The Atlanta Constitution from Atlanta, Georgia • 26

glie Atlanta ilournol WIM IM IT1 TM SUNDAY, JANUARY 13, 1984. 68 Nurse-midwives often last hope for teenagers, indigents By Jim Penney Special to th Journal-Constitution -V' i D. IS S- av hi are asked again, and 80 percent say, the nurse-midwife." The reason for this is clear, according to, Ms. Brown. "What we strive to do is emphasize the normal and give people a little more of our time and a little more of ourselves than obstetricians normally do." Ms.

Brown said that although obstetricians tave "absolute rule over what is abnormal because they are trained in pathology," nurse-midwives are the "experts in the normal and protecting the normal The team approach to obstetrics is a good one." Nurse-midwives also are cost effective. Office visit rates are cheaper and hospital delivery is about $250 cheaper than physician delivery because, according to Ms. Brown, "we don't use a lot of Intervention and medication." Some women, according to Ms. Brown, come her and ask, "Shouldn't I have a little something to ease the pain?" "To say we don't give any medication is erroneous, because we do," said Ms. Brown, "but It isn't as much, primarily because our patients can't afford It" Epidural anesthesia, one of the most common types of pain control administered during labor, Is often given too early and in too large a dose, causing further problems with labor, said Ms.

Brown. "It takes a normal process and turns it into an abnormal one," she added, contending that women often are so afraid of the pain they want to be "completely knocked out," which Is harmful. "Low birth weight is a real problem in Georgia," she commented, describing the problem as one of the leading causes of infant mortality. Georgia's infant death rate is one of the highest in the nation. The federally financed WIC (women, infants and children) program brings nutritional, high-quality food to the homes of Indigent pregnant women and women with small children.

However, when it comes to medical care, women often find themselves at a loss. No obstetrician in Bartow County accepts Medicaid as payment toward obstetricalgynecological care, said Ms. Brown, adding: "Even when women have finally gotten the means to pay for their pre-natal care, they can't" Teenage pregnancies constitute 47 percent of Brown's caseload. "Because of the way I felt about it when I first came here, I wouldn't see anybody younger than 16 because they're typically high-risk pregnancies, but I've just had to change my mind because there were so many 16-year-olds," she said. Ms.

Brown said she has delivered babies to a few 14-year-olds and a good many 15-year-old girls, and has taken counseling calls from girls as young as 12 who thought they might be CARTERSVILLE, Ga. The United States has been called the healthiest nation in the world. But health care often is not available to those women who need it most, according to Cartersville nurse-midwife Betsy Brown. Her patients are troubled. Forty-seven percent are teenage pregnancies, and nearly all cannot afford the care of a physician.

In fact, nurse-midwives such as Betsy Brown and her partner Becky Crosby contend with some controversy surrounding their practice. Care is less expensive and more personal, and yet a number of legal questions have been raised by the medical community questions concerning certification, competency and liability. Their concerns are unfounded, according to Ms. Brown. "Some obstetricians will say we are giving substandard care when we allow nurse-midwives to practice because they are not doctors and don't have a medical she said.

"And yet, they are refusing people not providing any kind of care for the people who can't get it" Ms. Brown and her partner, the only licensed nurse-midwives in this area, treat primarily indigent women who cannot afford to pay a regular physician. "Actually, the women I'm seeing are much sicker than the women the obstetricians are seeing," she added. Ms. Brown described the obstetricians' patients as "nice white middle-class people." The field of nurse-midwifery is a changing one.

Fighting local stereotypes of the "granny-midwife" of yesteryear Is constant battle, Ms. Brown observed. Nurse-midwives are, by definition, nurses who have completed training in nursing and midwifery. They hold master's degrees in nursing and must complete 'an accredited program at one of 16 nurse-midwife schools in the country, Emory University being the closest in Georgia. They also must be certified by a medical board similar to that of the American College of Obstetricians and Gynecologists, she said.

At all times, nurse-midwives must have the backup of a physician, so that "if we have a serious medical problem, a physician is there," said Ms. Brown. Because of this requirement, many nurse-midwives work with a physician. The physician-midwife "contract" defines what is mutually agreed upon that the nurse-midwife can do and what the physician must consent to delegate or handle himself. Although the practice of nurse-midwifery is defined 1 4 n1 ti-ff JOHN HARMANS(MCIM NURSE-MIDWIVES: Ms.

