Policy Update: Exciting Federal Opportunities for CPMs on the Horizon

Historic 116th Congress

A vibrant new energy is palpable in the halls of this 116 th Congress, the most racially, ethnically and socially diverse in history, and exciting new federal opportunities for CPMs are on the horizon. A new commitment among our nation's leaders has emerged to address the unconscionable rates of mortality, preterm birth and severe complications of pregnancy suffered by birthing people in our country, and especially and disproportionally by Black and Native American childbearing people - along with a critical recognition that midwifery care is key to improving outcomes while lowering costs. Two bills to support the education of midwives are on or will soon be on the docket this session, supporting the growth of and urgently needed racial diversity in the midwifery profession.

TESTING

Who are CPMs

A Certified Professional Midwife (CPM) is a knowledgeable, skilled and professional primary maternity care provider. Certified Professional Midwives are trained and credentialed to offer expert care, education, counseling and support to women for pregnancy, birth and the postpartum period. CPMs practice as autonomous health professionals working within a network of relationships with other maternity care providers who can provide consultation and collaboration when needed. All Certified Professional Midwives meet the standards for certification set by the North American Registry of Midwives (NARM).

In the United States, Certified Professional Midwives provide unique and critical access to normal physiologic birth, which profoundly benefits mothers and newborns. Although qualified to practice in any setting, they have particular expertise in providing care in homes and free-standing birth centers, and own or work in over half of the birth centers in the U.S. today.

Certified Professional Midwives are a fast-growing branch of the midwifery profession in the United States. With the first CPM certificate issued in 1994, and with over 2454 certificates awarded as of January 2014, approximately 1 in 6 midwives in the U.S. today is a CPM.

Policy Update: Exciting Federal Opportunities for CPMs on the Horizon

Policy Update: Exciting Federal Opportunities for CPMs on the Horizon

Historic 116th Congress

A vibrant new energy is palpable in the halls of this 116 th Congress, the most racially, ethnically and socially diverse in history, and exciting new federal opportunities for CPMs are on the horizon. A new commitment among our nation’s leaders has emerged to address the unconscionable rates of mortality, preterm birth and severe complications of pregnancy suffered by birthing people in our country, and especially and disproportionally by Black and Native American childbearing people – along with a critical recognition that midwifery care is key to improving outcomes while lowering costs. Two bills to support the education of midwives are on or will soon be on the docket this session, supporting the growth of and urgently needed racial diversity in the midwifery profession.

Two Bills:  First-Ever Federal Legislation to Fund the Education of CPMs

Funding for Midwifery Education included in the House 2020 Appropriations Bill

On June 19th, the U.S. House of Representatives passed H.R. 2740, the Departments of Labor, Health and Human Services, and Education Appropriations Act of 2020. NACPM and ACNM were invited to work with Congresswoman Roybal-Allard’s office to include $2,500,000 in this legislation to be allocated to educate midwives within the Scholarships for Disadvantaged Students program in Title VII of the Public Health Service Act. MEAC and ACME-accredited schools and programs will be able to apply for grants for direct support for CPM, CM and CNM students of color and Native American students. This funding will help address the critical national shortage of birth care providers, and specifically address the urgent lack of adequate racial representation in the birth care workforce . The Senate is currently at work on their version of the 2020 appropriations bill, after which the House and Senate bills will be reconciled to produce the final Congressional appropriations legislation for 2020. NACPM will continue to work with Congresswoman Roybal-Allard and Congress to advance this exciting and important legislation through these next steps and will keep you up to date.

Midwives for Maximizing Optimal Maternity Services (Midwives for MOMS) Act of 2019

NACPM has been privileged, along with ACNM, to assist in the development of legislation with Congresswoman Roybal-Allard’s (D-CA-40) office that has the potential to revolutionize progress for the Certified Professional Midwife profession and access to care for childbearing people in our country.

