The burn center at Merit Health Central in Jackson – then the state’s only such center – closed in October of last year. Ever since, both Mississippi Baptist Medical Center and the University of Mississippi Medical Center have been competing for the title of burn center.
In the months following the bill’s creation, though, it became clear the legislation allowed for multiple hospitals to be deemed qualified to host a burn center, and multiple hospitals could be eligible for the $4 million allotted by the Legislature intended to defray expenses.
By July, both facilities had been deemed eligible to run a burn center by the state Health Department, despite apparent gaps in their qualifications at the time, according to reviews of both health systems’ sites. Both have since submitted corrective action plans to address the deficiencies.
It hasn’t been clear until now how the agency would divide the money.
The state Health Department notified the facilities of their $2 million allotment each last week, a spokesperson for the agency said.
However, the facilities haven’t gotten that money yet.
In order to receive it, they have to submit receipts for expenditures associated with creating the burn centers. Once those are approved, the facilities will be reimbursed.
Neither facility answered questions about what the money will specifically go toward, or if the money will be enough to single-handedly fund each burn center.
UMMC estimates that the cost of constructing its burn center will be $6.3 million, according to the most recent Institutions for Higher Learning board book.
“We are grateful for this support of our burn center and look forward to receiving the funding to continue our efforts to develop an unparalleled burn program for the region,” said Kimberly Alexander, a spokesperson from Baptist.
When Janice Scaggs joined the University of Mississippi Medical Center in 2020, she became part of a growing effort by the state’s largest public hospital and academic medical center to reintroduce midwifery into Mississippi’s maternal health care.
Certified nurse-midwives like Scaggs are educated in graduate-level midwifery programs and also hold an active registered nurse credential at the time of certification.
In the last three years, Scaggs, as the hospital’s only midwife, attended a little over six percent of births at UMMC each year.
Midwives advocate for autonomy and comfort over efficiency for their patients, and have been proven to decrease unnecessary interventions such as cesareans in low-risk mothers – thereby improving morbidity and mortality, as well as postpartum mental health, and lowering the overall cost per capita of care.
Doctors and OB-GYNs are experts when it comes to abnormal pregnancies, Scaggs explained, but they don’t always know how to stand back and let a normal physiological birth unfold.
“Midwives … are the experts in normal, and have always been educated on a patient-centered model of care, really advocating for the patient and family, and empowering them,” she said.
Unnecessary cesareans and their increased use in Black pregnancies are not only a large contributor of preventable maternal deaths, but also a large contributor of maternal health disparities. Maternal mortality and morbidity after emergency cesarean birth is nearly five times than after vaginal birth.
Midwives are proponents of simple, but successful, low-intervention practices during labor – such as mobility and intermittent auscultation, or a technique of listening to and counting fetal heartbeats for a short period of time during active labor.
Editor’s note: This interview has been edited for clarity and length.
Mississippi Today: The term “midwife” translates to “with woman.” How do you see your role as a midwife, and how does it differ from that of, say, a doctor?
Janice Scaggs: We have so many similarities that sometimes that’s a really difficult question, but then on the other hand it’s really not.
If you look at the midwifery-led model of care, it really focuses on the individual, on putting them at the center of care, midwives being advocates for their patients and families – they want to empower the woman.
We focus on normal and healthy, certainly recognizing the abnormal. I look at us as the experts of that normal (births), whether it’s OB care, birthing, or gynecologic care, as well as family planning. I would say that that differs from our physician colleagues, because they really are focused on what the abnormal is, and they are experts when things are not going right.
MT: Tell me about the evidence around midwife-led care in reducing maternal and neonatal morbidity and mortality.
Scaggs: It’s well documented in other countries where midwifery is integrated into the health care system that it improves outcomes. We now have some good evidence in the U.S. to look at those evidence-based benefits, as well, including decreasing unnecessary interventions, improving the overall outcome of health – mental health as well as physical health – and decreasing the cost of health care, as well.
We increase breastfeeding rates, decrease preterm birth rates, and then (use) that approach of not using intervention unless absolutely necessary. We end up not performing interventions that can lead to morbidity, when maybe they didn’t need to be done, such as an unnecessary primary cesarean section.
MT: So, in today’s world, more women give birth in hospitals, and around technology, than ever before. But that hasn’t necessarily led to better outcomes. We know that because of infant and maternal mortality rates, and also high cesarean rates – across the country but particularly in Mississippi. Tell me about your non-pharmacological approach to birth and your philosophy around that.
