He was born in San Benito, Texas, in 1964, to a Mexican mother who was visiting friends when she went into labor. Hernandez was delivered by a midwife who appeared on the suspicious midwife list, though without a conviction. He returned to Mexico with his mother.
The two moved back to the U.S. a few years later. He attended schools in Texas and served in the Army.
In response to government requests, he collected mounds of documentation including papers from his military service, immunization and baptismal records, and witness affidavits. When he requested his school records, he was told that his elementary school papers no longer existed.
In April 2008, the government refused his passport application.
"I was born here," he said last fall when the ACLU took on the case. "I've lived and worked here and served in the Army. I feel betrayed, like my country is stabbing me in the back just because my mother didn't have the luxury of having me in a hospital."
http://www.google.com/hostednews/ap/article/ALeqM5is0334GfYSqsu-cGgWEPXPdB4NrwD96912JO0
Wednesday, February 11, 2009
Monday, February 9, 2009
Study links obesity with birth complications
Researchers found that they were at high risk of premature birth, having an underweight baby or suffering pre-eclampsia, a condition which can be fatal.
Obesity has previously been linked to a number of problems during pregnancy but researchers wanted to know if these were more serious during a first pregnancy.
The study, the findings of which were published in the American Journal of Obstetrics and Gynaecology, followed 385 obese women having their first child in Britain and the Netherlands.
The research found that almost four in 10 of the women, 39 per cent, had to have a Caesarean section, a rate they claim is the highest ever reported in the world.
Previous studies in obese women found that just one in five had to have the operation instead of a natural labour.
Obese first-time mothers were also almost twice as likely to have a underweight baby than women who were not obese, and a third more likely to have an overweight baby, the study found.
They were six times more likely than first-time mothers of healthy weight to develop pre-eclampsia and twice as likely as other overweight women.
The risk of premature birth was also twice the national average.
Pre-eclampsia is a potentially deadly syndrome in which blood pressure becomes raised because of significant amounts of protein in the urine.
Because of the complications the women spent longer on average in hospital compared to other new mothers, an average of 4.6 days compared to a national average of just three days.
The study was carried out by Tommy's, the baby charity, the Wellcome Trust, and the National Institute for Health Research (NIHR) comprehensive Biomedical Research Centre at Guy's & St Thomas' NHS Foundation Trust in partnership with King's College London.
Lucilla Poston, who led the research, said: "There are a number of findings which are very surprising. The large proportion of small babies was particularly unexpected as obesity is more often associated with the birth of overweight babies.
"The high number of cases of pre-eclampsia found in this group was very concerning, as this is a serious pregnancy complication which, in extreme cases, can result in maternal and or fetal death.
"We must now start to consider first-time pregnancy as an additional problem in obese pregnant women, who we know are already more likely than thinner women to have a complicated pregnancy."
Premature births and small babies are at risk of suffering brain damage, breathing difficulties, learning problems and infection.
Mervi Jokinen, from the Royal College of Midwives, said: "Obesity is an issue that is becoming increasingly prominent in maternity care and midwives are aware of the complexities and potential problems that obesity brings into pregnancy.
"We need to ensure that women get early access to a midwife so that she can get lifestyle and weight management advice as soon as possible, and that this continues throughout the pregnancy and after the birth of the baby."
http://www.telegraph.co.uk/health/healthnews/4557980/Obese-first-time-mothers-at-more-danger-of-complications.html
Obesity has previously been linked to a number of problems during pregnancy but researchers wanted to know if these were more serious during a first pregnancy.
The study, the findings of which were published in the American Journal of Obstetrics and Gynaecology, followed 385 obese women having their first child in Britain and the Netherlands.
The research found that almost four in 10 of the women, 39 per cent, had to have a Caesarean section, a rate they claim is the highest ever reported in the world.
Previous studies in obese women found that just one in five had to have the operation instead of a natural labour.
Obese first-time mothers were also almost twice as likely to have a underweight baby than women who were not obese, and a third more likely to have an overweight baby, the study found.
They were six times more likely than first-time mothers of healthy weight to develop pre-eclampsia and twice as likely as other overweight women.
The risk of premature birth was also twice the national average.
Pre-eclampsia is a potentially deadly syndrome in which blood pressure becomes raised because of significant amounts of protein in the urine.
Because of the complications the women spent longer on average in hospital compared to other new mothers, an average of 4.6 days compared to a national average of just three days.
The study was carried out by Tommy's, the baby charity, the Wellcome Trust, and the National Institute for Health Research (NIHR) comprehensive Biomedical Research Centre at Guy's & St Thomas' NHS Foundation Trust in partnership with King's College London.
Lucilla Poston, who led the research, said: "There are a number of findings which are very surprising. The large proportion of small babies was particularly unexpected as obesity is more often associated with the birth of overweight babies.
"The high number of cases of pre-eclampsia found in this group was very concerning, as this is a serious pregnancy complication which, in extreme cases, can result in maternal and or fetal death.
"We must now start to consider first-time pregnancy as an additional problem in obese pregnant women, who we know are already more likely than thinner women to have a complicated pregnancy."
Premature births and small babies are at risk of suffering brain damage, breathing difficulties, learning problems and infection.