This legislation will authorize the first-ever federal funding program that will support the education of CPMs. Soon to be introduced, the bill will authorize a funding stream of $15,000,000 for fiscal years 2021-2025 in Title VII of the Public Health Service Act. This funding will apply to CPM and Certified Midwife (CM) schools that are accredited by MEAC or ACME. (The Act authorizes a corresponding $20,000,000 for nurse-midwifery education in Title VIII.) Grants from this funding can be used for these purposes:

  • Establish or expand CPM and CM accredited midwifery schools and programs

  • Secure, prepare and/or provide support to increase the number of qualified preceptors for training the students of an accredited CPM or CM midwifery school or program

  • Provide direct support for CPM and CM students (stipends/tuition reimbursement), including minority students, in an accredited midwifery school or program

Special consideration will be given to schools that prioritize students planning to practice in health professional shortage areas and that demonstrate a focus on increasing racial and ethnic minority representation in midwifery education.

Once the Midwives for MOMS Act is introduced, NACPM will reach out for your help securing your legislators’ support for this exciting and important legislation. We at NACPM are thrilled with this opportunity and its potential to transform our profession.

Key Federal Policy Opportunity for CPMs: Including CPMs in the Federal Medicaid Program

NACPM commends Congresswoman Gwen Moore (D-WI-4th) for her focus on including CPMs in the federal Medicaid program in H.R. 2751- the MAMA’s First Act, and the Midwives Alliance of North America (MANA) for their support to this office on this legislation.

Securing federal recognition and inclusion in the federal Medicaid program for Certified Professional Midwives by amending the Social Security Act has been a top priority for NACPM since 2009. CPMs have a critical role to play in improving outcomes for all childbearing people in the U.S., and in eliminating racial inequities and disparities for Black and Native American and Alaska Native people and their infants in our country. Including CPMs in the federal Medicaid program is urgently needed to achieve these goals. NACPM appreciates Congress’s continued and current interest in this policy, one that will make such a difference in outcomes for those most affected, while also reducing healthcare costs.

 Historical Context for this Policy

Congresswoman Moore has been a champion of this initiative since its inception, and was an original co-sponsor of the Access to Certified Professional Midwives Act introduced in the 112th and 113th Congresses by NACPM - H.R. 1054  and H.R. 1977 . NACPM subsequently consulted with her office during the 114th Congress on draft legislation, the Midwifery Access Act of 2015, to federally recognize both CPMs and Certified Midwives (CM). Following six years of significant investment and dogged advocacy with Congress, this draft bill reflected a new strategy to overcome several years of persistent opposition and to achieve success for this policy by including US MERA agreements for accredited education and the Midwifery Bridge Certificate for purposes of reimbursing CPMs in the federal Medicaid program.

Since 2016 when the current administration came into office, NACPM has focused our efforts on working behind the scenes to listen to concerns from midwives about the implications for and impact on their states of this federal policy, to search for innovative solutions, to build resources and to cultivate key relationships. Now, with the advent of this new Congress and its welcome commitment to using the power of the federal government to improve the health and save the lives of childbearing people in our country, there are new opportunities for success. NACPM has renewed its commitment to working with Congress and with colleagues to shape this important policy of including CPMs and CMs in federal Medicaid in a way that can be as inclusive as possible and in a way that has the best chance of becoming law.

As of April 2019, of the thirty-three states that license CPMs , only fourteen of these states include CPMs as reimbursed providers in their state Medicaid plans. In addition to expanding access to CPM care to all states where CPMs are licensed, recognizing CPMs in the Social Security Act (the law that houses the Medicaid and Medicare statutes) would:

  • Open doors for CPM inclusion in the systems of care and reimbursement that define the delivery of health care in our country

  • Support participation in other federal insurance programs, such as Tricare, expanding access to care for members of the military

  • Allow CPM participation in federal student loan repayment programs and support the increase of critical racial representation in the CPM workforce

  • Open access to participation in the National Health Service Corps - student loan forgiveness for serving underserved areas & populations

