| | "When we love the Earth, we are able to love ourselves more fully. I believe this. The ancestors taught me it was so," - Bell hooks, Touching the Earth
Struggles within the calling and profession of midwifery reflect some of the deepest truths and challenges of the culture in which a midwife cares for others. Painful reckonings include the impacts of racism, the environmental crisis, and the human struggle to remain healthy in a global society and the |
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| human struggle to remain healthy in a global society that commodifies human life and destroys health by prioritizing the market and industry over the values of justice and health. At its core, midwifery seeks to center the health of a human being, family, community, and environment by working to identify and dismantle the existing barriers for both individuals and communities. The midwife is not immune to the impacts of this struggle. We are human as well and often suffer with our communities to support reproductive care, justice, and access.
What does it mean in midwifery to engage in sustainable practices, and do work in midwifery with climate and environmental consciousness, while finding balance and health for ourselves? This is an art and perhaps a science- something midwives are in constant relationship with.
Burnout culture, the commodification of health, and the emphasis on values that undermine the balance of artful living and midwifery practice are ongoing challenges. These all present hurdles to living and working with balance. How can midwives resist the urge to focus on elements of success that do not serve us or our communities? How can we engage in sustainable work as care providers in our communities without compromising our well-being and the well-being of our planet?
These may be rhetorical questions, asked in the intimate moments of each midwife’s practice development, or the open discourses of activism within our communities as we work to dismantle white supremacy, misogyny, and anti-queerness. Our solutions must be rooted in truth-telling, compassion for self and others, and courage to walk in opposition to the dehumanization and planetary destruction caused by greed. Though there are universal truths to creating sustainable practice, and communities, it is also true that this is a deeply personal process with layers that acknowledge privilege of many kinds. Our midwifery siblings may find sustainability in ways tailored to our personal lives and our work. This may mean setting goals to decrease or impact the planet in our personal or professional lives or working in our communities to support the growth of sustainable ways of being.
Some of the ways midwives already care for our planet, and our communities and create sustainability include support of physiology, emphasis on nutrition to create lasting health, and discussions around community building. Acknowledging interdependence, and seeing ourselves and our families as a part of the totality- this understanding is life-shifting in many ways. These principles of interconnectedness and accountability to the whole, are ultimately grounding and create health in individuals, and communities and can have an impact on our environments.
Each of us is on a humbling and transforming adventure in our relationship with the Earth, the work of midwifery, and our body/ heart/ spirit. Only through a return to the deep reverence for all things can we be in a balanced relationship. |
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| | | NACPM is proud to announce we were able to make a $665 donation to NBMA from our February membership fundraiser. Thank you new members for showing up for our profession and our allies in this way! | |
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| Thank you to our March Newsletter sponsor - HiveCE |  | 1. True! [Learn More]
2. Almost! Hands-On Suturing meets the “hands-on” requirement for Category I, and our Bridge Bundle provides 36 MBC approved contact hours. (All you need to add is NRP.)
3. True! NACPM’s Organizational Membership provides discounts on all on-demand courses at HiveCE. Members will soon be hearing from NACPM with all the details. www.HiveCE.com | | Clinically Integrated Networks - a model that can make midwifery more sustainable across the United States | | In the almost 15 years since I have practiced as a Licensed Midwife in Washington, I have experienced the great joys and challenges of practice in what is arguably the best integrated community midwifery system in the United States.I built a busy practice, opened a birth center, employed other midwives, and welcomed hundreds of babies to earth alongside their families. From these experiences, I also learned firsthand the crushing pressures of the profession and the glacially slow speed of legislative |
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| and payer change. Both of these are critical for the financial and personal sustainability of independent midwifery practice.
I am not alone in my challenges as a midwife. In the United States, full-time midwives who work catching babies on-call struggle to keep up with that sort of practice, and not for a lack of passion. It is this nearly universal struggle that leads to my questions: How do we keep midwifery not just alive, but thriving? How do we help midwives to care for their communities while being cared for themselves? How do we make midwifery truly financially, professionally, and personally sustainable for those who do this difficult, necessary, and beautiful work? And how do we increase access to high-quality midwifery care for a broader range of birthing people?
The answer lies in a concept that is common among many healthcare practitioners but never seen in the world of community midwifery: Clinically Integrated Networks.
A Clinically Integrated Network, or CIN, is a model that can make midwifery more sustainable across the United States. At its core, A CIN is a partnership of providers. It focuses on enhancing care experience, improving outcomes, and increasing the overall health of communities.
Most significantly, the legal framework of a CIN allows us to negotiate rates collectively on behalf of the network based on the real outcomes of its members, something that is otherwise restricted for independent providers.