Scaggs: I look at non-pharmacologic support as being an option that can either be done on its own or can be integrated with medical technology and pharmacologic options for women, as well. So they don’t have to stand separated.
But if we’re focusing on non-pharmacologic, we know from research that mobility, upright positions in the first stage of labor, decreases the length of labor, it decreases other interventions, it decreases cesarean rate. It improves comfort for moms who are trying to cope with labor without pharmacologic methods.
So, giving women permission and opportunity to move in labor – they will and they want to. If we put them in a bed and don’t encourage them to move, they won’t, because they feel unempowered, they don’t feel like they can safely move around.
That non-pharmacologic approach to giving women options, having them understand they are safe options in most settings, and we’re talking about primarily low-risk births with midwives. And then looking at things like acupressure points can be extremely helpful, using heat and cold in different aspects can be helpful. Touch – we know that there’s therapeutic touch for all aspects of health care, and that includes in labor and birth.
Using things like birthing balls when women are either in the bed, when they may be tired, either with epidurals or without epidurals, for positioning, can be extremely helpful in opening the pelvis to its most optimal position so that the fetus can get into the most optimal position. Babies come out a lot easier if they are head down and looking down, in relation to mom’s body, as opposed to what I would call sunny side up or coming down a little bit crooked. Changing the shape of the pelvis and having mom moving, whether it’s in the bed or out of bed, does lead to better outcomes, insofar as getting baby in a good position and having a faster labor.
It als just helps mom to cope better. When you’re hurt, you want to move. And if women stay in one position and don’t move, then we know that they’re not going to cope as well. I always talk to students and moms about how part of my job is to help you recognize when you’re suffering and to help you cope and to limit suffering. We know that doing that for women in labor actually improves our mental health outcomes and in the postpartum period it decreases anxiety and depression. And we know that that is something we should all be focusing on, and we’re just beginning to see more attention to that mental health aspect of the process of labor and birth.
MT: So, midwives primarily use intermittent auscultation, as opposed to electronic fetal heart monitoring, to listen to fetal heartbeat. Can you explain the difference between the two and how EFM can increase one’s chances of an unnecessary cesarean?
Scaggs: Continuous electronic fetal heart monitoring has two small, round devices – plastic devices that fit on mom’s belly. One graphs on a computer system to show when (the mother) is having a contraction. The other one is a little ultrasound piece. It’s not an ultrasound visually; it’s for hearing. We hear the heart rate, or auscultate the heart rate. And on these monitors, you can have continuous monitoring of the fetal heart rate, as well as uterine contractions.
We introduced this thinking we were going to decrease the overall cerebral palsy rate and we didn’t quite have the evidence to support that. And we have found now, 25, 35 years later, that for high-risk women, it’s extremely advantageous to have continuous electronic fetal monitoring. But for low-risk women, who are in spontaneous labor, who don’t have risk factors, we many times actually offer or perform interventions that aren’t necessary because (the continuous electronic monitoring) really sometimes provides more information than we need to have.
If we use intermittent auscultation, which is using either a handheld little Doppler which is another ultrasound device to hear heart tones, or even the old fashioned fetoscope that looks like the ear trumpet, that we can use to listen on mom’s belly. We listen before a contraction, throughout a contraction and one minute after the contraction, and we do that every 15 minutes during labor and five minutes during active labor and every five minutes when they’re pushing. And in doing that, if we hear anything abnormal we then can transition to more continuous monitoring to find out how the fetal heart is and to assure that we actually have a healthy baby. But you’re not having to be strapped down and continuously monitored. It may be that if everything sounds good and normal, that you never have to utilize the continuous electronic fetal monitoring.
MT: Tell me more about that relationship between a traumatic birth and postpartum depression.
Scaggs: Well, I can’t define trauma for somebody else, but if I don’t ask the right questions I’m not going to know if there’s been trauma.
I’ve had women who have come to postpartum visits, who I thought had the most beautiful birth and labor experience ever, and who seemed wonderful, and I find out a couple weeks later that there was something that caused them a trauma – whether it was terminology that was used, whether it was moving forward with a plan that maybe was not clear to them.
I’ve seen women have emergency cesarean sections who really needed them who show no signs of trauma, and then women who have planned cesareans who have trauma related to that. I think there are so many small things we can do to decrease trauma for women and that’s going to be, number one, communicating and finding out what helps them the best, not necessarily ourselves.
