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| As a practicing midwife, my recent journey to Piste, Mexico provided me with a profound opportunity to learn from the ancient traditions of midwifery intertwined with plant medicine. In rural communities of Latin America, where modern healthcare facilities are often inaccessible due to geographical barriers, caregivers continue to rely on ancestral practices passed down through generations. In the time I spent in Piste, learning at the feet of Mayan midwives, I was struck by the flourishing |
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knowledge of plant-based medicinal care. Walking through lush gardens, it became clear that these were more than just beautiful landscapes; they were vibrant, self-sustaining pharmacies in nature.
These midwives, or Parteras and Shamans as they are respectfully known in their communities, confidently care for whole families, with special emphasis on the childbearing woman. I was in awe as we walked through acres of foliage and plants, and our guide named every plant by name, even pointing to the smallest ones growing so close to the ground they could easily be missed or mistaken for a weed. In addition to knowing what plants and herbs to use for various conditions, it was also explained that knowing how to prepare them and apply them is equally important. For example, some work best with heat, and others with cold.
I learned that plant based medicinal wisdom must be carefully shared from one generation to the next in explicit detail. Our guide confidently gave us instructions on how to use angelica to aid placenta birth, pomegranate for fever and rash, rue for eye problems, and so much more. From the same medicinal garden came vegetables that would be a part of our dinner that same evening. Rather than see this plant wisdom as primitive, all present gained a deeper respect for the wisdom of the earth and all it has to offer.
On this trip, I was reminded of lessons learned from other cultures as well. In many African cultures medicinal plant use is very common, and has profound effects on pregnancy, birth, and the postpartum period. Many African traditions were brought across continents during the days of slavery, without written records to rely on. Fortunately, so much of midwifery was learned, ingrained, and passed down generationally as a normal part of life. This heritage was so common, that in many African languages, there is no word for ‘midwife’. This was simply woman’s work and embraced honorably.
Across native lands and rural southern communities in the United States, the wisdom of women elders guided generations through pregnancy and postpartum periods. Communities relied on herbs and roots wildly grown in their areas. Using herbs like black haw, ginger ,mayapple root and more, these traditional midwives and caregivers were keepers of the secrets to relieving cramps, inducing labor, and stopping or starting menstrual cycles as warranted under various conditions. Today, as we use herbs like elderberry and echinacea as common practice, we must recognize and honor their origins with enslaved Native Americans and Africans. The wisdom of our ancestors and their plant medicine continues to hold value in our midwifery practices to this day. |  |
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| A Blueprint for Improving Maternal and Infant Health Outcomes Under Medicaid : Recommendations from the 2023 Maternal Health Policy Equity Summit As federal and state policymakers seek to improve maternal and perinatal health outcomes, policies such as community- based models and an extension of 12-month postpartum coverage have been implemented. The Medicaid program will serve an important role in implementing these innovative changes, including evaluation of health outcomes, assessment of the economic impact, and establishment of strategies to support sustainability. To continue this momentum and with |
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the support of several national foundations, the Institute for Medicaid Innovation convened a two-day summit on Medicaid maternal health equity policy as the first step in the development of such a plan. The event was hosted by the Aspen Institute in Washington, D.C. and held in Fall 2023. NACPM President , Kiki Jordan CPM was invited to be a summit participant. |
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February Legislative Efforts |
NACPM along with AABC and ACNM continue to work on a proposal for the Defense Health Authority to expand TRICARE's midwifery care coverage to include CPMs and CMs. Progress this month has included a productive meeting with the Defense Health Agency, and the development and design of a postcard campaign urging Congress to support TRICARE expansion. One dedicated volunteer received this promising letter back from Congressman Derek Kilmer (D-WA). Read the full letter and see why we’re feeling optimistic about this endeavor. | |
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Alaska Midwifery Board Support This month, NACPM sent a letter of opposition to Executive Order 130 and in support of House Bill 175 to maintain the midwifery licensing board. | |
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Illinois Regulatory Advocacy NACPM attended an introductory meeting with IDFPR, alongside the Holistic Birth Collective, and the Black Midwifery Collective. |
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| NACPM authored and sent in collaboration with AABC and ACNM a letter to CMMI detailing the expectation that CPMs are not excluded from reimbursed under the TMaH initiative. We have received word back that CPM reimbursement will be allowed under this model! | |
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Interstate Compact Agreement Application Submitted At the end of January NACPM had the pleasure of submitting to the Council for State Government the application for help with creating interstate compact agreements. They told us they will let us know in 4-6 weeks if we were selected. Either way it is a win for our organization. This was our first attempt at gathering support for an initiative in 2024 and we were able to send 15 letters of support, including ones from our sister organizations NARM and MEAC! You can see a full list of the organizations like National Black Midwives Alliance and Changing Woman Initiative at NACPM.org |
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Collection of the Smithsonian National Museum of African American History and Culture, Gift of Robert Galbraith © 1987 |
“One of the darkest moments in US history was the systematic eradication of the African American midwife from her community, resulting in a legacy of birth injustices.” - Shafia Munroe |
February marks Black History Month, a period for honoring African American contributions and their pivotal role in U.S. history. Midwifery in the United States has a complicated history of marginalization and division. Prior to the twentieth century, midwives served in their communities as the primary maternity care providers for childbearing people in the U.S. The percentage of midwife-attended births declined steadily over time as chattel slavery ended, native and indigenous communities were decimated, and community midwives, foreign-trained midwives, and home birth were stigmatized through disinformation and anti-midwifery campaigns. These primarily physician-led campaigns were fueled by racism, classism, sexual discrimination, and anti-immigrant fervor.
