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Advocates say licensed midwives could help Mississippi’s maternity care desert. Bills appear dead

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Advocates say licensed midwives could help Mississippi's maternity care desert. Bills appear dead

Advocates say pending legislation on midwifery could alleviate Mississippi's lack of maternity and protect mothers and babies from those practicing without proper .

But Senate Bill 2793 and House Bill 1081 are likely going to die without a vote in committee this session, as legislative say they need more time to study the issue.

More than half of Mississippi's 82 counties are considered “maternity care deserts,” with no hospitals providing obstetric care and no OB-GYNs. Advocates say trained midwives could help this shortage of care for low-risk pregnancies, but say the state should license and regulate them.

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With the overturning of Roe v. Wade and a ban on abortions in Mississippi, advocates say trained midwives could help with the expected increase of thousands of deliveries a year for a health care system that is already woefully inadequate.

Mississippi is one of 14 states that does not regulate or license direct-entry midwives, those who practice without first becoming a nurse. Certified nurse midwives in the state are licensed as advanced practice registered nurses. There are only 26 certified nurse midwives in Mississippi, and only a few deliver babies, because only three hospitals allow them to.

Mississippi prevents -standing, midwife-led clinics for low-risk births and prohibits certified nurse midwives from performing in-home births – both of which are popular in other states and in Europe. More mothers want personalized care at home or in a small clinic as opposed to giving birth in a larger hospital, and want natural birth instead of induced labor or non-necessary C-section surgeries for delivery that have become more and more common in hospitals.

But Mississippi's lack of licensure or regulation also results in untrained or poorly trained people claiming to be midwives providing substandard – or dangerous – care to mothers and newborns at home.

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“Anybody can say, ‘I'm a midwife,' and nobody can stop them,” said Getty Israel, founder of Sisters in Birth, a nonprofit that pairs community health workers with low-income women, primarily Medicaid beneficiaries, to provide support during and after their pregnancies. Israel hopes to open Mississippi's first birth center. Such centers in other states serve women with low-risk pregnancies, and provide compromise between hospital births and home births.

READ MORE: Bills to watch in the 2023 Mississippi legislative session

Israel said she supports midwifery and wants to see it become a viable alternative in Mississippi, but believes they should be state regulated and licensed.

Erin Raftery is with Better Birth Mississippi, a group advocating for the midwifery legislation. The group says, “Community-based midwifery is a key solution to the challenges by the maternity care system in Mississippi.” Trained midwives could help with health care shortages caused by closure of rural hospitals and help save Medicaid money by “minimizing the use of costly, ineffective interventions.”

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“The goal of these bills is accountability,” Raftery said. “… This would provide protection for patients, and for midwives. This would also hopefully open the door for insurance coverage for midwife services, and help with the maternity desert.”

Raftery said her group knows of at least one infant death in Mississippi overseen by an unlicensed midwife, and that a similar instance a decade or so ago had also prompted proposed legislation. Raftery said licensure would help protect patients from the “select few” midwives practicing without training.

Senate Medicaid Chairman Kevin Blackwell, R-Southaven, authored the Senate midwife bill.

“I think we need to look at all our opportunities for health care in Mississippi,” Blackwell said. “We are last, and we won't change. We need to look at all the other states that are changing the way they do things.”

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Both Blackwell's bill and a mirror one authored by Rep. Dana McLean, R-Columbus, would create a state board of licensed midwifery.

“There are community midwives already practicing in this state, and this would help legitimize them, provide some oversight, and I think our primary responsibility is to make sure those that are practicing are doing so with some standard of care and level of experience,” McLean said. “Safety for moms and babies is the first priority. But I think there's also an issue of allowing for reimbursement for Medicaid and private insurance. They do require some sort of certification or licensure before they would reimburse for these services.

“Rural are closing maternity wards, and if this is an option that can help for low-risk births, then we need to explore that.”

But many physicians and hospital groups say child delivery should be overseen by trained physicians in hospital settings. Beyond these arguments, there has been a push by conservative groups and GOP lawmakers to reduce agencies, boards and regulations, not create new licensing and a new regulatory board.

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Nurse practitioners have also struggled for more autonomy and expanded scope of practice in Mississippi – with limited legislative success – saying they, too, could help with the state's shortage of doctors and health services.

Israel said doctors and hospitals treat child birth as a “cash cow,” and that their lobbyists and influence at the Capitol prevent “progressive, evidence-based health care.”

The House and Senate bills are now in each chamber's public health committee, facing a deadline for committee passage next . That passage this year, or even a vote in committee, appeared unlikely days before the deadline.

House Public Health Chairman Sam Mims, R-McComb, asked Wednesday about the midwifery bill pending in his committee, said he was unaware of it.

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“I'll go look at it,” Mims said. “I will read it. I will go look at it. Thank you, though.”