And as a provider, of any kind, whether you’re a midwife, a physician, a nurse, you can love your job so much and impose what you think somebody else should need. Being very self aware and self reflective, having humility of the process of labor and birth, is one of the best ways I think we can eliminate severe trauma.
MT: Do you think Mississippi will ever have a birth center? Would that be helpful here?
Scaggs: I think it would be wonderful if we could have regional freestanding birth centers that are supported by nurse-midwives with, you know, appropriate consultation, collaboration and referral to OB-GYNs and maternal-fetal medicine physicians for care as needed.
It would give us a better sense of community support in places where we don’t have as good of access. It could provide prenatal care, as well as care for labor, birth and postpartum period, as well as family planning.
MT: What do you think is needed to shift the paradigm from the hospital model of birth, which relies so heavily on technology, to a model of fewer interventions for low-risk pregnancies and empowering women to give birth according to their own plan when safe?
Scaggs: That’s a big question and I think it has a multifaceted answer. I think it always comes down to: what is the culture for supporting intended vaginal birth? What is the culture for putting women in the center of care? And what the relationships are between health care providers and nurses within a hospital, and support from administration for the type of training that is needed to be able to do things like intermittent auscultation. There’s a specific way to do that. So there needs to be education for nurses to be able to learn that; there needs to be a better nurse to patient ratio. So, we have some workforce issues. There’s also financial issues, educational issues. The bottom line is it’s really difficult to change culture. It takes time.
The more we can lean into family-centered, patient-centered, care, the more we can use the evidence that we currently have around us to improve outcomes.
If Mississippi can integrate midwifery into the health care system, that’s going to be the simplest answer. Who better to change the culture than midwives, who are the experts in normal, and have always been educated on a patient-centered model of care, really advocating for the patient and family, and empowering them, as well. The more we can empower women to have these choices and to understand they have these choices is really going to help.
MT: Is there anything else you’d like to add about midwifery in Mississippi?
Scaggs: I would like to say that I have been very supported within the university and from the chair of the department (Dr. Marty Tucker), to be able to grow midwifery. He’s the one who initially reached out to me when I had moved to Mississippi and was trying to navigate and figure out where jobs were and not finding many. He believes in midwifery being integrated into our model of care.
And I think if we had more physicians and administrators who understood midwifery and were open to hearing about it and really looking at the evidence, that we would have more midwives in Mississippi. But it takes us partnering to do that. I need them, and I need for them to realize also that they need my profession in order to best care for women in the state.
The Mississippi Republican Party is asking the state Supreme Court to dissolve an emergency order a judge issued on election night keeping polls open in Hinds County, saying the order violated state law and the court lacked jurisdiction.
The state Republican Party filing notes the issue is spilled milk with the election over, but says the high court should make a ruling to prevent future problems and because the issues are “of great public interest.” It said conflicting court actions on election night caused confusion and run the risk of “sowing public doubt about the reliability of election results.”
On Nov. 7, there were numerous reports of Hinds County precincts running out of ballots or not having proper ballots, and voters reportedly waited in long lines or left without casting ballots. The state Democratic Party filed for an emergency order in chancery court to keep Hinds County polls open an extra hour that night. Chancellor Dewayne Thomas granted the order.
But in a separate case filed that night by Mississippi Votes, a Jackson nonprofit organization, in Hinds County Circuit Court, the Mississippi Supreme Court appointed a special judge, former Supreme Court Judge Jess Dickinson, to hear the matter. Dickinson issued an order that simply repeated existing state law: that people who were in line when the polls closed at 7 p.m. could vote if they remained in line.
In a petition filed this week with the state high court, the Republican Party argued chancery court lacks jurisdiction to be involved in such issues, that it should have been given notice of the Democratic Party’s petition that night, and that there is a lack of evidence that the ballot shortage was widespread or caused problems for many voters. The petition describes the “unknown and possibly surreptitious nature” of the Democratic Party’s filing that night.
State law appears to give the state’s high court exclusive power to appoint judges to hear election day disputes, and would appear to prohibit judges from dealing with such election day issues in their own counties. It says, “The Supreme Court shall make judges available to hear disputes in the county in which the disputes occur, but no judge shall hear disputes in the district, subdistrict or county in which he was elected nor shall any judge hear any dispute in which any potential conflict may arise.”
Besides this, the state GOP petition says, “Chancery courts in this state do not have the jurisdiction to enjoin elections or to otherwise interfere with political and electoral matters which are not within the traditional reach of equity jurisdiction,” quoting precedence from a previous state case.