By 1975, the number of midwife-attended births reached its lowest point at less than 1% of births overall and 2.4% of non-white births. Many traditional midwives were being forcibly retired and the legacy of race, gender, and class injustice surrounding midwifery was deeply embedded in the dominant American cultural beliefs about birth and midwifery. For instance, in 1925 in the state of Georgia there were approximately 9,000 black, indigenous and immigrant midwives serving in their own communities. By 1944 that number had been reduced to 2,200. Today, there are approximately 600 midwives practicing in Georgia, and most of them are white (Georgia: “The Midwife Problem”).
The U.S. currently ranks 50th in maternal mortality and 38th in infant mortality, and the impact is not experienced equally. In our country, there are tragic disparities in health outcomes for childbearing people and infants of color due in large part to institutional racism. Black babies die at more than 4 times the rate of white babies, and maternal mortality is almost 3 times higher for Black childbearing people than for whites.
Research shows, midwifery and culturally congruent care are proven methods to address perinatal health disparities in US communities of color.“Despite a long history of midwifery in the black community, black women currently represent less than 2% of the nation’s reported 15,000 midwives. Relatedly, black women and infants experience the worst birth outcomes of any racial-ethnic cohort in the United States.” Keisha Goode, PhD. NACPM acknowledges the profound barriers to becoming midwives that exist for Black midwifery students. Black CPMs and students continue to face workplace microaggressions and feel compelled to code-switch to align with the dominant culture, a practice linked to burnout and emotional distress. We know that until the CPM workforce comes to represent the evolving racial and social makeup of the childbearing population, and that a diverse workforce is met with support, encouragement and kindness, all CPMs will be limited in their ability to play an essential role in eliminating the unconscionable racial disparities and improving outcomes for the childbearing population.
At our core, NACPM is committed to dismantling systemic racism in midwifery, eliminating unconscionable disparities in birth outcomes for people of color and their infants, and investing in a strong, racially representative CPM workforce to meet the needs of childbearing people.. NACPM honors the legacy of the Black midwives, who helped birth this nation, through our uncompromising lens on equity our ever evolving work encompasses a range of approaches, from systemic change through state and federal policy initiatives to critical direct support for student midwives to grow and diversify the midwifery workforce, from support for CPMs through our Chapters Program to Professional Development opportunities, and planning for the future of the profession.
We ask you to celebrate Black History Month by spending some time to learn:
Keep an eye out on our website for the launching of our updated Equity Resource which we will publish in the coming weeks intended to begin to fill in social and historical knowledge gaps, to raise awareness within the CPM community about how racism and other forms of oppression are contributing to these deplorable outcomes for black and indigenous people and to stimulate dialogue and action. We believe midwives have a critical role to play in addressing these outcomes--but only if we each take individual responsibility for our part in bringing about change. If you have a resource worth sharing please share it with us so that we can include it in the next iteration of NACPM’s equity resource guide.
Through this continued learning, we aim to not only celebrate Black History and contributions but also to make tangible progress towards an equitable and supportive midwifery profession. |
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We are excited about the incredible work midwives are doing across the country. To celebrate and showcase the impactful initiatives happening in each state, we would like to highlight your individual and Chapter achievements, challenges, legislative efforts, fundraising activities, and more in our newsletter , on our website and on our social media platforms. Use the form linked below to let us know any news worth sharing! | |
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| We’re asking every member to consider a $10 donation for every birth they attend in 2024. Imagine the impact, if every one of their clients also donated $10 to support their midwife’s profession! Help make this campaign a success by making a donation today. | |
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Each Newsletter in 2024 will feature exclusive merchandise, perfect for personal use or thoughtful gifts for your clients. Your purchases contribute directly to our Bigger Table Fund Initiative, enabling us to to help grow a racially, ethnically and socially representative CPM workforce. Join us in making a difference while enjoying quality merchandise that aligns with your passion for midwifery. |
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AABC authored and sent in collaboration with NACPM and ACNM a letter to the NRP steering committee regarding the exclusion of CPMs. |
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NACPM executive director attended the BMMA National call. |
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| The legal landscape for home births varies by state, leaving some moms outside the law. |
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Support our work: Donate to NACPM | |
| NACPM’s annual goal for fundraising from individual donors and increasing the volume of our collective voice is $100K. In 2024 so far we have raised $500.
If everyone receiving this newsletter donated $25 or became a member of NACPM we would reach our goal! |
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