  • Allow CPM direct participation in Federally Qualified Health Centers- a sustainable model for serving Medicaid populations

In 2017, NACPM wrote and distributed a set of Briefing Papers: Midwifery Landscape and Future Directions that describes the momentum generated by the US MERA agreements in gaining legal recognition and access to midwifery care for more people. The papers address the opportunities to overcoming long-standing barriers, both state and federal, that have stood in the way of midwives and birthing people for far too long. The NACPM Briefing Papers are designed to answer questions and engage midwives and students in further conversations about the future of the profession. One of the briefing papers Certification and a National Credential has recently been translated into Spanish. We are working to ensure that the remaining papers will also be translated.

We invite you to explore and engage with us:

NACPM’s position on the Portfolio Evaluation Process (PEP)

NACPM has been asked by members of our community to clarify our position in relationship to the Portfolio Evaluation Process (PEP).

Importantly, NACPM values the Portfolio Evaluation Process (PEP) as an innovation ahead of its time, whose attributes of accessibility, affordability, and student-directed learning and pace are only now being acknowledged and reflected in the most cutting- edge innovations in higher education in the country – in particular in competency- based, direct-assessment education . NACPM is committed to advancing midwifery education that reflects the innovations, affordability, accessibility and benefits to students that are embodied in the PEP process within accredited institutions and programs.

You can read   NACPM’s full statement here.

Announcing Four New Chapters as of 2019!

The NACPM Chapter Program had a strong finish to 2018 with the formation of four new chapters! Georgia, Idaho, New Hampshire, and Virginia were all able to take advantage of the generous start-up funding from Ann Geisler and Southern Cross Insurance before the close of our chapter program launch period at the start of 2019. We are so excited to have these new chapters as part of our community, and encourage you to reach out and get involved!

READ MORE IN OUR CHAPTER NEWSLETTER

Celebrating Bigger Table Fund Awardees

NACPM Congratulates Bigger Table Fund Awardees

NACPM celebrates and heartily congratulate the first awardees of the Bigger Table Fund! The Fund provides awards to student midwives of color, indigenous and/or LGBTQIA+ student midwives to cover the initial NARM certifying examination fee, the fee for retaking the NARM examination when needed, and state licensing fees. In addition, Cascade Birth Supplies is generously supporting the Bigger Table Fund by providing a doppler or a five-hundred-dollar gift certificate to one awardee a year.

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2019 Application Deadlines
January 15, April 15, July 15, October 15
2019 Bigger Table Fund Award Announcement Days
February 1, May 1, August 1, November 1

Apply now for the January/February Award Cycle

The goal of the fund is to remove some of the significant financial barriers that student midwives of color, indigenous and/or LGBTQIA+ student midwives face when entering the CPM profession. We recognize that there are multiple barriers beyond the NARM examination and state licensure fees that student midwives encounter, and it is our ardent intention go grow this fund in the coming years to help defray some of those additional expenses.

Funds are distributed quarterly, according to a lottery system, with $3000 available per cycle. The maximum individual award is $1000.

 

Your Donation Makes a Difference

Please support the work of NACPM with your year-end giving! Your donation makes a difference . NACPM relies on your kind generosity to support our work to support you – midwives and students, and to increase access for all birthing people and their infants to the high-value care of Certified Professional Midwives. Please give today!

We hope you will also make a donation to the Bigger Table Fund and help support emerging new midwives and leaders. The name of the fund derives in part from the quotation: “When you have more than you need, build a bigger table not a higher fence.” Let’s work together to build a bigger table!

 

Increasing safety for families across all birth settings

In response to the recent GateHouse Media piece, the Midwives Alliance of North America Division of Research Coordinating Council came together with a number of organizations, including NACPM, to release a statement on increasing safety for families across all birth settings. Signatories include:

American Association of Birth Centers
American College of Nurse Midwives
Association of Midwifery Educators
Birth Place Lab
Citizens for Midwifery
International Confederation of Midwives
Midwifery Education Accreditation Council
National Association to Advance Black Birth
National Association of Certified Professional Midwives
National Black Midwives Alliance
North American Registry of Midwives
Queer and Transgender Midwives Association

We welcome you to read, share, and sign on to the statement here. Find it here on Facebook.