In its filing on election night, the state Democratic Party said a large number of precincts in Hinds County ran out of ballots, “leading to long lines, extensive delays and voters leaving the polling places without voting.” It said the problem was affecting the rights of all voters and that “the relieve sought in this case is a request in equity” which would give the chancery court jurisdiction.
Republican House members chose Jason White as the chamber’s next speaker, elevating a new person to one of the most powerful political roles in Mississippi for the next four years.
The 79-member GOP caucus met Wednesday morning at the Annandale Golf Club in Madison, according to multiple lawmakers. Unanimously and without dissent, the caucus threw its support behind White, a three-term lawmaker from West, to become its new leader. They also elected Manly Barton, a lawmaker from Moss Point, to become the new speaker pro tempore and second in command.
“I appreciate the trust my fellow Republicans have now placed in me as the nominee for Speaker,” White said in a statement. “I am energized going into the 2024 Legislative Session, and I look forward to addressing the challenges and opportunities facing our state with conservative policies and principles.”
The closed-door meeting this week is technically an unofficial coronation of the speaker. After this week’s vote, House Republicans, who hold a two-thirds supermajority in the 122-member House, are expected to stick to this week’s vote and unanimously elect White and Barton on the opening day of the 2024 session, formalizing the decisions they made on Wednesday.
White, 50, was first elected to the House in 2011 as a Democrat, but he quickly switched to the Republican Party that next year. He represents portions of Attala, Carroll, Holmes and Leake counties and previously led the House Rules Committee and the House Management Committee.
White will replace Philip Gunn, a Republican from Clinton, who announced last year that he would not seek another term for his House seat. White was one of Gunn’s top lieutenants and most trusted advisers over the past three terms.
The speaker is not a statewide office position, but it carries power and influence similar to a statewide post. The speaker appoints committee leaders in the House and helps drive policy decisions during a legislative session.
Similar to the speaker of the U.S. House, a majority of the Mississippi House’s members must agree on a person to lead the chamber. But since the GOP gained a tight grip on the Capitol’s lower chamber, they typically meet behind closed doors to decide on a leader.
After the private meeting, the formal, public vote during the start of the new, four-year term has mostly become a predictable affair with little drama.
Barton was first elected to the House in 2011 and sworn into office in 2012. He represents portions of George and Jackson counties and previously chaired the House Local and Private Committee.
The speaker pro tempore presides over the House when the speaker is absent and often serves as a key advisor to the speaker.
Lawmakers will convene at the Capitol on Jan. 2 for the start of the 2024 session.
Lebby, the Ole Miss-Missouri controversy, the Southern Miss overhaul, the Iron Bowl Miracle, Georgia-Alabama, Patrick Shegog and a fabulous State Championships slate. This might be the most newsy week of the football season, so the Cleveland boys have plenty to cuss and discuss.
Longtime state Rep. Earle Banks, a Democrat from Jackson who pleaded guilty in May to evading the payment of federal taxes, has been sentenced to two years of supervised probation and ordered to pay nearly $85,000 in restitution.
Banks, according to news reports, has already paid the restitution.
Banks, who was recently reelected after running unopposed for the Mississippi House, was sentenced Monday in federal court for the Southern District of Mississippi by Judge Carlton Reeves.
The maximum penalty Banks could have faced was three years in prison and a fine of $250,000 followed by one year of supervised release.
Banks will continue serving in the Mississippi House during his probation. He has been a member of the House since 1993.
The Mississippi Constitution prohibits people convicted of most state or federal felonies from serving in elected office. But Section 44 of the state constitution does not bar people convicted of federal tax crimes from serving in elected office.
According to court documents unsealed in May, Banks received more than $500,000 in 2018 but only reported income of $38,237 on his federal income tax return.
Banks’ attorney Rob McDuff said in May, “Mr. Banks has cooperated with the U.S. attorney’s office and today had the opportunity to speak directly to the judge and admit that he made a mistake in failing to report on his tax return the proceeds from the sale of land that had belonged to his family for many years.”
Banks is an attorney, funeral home director and ran unsuccessfully for the state Supreme Court in 2012.
As the state seeks to set his execution date, Willie Jerome Manning continues to maintain his innocence, challenging a double-murder conviction that his attorneys say was based on unreliable evidence, including the recanted word of a jailhouse informant and forensics the Justice Department deemed faulty.
Manning was convicted of the shooting deaths of Mississippi State University students Tiffany Miller and Jon Steckler in 1994. He has pursued appeals and post-conviction relief that have questioned the state’s evidence and testimony that served as the foundation of his conviction.