Raftery said her group had met with Mims and his committee vice chair only a couple of weeks ago and outlined the bill. She said Mims told her he would be opposed because he's against new government boards and licensing.

Senate Public Health Chairman Hob Bryan, D-Amory, said he doubts he will bring the bill up for a vote in his committee this year.

“It's sort of late in the session, and I really wasn't aware of this legislation before we got here,” said Senate Public Health Chairman Hob Bryan, D-Amory. “I don't think the committee would have time to fully study this … I've met with two different midwife groups, and I try to listen to people. I learned that at least one group will assign someone to an individual, and they will stay with that person, work with them, throughout their pregnancy and after delivery, and be there for them to discuss other health care issues. I think that is a very good idea, that could perhaps carry over into other health care services, and I am interested in learning more.

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“I am neither opposed to nor supportive (of the midwifery legislation), but I have an open mind,” Bryan said.

This article first appeared on Mississippi Today and is republished here under a Creative Commons license.

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Remembering ‘The Gunslinger’ of college football, Archie Cooley

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Archie Cooley, center, with Jerry Rice, left, and Willie Totten when they were honored at Mississippi Valley State at an function in recent years. (Photo courtesy of MVSU)

Archie “The Gunslinger” Cooley, the most unconventional of football coaches, has died at the age of 84, and, frankly, I don't even know how to begin to describe him.

So let's begin like this: There will never be another one. Cooley, which is how he referred to himself so often in the third person, was an original. In the mid-1980s, in Mississippi, he wrestled the college football away from , Mississippi State, Southern Miss and State, his alma mater, and shined it ever so brightly on Mississippi Valley State.

Rick Cleveland

He was a sports writer's dream. Need a column? Call Cooley. He always delivered. He wore a cowboy hat, usually with a feather in it, and that hat covered a brain that was years and years ahead of all others when it came to offensive football.

Back when most college football teams were running “three-yards-and-cloud-of-dust” offenses, Cooley's MVSU Delta Devils were spreading the field, never huddling, and throwing the ball on every down and then throwing it some more. The stuff you see big-time college and NFL offenses doing now, he was doing then.

The only thing the Valley Delta Devils had more of than passing plays were nicknames. Cooley was The Gunslinger. Jerry Rice was World, short for All World. Willie Totten, the quarterback, was Satellite. The offense was The Satellite Express. The offensive line was known as Tons of Fun. Vincent Brown, the great linebacker, was The Undertaker. Together, they were a blast.

The first time I saw then in person was Sept. 24, 1984, when they came to Jackson to play one of W.C. Gorden's terrific Jackson State teams. Valley had scored 86 points in its opener and 77 points in its second . Rice was catching about 20 passes and four touchdowns a game. Totten's passing stats were so gaudy that the NCAA chief statistician accused Valley sports information director Chuck Prophet of making them up. Prophet sent the NCAA the game films and said, “Correct me if I'm wrong.” He wasn't.

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So Valley came to Jackson, drawing a crowd of more than 50,000, and on the first offensive play, the Devils flanked four wide receivers in single file to the left side and one wide receiver, the one wearing jersey number 88, to the far right. No. 88 was Jerry Rice and Jackson State had only one defensive back to him.

Well, you know what happened next. Rice ran right past the defender, Totten lofted a pass down the field, which Rice caught and gracefully ran to the end zone a good 10 yards ahead of the defender.

Valley won 49-32. During the game's final minutes, Cooley paraded up and down the Valley sideline, waving a green and white Valley banner. Valley had not defeated JSU in 30 years. Afterwards, he led the Valley players in a victory lap around the Memorial Stadium. “We've done the impossible!” Cooley, a former Jackson State All American center and linebacker, shouted.

“Now I know how they've been feeling for the last 30 years,” Cooley said, and he said a lot more.

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“Jackson State said they had to score 30 points to win,” he said. “Ha! They would have had to score 50 because we scored 49. I'm gonna now because they have to live with it for a year.”

Cooley could ever more talk. He could brag and he could back it up. He was from the old Dizzy Dean school of boasters: “It ain't braggin' if you can do it.”

Cooley could do it and did.

He was a Laurel native, a graduate of tradition-rich Oak Park High School, also the alma mater of such famous as Olympic long jumping champion Ralph Boston and world renowned opera soprano Leontyne Price. Cooley grew up with next to nothing. “A lot of times, growing up, I'd open the refrigerator for something to eat, and the only thing in there was water,” Cooley told me. “So, I'd drink a glass of water and go out and play football.”

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He played center and linebacker at Jackson State. He was a defensive coordinator for years at Tennessee State before taking the job at Valley. He said all those years as a defensive coach, he kept a notebook of plays other teams used that he knew he wanted to use when he became a head coach. Clearly, most were passing plays.