Mervi Jokinen, from the Royal College of Midwives, said: "Obesity is an issue that is becoming increasingly prominent in maternity care and midwives are aware of the complexities and potential problems that obesity brings into pregnancy.
"We need to ensure that women get early access to a midwife so that she can get lifestyle and weight management advice as soon as possible, and that this continues throughout the pregnancy and after the birth of the baby."
http://www.telegraph.co.uk/health/healthnews/4557980/Obese-first-time-mothers-at-more-danger-of-complications.html
New Midwifery Clinic - Jackson TN
When Heather Moore gave birth to her first child two years ago, she was under a physician's care. For her second pregnancy, she chose to go to a midwife instead.
"I really liked it when a doctor would sit down and talk with me during my pregnancy," she said. "But he didn't always do that. Sometimes he'd say 'Everything looks great,' but he wouldn't get specific."
Her midwife, Sheridan Skarl, said the difference in care between a physician and a midwife is time spent with the patient.
"It's also more cost-effective," Skarl said. Skarl is a certified nurse midwife.
Skarl works at Regional Hospital of Jackson, which recently opened Regional Midwifery Services, where Moore went for a check-up Tuesday.
Sharon Holley is another certified nurse midwife who works at the hospital. She believes in spending time with women and using each appointment as a time to educate, she said.
"A midwife works with women of all ages through all stages of life," she said. "We provide pap smears, gynecological care, birth control, pregnancy and post-partum care. We could see a woman through each stage."
Holley said one of the major differences in using a midwife for labor and delivery is that the number of Caesarean sections and other complications are lower.
About 30 percent of physician deliveries ended in Caesarean sections, while about 13 percent of midwife deliveries ended the same way, she said.
Also, midwife deliveries have fewer interventions, such as episiotomies, which enlarge the birth canal, Holley said.
Holley and Skarl do their deliveries in the hospital. Midwives nationwide either deliver in a hospital, a birth center or a patient's home, Holley said.
"The midwife approach to care is to say that pregnancy is a normal state for a woman, not an illness," she said. "With women, we want to empower them with that idea."
Skarl said more insurance companies cover the cost for midwifery services now, so the option is more widely available.
"Using a midwife allows a woman to be a part of her own pregnancy," she said. "We're here to assist, but we want their experience to be what they want it to be."
Moore, whose baby is due in a few weeks, said her second pregnancy has seemed easier with the help and instruction from Skarl. Her midwife has been helping her to maintain a good blood pressure rating and is keeping her from having too much stress.
"I like when everything is explained, and they ask how I'm doing," she said. "I feel good about this delivery."
Visit jacksonsun.com and share your thoughts.
- Tracie Simer, 425-9629
http://www.jacksonsun.com/article/20090209/LIFESTYLE/902090302
"I really liked it when a doctor would sit down and talk with me during my pregnancy," she said. "But he didn't always do that. Sometimes he'd say 'Everything looks great,' but he wouldn't get specific."
Her midwife, Sheridan Skarl, said the difference in care between a physician and a midwife is time spent with the patient.
"It's also more cost-effective," Skarl said. Skarl is a certified nurse midwife.
Skarl works at Regional Hospital of Jackson, which recently opened Regional Midwifery Services, where Moore went for a check-up Tuesday.
Sharon Holley is another certified nurse midwife who works at the hospital. She believes in spending time with women and using each appointment as a time to educate, she said.
"A midwife works with women of all ages through all stages of life," she said. "We provide pap smears, gynecological care, birth control, pregnancy and post-partum care. We could see a woman through each stage."
Holley said one of the major differences in using a midwife for labor and delivery is that the number of Caesarean sections and other complications are lower.
About 30 percent of physician deliveries ended in Caesarean sections, while about 13 percent of midwife deliveries ended the same way, she said.
Also, midwife deliveries have fewer interventions, such as episiotomies, which enlarge the birth canal, Holley said.
Holley and Skarl do their deliveries in the hospital. Midwives nationwide either deliver in a hospital, a birth center or a patient's home, Holley said.
"The midwife approach to care is to say that pregnancy is a normal state for a woman, not an illness," she said. "With women, we want to empower them with that idea."
Skarl said more insurance companies cover the cost for midwifery services now, so the option is more widely available.
"Using a midwife allows a woman to be a part of her own pregnancy," she said. "We're here to assist, but we want their experience to be what they want it to be."
Moore, whose baby is due in a few weeks, said her second pregnancy has seemed easier with the help and instruction from Skarl. Her midwife has been helping her to maintain a good blood pressure rating and is keeping her from having too much stress.
"I like when everything is explained, and they ask how I'm doing," she said. "I feel good about this delivery."
Visit jacksonsun.com and share your thoughts.
- Tracie Simer, 425-9629
http://www.jacksonsun.com/article/20090209/LIFESTYLE/902090302
Welcome!
Hi my name is Mike. I am not a midwife. I work for Utah College of Midwifery as the IT guy. I started this page as a way of discovering the many facets of Midwifery and how it is important to the ongoing national health care discussion. I believe that natural birth, with well trained and qualified midwives will lower pre and post natal care costs, thus making our healthcare system more effective. We'll discuss many issues that you may feel passionate about. We'll also have resources where you can learn more about midwives, and the practice of Midwifery in the United States and Canada.
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