Crosby (left) and Ms. Brown review file with mother-to- be Kathy Harris. 'with and so that Is what we want to do give more support to women than what an obstetrician normally gives, but we also want to offer people what Is medically safe." Although many obstetricians resent the practice of nurse-midwifery and see it as competition, Ms. Brown said that in Dalton, there is an obstetrical practice that is run with three doctors and three nurse-midwives with the nurse-midwives delivering about 80 percent of the babies. "Interestingly enough, when women first come there they are asked, 'Who do you want to deliver your and 80 percent say 'the said Ms.

Brown. "But later, when they are ready to deliver, they as "normal obstetrics," according to Ms. Brown, "there are a whole host of problems within the range of normal." Contrary to popular belief, nurse-midwives usually don't deliver babies in the home, although Ms. Brown says she knows of one in northwest Georgia who does. "I have available to me all the backup that a physician has," she said, noting that her practice operates out of Sam Howell Memorial Hospital In Cartersville.

"There is a general misconception in the South, especially, of the tradition of granny-midwives, and that is very confusing for most people," said Ms. Brown. "We do like to cherish and treasure that tradition because the word midwife is actually from the Greek and means MAIER 8 BEKKELE Jewelers to the South since 1887 Save 40 on Oneida Stainless Flatware! Atlanta's flatware headquarters gives you so much more! Atlanta's best in-stock selection of patterns, professional sales help, free gift wrapping, complete bridal registry and delivery service. Allow two days delivery to Decatur, Lenox, Cumberland, Perimeter and Southlake Malls. mm yVA Jl 4 I li Allium! I KZ) CZZZDO OCX JOHN SPINKStaH the poie base.

The bass had been damaged by large trucks and its unstable condition posed a hazard. COMMUNITY Satinique, Paul Revere, Louisiana, Frostfire Catbird seat Porter Lymon, an electrician for the city of Atlanta, Is silhouetted as he sits high above Forsyth Street on a tower lift studying a light pole as co-workers replace 184l Reg. S32 5-pc. pi setting Judge rules killer's rights intact HEIRLOOM Dover, Michelangelo, American Colonial 2 6 "Re Reg. S4S 5-pc.

setting Owens concluded that if Whalen had held an evidentiary hearing before removing the juror, he would have learned "that Mrs. Fambro was ill and unable to then continue to serve as a juror, would have sent her to the hospital as was done and would have replaced her with an alternate juror." The federal judge concluded that there was no possible way, according to the evidence presented to him, that Whalen could have known which juror was in favor of or opposed to the death penalty for Green. The case will be returned to the 11th Circuit for further review Judge Andrew J. Whalen erred In discharging juror Dorothy May Fambro. Attorneys representing Green contended that the woman was discharged against her will, without the judge talking to her personally and because she was one of only two jurors opposing the death penalty for Green at the time of her removal.

Judge Owens held a hearing Oct 24 at which Mrs. Fambro testified that she was too ill to continue that day, but she believed she would have been able to continue the next day had she been given an opportunity to do so. By Dennis Williams Special to The Journal-Constitution MACON A federal judge has ruled that convicted and condemned murderer Roosevelt Green's constitutional rights were not violated when a Superior Court judge discharged an ill juror during Green's second resentencing trial in Monroe County in November 1979. U.S. District Court Judge Wilbur Owens' finding of facts Friday was in response to an order issued last October by the 11th U.S.

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The next move is up to the legislative delegation, whose members will draw up the necessary legislation to establish the citizens' committee. The proposed legislation then will be submitted individually to all five local governmental units in Floyd County, including the Floyd County Commission, the Rome City Commission, the Rome City Board of Education, the Floyd County Board of Education and the Cave Spring City Council. State Rep. E.M. "Buddy" Childers (D-Rome) said he hopes to have the legislation prepared in about a week.

The study is expected to cost between $50,000 and $55,000, and the delegation is asking local governmental units to share the cost It has been estimated that the studyiwould take eight to 10 months to complete. Get the paper. And get Grizzard. He's a Southern sage with a knowing smile. A junk food junkie with a heart-warming, humorous approach to life.

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