And, yes, it helped to have a receiver like Rice and a quarterback like Totten, both now in the College Football Hall of Fame. But Cooley called the shots and he brought the cameras and microphones to Itta Bena, which is Choctaw for “Home in the Woods.” I remember to give driving directions from Jackson to Itta Bena to a reporter from The New York Times. He said I lost him at “turn right at the cotton gin.”

That 1984 Valley team was undefeated at the same time SWAC rival Alcorn State was undefeated through mid-October. They were to play in November in Itta Bena. A young Jackson sports columnist – this one – wrote a column that the game should be moved to Jackson where 50,000 more people could see it. So, they moved it to Jackson and played it on a Sunday. More than 64,000 people attended, which made it the biggest pay day in the history of either school. Marino Casem's Alcorn State Braves won 42-28 in a game never to be forgotten by anyone who was there.

Cooley would leave MVSU after the 1986 season and go on to coach at Arkansas Pine Bluff, Norfolk State and Paul Quinn College in Dallas. His teams never again rose to the prominence of those Valley teams when CBS, NBC, ABC, The New York Times and Sports Illustrated all found their way to Itta Bena, where they told the story of the highest scoring college football team in history and their leader, the self-proclaimed Gunslinger.

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This article first appeared on Mississippi Today and is republished here under a Creative Commons license.

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Legislative panels will consider restoring some Mississippians’ voting rights

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mississippitoday.org – Taylor Vance – 2024-04-19 13:56:14

The two legislative committee responsible for criminal justice measures say they will move bills forward to restore suffrage for individuals, raising the prospect that some Mississippians will have their voting rights restored. 

House and Senate Judiciary B Chairmen Kevin Horan and Joey Fillingane announced Friday that they will have hearings on Monday to consider the suffrage bills. 

The House earlier in the session passed a substantial restoration bill that would have automatically restored suffrage to people convicted of nonviolent felony offenses, but Senate Constitution Chairwoman Angela Burks Hill killed it without bringing it up for debate.

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Lawmakers, however, can still consider individual bills to restore suffrage to people who have been convicted of disenfranchising felony offenses, though only a small number of those bills typically survive the legislation .

Horan, a Republican from Grenada, said the House will not restore suffrage to people convicted of violent offenses or those previously convicted of embezzling public money. Additionally, Horan said people must have completed the terms of their sentence and not have been convicted of another felony offense for at least five years to be considered. 

Fillingane, a Republican from Sumrall, said the Senate also will likely only restore voting rights to people previously convicted of nonviolent felony offenses – not violent crimes such as murder or rape. 

The Lamar County lawmaker also said the amount of time after someone has completed their sentencing terms is not a major factor in his to advance a suffrage bill out of committee or not. 

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“The further out the better, but the time since completing the sentence doesn't really matter,” Fillingane said. 

Under the Mississippi Constitution, people convicted of any of 10 felonies — perjury, arson and bigamy — lose their voting rights for . Opinions from the Mississippi 's Office have since expanded the list of disenfranchising felonies to 23.

READ MORE: ‘If you can't vote, you're nobody:' Lawmakers hear from rehabilitated felons who still can't exercise right

About 55,000 names are on the Secretary of State's voter disenfranchisement list as of March 19. The list, provided to Mississippi through a public request, goes back to 1992 for felony convictions in state court. 

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The state constitution gives lawmakers the power to restore suffrage to citizens, but the process is burdensome. It requires two-thirds of lawmakers in both legislative chambers to vote in favor of restoring suffrage in individual cases. 

“We have a process in the that helps to restore individuals' voting rights, but it is a terrible process,” Democratic Rep. Zakiya Summers of Jackson said on Wednesday. “And it's a cumbersome process. And there really is no easy way to navigate it.” 

The Legislature last year did not pass any suffrage restoration bills, but a willingness from both of the relevant committee chairs to push some of the bills forward could mean lawmakers will approve some bills this year.

Lawmakers have until the final days of the session to vote on suffrage bills, and legislators are coming to the end of their regular session, but it's unclear when they will adjourn. 

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Legislators still have major items they can consider, Medicaid expansion legislation, addressing the public retirement system and rewriting the public K-12 formula. 

This article first appeared on Mississippi Today and is republished here under a Creative Commons license.

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Look for the “why” when engaging in disagreement

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“Bought sense is better than borrowed sense” lives in my memory, rent-free. I've always cringed at it because, at every stage of life, some lessons have been costly to learn.

At the Alluvial Collective, we show up to the office, on the screen, or in a community with one overarching : to create or deepen the connections that will support collective thriving. That is our “For what.” We get to show up with wisdom purchased over our organization's last 25 years of work and with wisdom borrowed from many generations and traditions. In most traditions, self-reflection and stories reveal the path to where we should go and how we should travel.