We know that driving cost savings to the healthcare system is a major incentive for insurance companies and that midwives save these companies a lot of money. Integrating midwives into the healthcare system through network models can lead to equitable pay for midwives as their value becomes more recognized. Providers within the network are able to demonstrate high-quality outcomes and meaningful impact by aggregated birth volume. We already know midwife-led care leads to better outcomes, but a Clinically Integrated Network would help provide the pathway to effectively demonstrate that value to insurance payers. A CIN shifts from a world in which midwifery care must be continuously legitimized to one in which we have the capacity to optimize our model and continuously improve it. While members of a CIN maintain their statuses as independent practitioners, there is space for collaboration and cooperation, difference of opinion, innovation, and clinical excellence.
Midwives have fought for every bit of the limited integration into the health care payment system that we currently have, and those small wins have barely helped us to achieve broader access to our services. I myself have struggled with this. In 2020 I began searching for ways to improve the sustainability of the work which is so central to my identity. After abandoning my insurance contracts, I restructured my practice but found that the clients who needed midwifery most couldn’t afford my care. Frankly, it's not fair. Midwives shouldn't have to choose between providing care and providing for themselves and their families.
Increasing access to midwifery care in all venues and making it accessible to all people is a key ingredient of building a better system for pregnancy and reproductive care. Clinically Integrated Networks aim to establish reliable paths for midwife-led practices to be both financially and professionally sustainable while providing the sort of care that gives people agency and choice in how and where they give birth and where their experience and health is not negatively impacted by their race, income, gender, geography, sexuality, or ability. A CIN creates a path where midwives are centered, valued, and integrated throughout the healthcare system of payers, hospitals, and other large providers, while preserving the autonomy, uniqueness, and community-orientation that makes midwifery care special.
To learn more about the Quilted Health Clinically Integrated Network and our plans for expanding our CIN model outside of Washington, please SAVE THE DATE for a free webinar hosted by NACPM on April 15th at 3:00 ET/12:00 PT. Louisa Severn, LM, CPM (she/her)Senior Manager, Provider Community at Quilted HealthLouisa is a practicing Licensed Midwife in Washington state. She currently runs her own homebirth practice in greater Kitsap county and is the president of the Midwives Association of Washington State (MAWS). At Quilted Health, Louisa is the Account Manager and liaison for all midwives in Washington for the Clinically Integrated Network. Previously, Louisa worked in fertility care and opened the first birth center in Poulsbo, WA. She has long been an advocate for community midwives and equitable pay for midwives. When not midwifing, Louisa enjoys knitting and baked goods and spends her time caring for her large family. | |  | This month, Board President Kiki Jordan, Board Vice President Keisha Goode and, Board Treasurer Catrice Harris presented Building Bridges: Reflections from NACPM’s Black Leadership at the National Black Midwives’ Conference. | | We’re thrilled to share that, while there, NACPM Vice President Keisha Goode was awarded an Astounding Advocacy Award from NBMA in recognition of her astounding solidarity with Black midwives, her work highlighting their experiences, and her advocacy for improving professional conditions for Black midwives.
To learn more about the conference, visit NBMA 2024 Conference Website. To see the deck that NACPM Board Members Presented, Click Here.
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| March Legislative Efforts and Places We’re Showing Up | | | | | | | The Certified Professional Equity Initiative in RI The Urban Perinatal Education Center (UPEC) is partnering with the Rhode Island Department of Health (RIDOH) to establish a community-based midwifery workforce in RI and improve perinatal outcomes in the State of Rhode Island. Through the State Maternal Health Innovation grant UPEC is implementing the Certified Professional Midwifery (CPM) |
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| Equity Initiative (CPM EI) alongside other maternal health projects with RIDOH. The collaborative development plans to promote a culturally competent midwifery program with a focus on attracting a more diverse student body will serve to provide concordant care to people of reproductive age in Rhode Island, as midwives of color are uniquely positioned to address the economic, political, and social determinants of health that impact people of color.
To accomplish this UPEC has partnered with Commonsense School of Midwifery (CCSM) a MEAC-accredited institution, which offers a structured racially congruent, and culturally sensitive program rigorous for students to become leaders in the maternal health field, as well as in their communities. Commonsense School of Midwifery states, it "was designed to enable students to gain the knowledge and skills needed to become highly competent midwives. We place an emphasis on teaching the art of out-of-hospital birth, differentiating between low-risk and high-risk pregnancies while preparing students to organize and operate as a professional midwife." UPEC will support the accepted students from Rhode Island through the CPM EI.
The CPM EI addresses key areas such as expansion and diversification of the Certified Professional Midwifery workforce, promoting access to primary care practitioners in community settings, and community collaboration for postpartum clinician care. | | 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 features 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. |  | | | | | | | | | | | | | Bill to expand midwifery care in Alabama filed in House of Representatives Legislation to allow licensed Certified Professional Midwives to deliver babies in all out-of-hospital birth settings has been filed in the House of Representatives. House Bill 312 (HB312), sponsored by State Rep. Ben Harrison (R-Cartwright), would broaden the scope of midwifery care in the state. |
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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 $17,863.
If everyone receiving this newsletter donated $25 or became a member of NACPM we would reach our goal! |
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