“Willie Manning is sentenced to die for a crime he did not commit,” states the opening line of his Sept. 29 petition for post-conviction relief.
Last month, Attorney General Lynn Fitch asked for a stay of Manning’s execution, granted in 2013, to be lifted and for his execution to be scheduled. She also is seeking an execution date for Robert Simon Jr., who has been on death row for over 30 years.
In response, Manning’s attorneys from the Office of Post Conviction Counsel are seeking to dismiss the motion and allow him to continue to challenge his conviction.
His attorneys said in an Oct. 10 statement that the state hasn’t responded to the petition or considered the evidence. The state said deadlines in other death penalty cases through the end of the year have prevented it from responding to Manning’s petition, according to court records.
The court approved a Dec. 29 extension.
As of Monday, the Mississippi Supreme Court has not yet set an execution date for Manning.
The bodies of Miller and Steckler were discovered early Dec. 11, 1992. Steckler was shot in the back of the head and run over with Miller’s car. Miller was shot in the face at close range, and she was found with one leg out of her pants and underwear and her shirt pulled up, according to court documents.
From the beginning, law enforcement struggled to come up with leads, including a theory that the murders were connected to a car break-in that happened outside of a university fraternity that Steckler was a member of. The sheriff believed the couple encountered Manning during a break-in and he forced them to drive to another location, where he killed them.
It wasn’t until months after the shootings that Manning became a prime suspect. The state argued that he was caught selling items linked to Jon and taken from the burglarized car. Because there wasn’t physical evidence to link him to the murders or the car burglary, Manning’s attorneys argued that this urged the state to turn to jailhouse informants.
Manning, who has spent more than half of his 55 years on death row, allegedly confessed to the killings to his cousin, Earl Jordan. Jordan lied about the confession and another man, Frank Parker, who was also in jail, lied about overhearing Manning talking to another man about how he disposed of the murder weapon, according to new affidavits cited in the post-conviction petition.
His attorneys argue that the testimony of Paula Hathorn, Manning’s former girlfriend, was not entirely reliable because law enforcement pressured her for her cooperation, which included receiving a cash reward of $17,500 for being a state witness at trial, according to court documents.
She also provided the state with the link to a gun believed to have killed Steckler and Miller. An FBI firearms examiner matched bullets found on the victims’ bodies to ones removed from trees in Manning’s yard, which she said he shot at for target practice, according to court records.
A 2013 letter from the Department of Justice said there were errors from FBI testimony about firearms and hair analysis. This led to the delay of Manning’s scheduled execution to allow the testing of evidence, including a rape kit and fingernail scrapings.
The firearms testimony was an error because the science behind firearms examinations “does not permit examiner testimony that a specific gun fired a specific bullet to the exclusion of all other guns in the world”, according to court documents.
A firearms expert who worked with Manning’s attorneys and commented on findings of the DOJ’s 2013 letter provided affidavits that year. In another affidavit provided this year, the expert said new research and studies have shown that firearm identification and toolmark analysis are an unreliable form of forensic science, according to court records.
Manning should be granted a new trial based on the state’s use of scientifically invalid testimony, his attorneys argued.
“There are already compelling reasons to question the reliability of the convictions,” the post-conviction relief petition states. “When the totality of available evidence is reviewed, there is no longer any reliable basis for Manning’s convictions to stand.”
Attorneys laid out grounds for the court to grant relief, including how the state allegedly violated Manning’s due process rights when it “intentionally or merely failed to disclose” evidence favorable to his defense, including the sheriff’s arrangement for Jordan to cooperate in exchange for reduced charges and how the overheard conversation about Manning disposing of the weapon never happened, according to court records.
Manning has already been exonerated in another double murder case. His attorneys noted similarities in how law enforcement pursued a case against him.
In 1993, Manning was accused of killing 90-year old Alberta Jordan and her 60-year-old daughter Emmoline Jimmerson in their Starkville apartment, and convicted for their murders in 1996.
The Mississippi Supreme Court ordered a new trial in the case after determining the state violated Manning’s due-process rights “by failing to provide favorable, material evidence,” according to court records. Since the state’s main witness recanted his statements in sworn affidavits, then-Oktibbeha County District Attorney Forrest Allgood dismissed the charges, according to the National Registry of Exonerations.
A study by the registry found that false testimony or accusations were the single largest factor in wrongful homicide convictions between 1989 and 2012.