As you engage in the National Week of Conversation, here are a of stories and a few to help you show up for each other, our communities, and our country.

What Do You Need

The first story emerges from a book called “Getting To Yes,” about negotiating.

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Two people were arguing over an orange, and after some time, they decided to split it in half, feeling that equal parts were fair, like in elementary school. Before splitting the orange, they never asked each other the reason the other wanted it. As it turns out, one wanted the orange peel to flavor a cake, and the other wanted the orange's “meat” to eat.

In another story, an arriving house guest is deeply offended by their host's demand that they their shoes upon entering their family home. The visit goes off the rails and probably off the porch, too.

Each of these stories reminds you of tensions and dilemmas that are all too familiar in our families, towns, and – for me – our leadership discourse.  We have notions about what the other person, or people, want, but at critical points, we need more humanizing insight into what makes it essential to them.

The Cost of Wisdom

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In the second story, the home's foyer had a large rug on its floor that had been in the family for generations. Understanding that, I would have offered to remove my shoes.

We benefit from being curious about the interests, the “for what” the other person engages with, rather than just the “what” or their position. It may seem inefficient, but it pales compared to the value curiosity brings to relationships. Good relationships are win-win; our team leans on telling and hearing stories to build relationships. They are the wellspring of “for whats” and “whys.”

The truthful stories that your neighbor or coworker tells to you and themselves comprise reality as they see it.  Your stories teach your in-laws and teammates history from your the learned or experienced vantage point. Dialogue and stories make our actions and attitudes make sense.  This is where trust begins to form.

Dialogue over Debates and Diatribes.

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As you begin your week, remember that how we engage matters as much as why. Diatribes and speeches don't make us good neighbors, and debates require someone to lose. We like authentic connections and hearing familiar themes in the stories of others. This week, open and honest dialogue is the strategy; to thrive together should always be the goal. We've paid too much for everything else.

more; proclaim less. It's one of our mottos here at The Center for Practical Ethics (TCPE). Put another way, we might say our goal is to foster conversations rather than diatribes. This task is more difficult than most realize. What we know as ethicists is that merely having conversations isn't enough. There's a wide variety of skills needed for fruitful dialogue to take place, and some are harder to by than others.

The ideal conversation partner is curious and humble, able to actively listen, knowledgeable about his or her own positions, familiar with basic principles of logical argument, charitable when interpreting claims, and—most importantly—willing to be wrong. Our work centers around equipping with these skills and helping them navigate the complex ethical issues within our society's most contentious disagreements.

This year, National Week of Conversations (NWoC) coincided with Ethics Week here at the University of Mississippi (UM). Many of our are conversation-based because dialogue is the best way to evaluate the ideas of others and open ourselves up to new information and interpretation of facts, while gaining a better understanding of our own views.

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Two of our events in particular are worth examining more closely to see why NWoC and the work we do at TCPE are critical for sustaining civil society and the myriad public goods we all take for granted. First is our signature Just Conversations . Students are placed in small groups and given a couple of ethical dilemmas to discuss. Trained student moderators guide the discussion to point out important aspects of the dilemmas, such as logical fallacies, analysis of stakeholders, ethical concepts and assumptions, and varying methods to achieve goals. Students often discover they agree with others—on the dilemma outcome and the details—far more than they expected.

Second, we have invited free speech scholar Sigal Ben-Porath to give a talk about her new book Cancel Wars: How Universities Can Foster Free Speech, Promote Inclusion, and Renew Democracy. Ben-Porath contends that universities are laboratories of democracy where students must learn to engage with disagreement. If the university is to be a place where truth is discovered, it must take seriously its historic social and educational obligation to train students in the skills needed for civil discourse and critical thinking. Her work is especially relevant in our ever more polarized times.

What these events demonstrate is that conversations—that is, engaged and fruitful conversations—must take place at all levels. Students must learn to talk to students just as much as faculty must learn to talk to faculty and administrators to administrators. What's more, these groups must talk to each other because while each of us have a role within academia (faculty, staff, student, dean, vice chancellor, etc.), we are also all citizens who work and live together.

Policies must be made, votes cast, businesses founded, churches attended, friendships established, and life lived. TCPE focuses on the skills of civil discourse by providing opportunities to cultivate those skills through Ethics Week, and highlights conversations that ask us to reflect on the role of universities as part of the NWoC.

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Join us at Noon on Friday, April 19 for a VIRTUAL lunch and learn session exploring tools to make us better listeners, and in turn, better equipped to engage in meaningful conversations across differences.

The session will be led by Dr. Graham Bodie, professor and Interim Chair of the Department of and Communication in the School of Journalism and New Media at the University of Mississippi.

This event is free and open to the public. Register to receive more information.

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This article first appeared on Mississippi Today and is republished here under a Creative Commons license.

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