 

Please Join Us for our Annual Meeting!

Tuesday, January 8, 2019 4-6pm, ET

Register Now




Every year, NACPM increases our capacity to carry out our functions as a professional organization – to serve our members, grow and strengthen the profession, to increase access to our care for all childbearing people, and to influence public policy in favor of better health for all families. Please join us on Tuesday, January 8! Please note that if you previously registered for the December 6 meeting, you are already registered for the new time.

Save the Date: Tackling Quality of Care Issues Locally/The Oregon Experience

Thursday, January 17, 2019 from 2pm – 3:30pm, ET

1.5 MEAC CEUs available

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Silke Akerson, CPM, LDM

Ongoing work on quality improvement is essential to safe, excellent and responsive midwifery care in any setting.  Please join Silke Akerson, CPM, LDM, Director of the Oregon Midwifery Council, to learn about the Oregon experience of creating a community-based midwifery Quality Improvement (QI) Program in response to safety concerns.  In this webinar, which is part of our CPM Clinical Practice series, Silke will cover each strategy used in Oregon for quality improvement and discuss the improvements in outcomes and transport relationships the midwives have seen as a result.  Participants will come away understanding the concepts and evolution of quality improvement, the use of QI in midwifery, cultural competency in relation to QI, the benefits of QI, and with concrete tools for addressing quality issues in your own state or community. 

Season’s Greetings!

As we approach the winter months, this time when the earth goes into hibernation, we want to take a moment to express our gratitude for all the challenges and lessons of this year as it heads to a close. We are grateful for our new members and new chapters, the advisors and partners who are walking with us on this journey towards excellent health for all families in our country, and toward a fair, just and peaceful world. And for those of you who are celebrating the season, all of us at NACPM wish you happy holidays and warmest wishes for the new year! We look forward to working with you in 2019 to ensure the manifestation of our vision for childbearing families.

Fall 2018 Chapter Newsletter

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The NACPM Chapter Program is growing in depth as well as breadth as we focus on how to bring an even deeper level of support to our chapters in the coming year. We currently have nineteen fully formed chapters with four in formation and inquiries from an additional eight states. We have so far hosted fifteen quarterly Chapter Collaboration Calls and offer quarterly chapter newsletters. The NACPM State Chapter Equity Toolkit is currently undergoing an external review process in an effort to enhance value and mitigate bias, and we hope to have this resource available very soon. Lastly, we hosted the first-ever in-person Chapter Leaders Day on May 20, 2018 outside of Washington, DC. We are building momentum, and we would love for you to join us! Contact Susan at chapters@nacpm.org for more information.

Limited Time Launch Funding for Newly Formed Chapters Through the End of 2018

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We would like to thank Ann Geisler of Southern Cross Insurance Solutions for her generous support of the NACPM Sate Chapter Program.  Since 2015, she has offered $500 start-up funding for each new chapter. This launch funding, which more than covers the cost of chapter formation and gives new chapters a surplus to put toward their state priorities, will no longer be available after the end of the calendar year. If you are considering forming a chapter in your state, now is the time! Contact Susan at  chapters@nacpm.org for more information on forming your state chapter today


State to State Sharing of Resources & Models Through the Chapter Program

In our experience of working with chapters, NACPM is collecting resources and models from states that can be shared with other states. The great value of a vibrant network of CPMs across the country lies in no one state having to toil in isolation or reinvent the wheel. We all benefit from this state to state sharing, and we hope to continue growing these sorts of relationships and collaborations through the Chapter Program. Some exciting examples coming out of our state chapters include the following:

  • Maine’s example of cross-system collaboration and the benefits that are now leading to a system-wide perinatal collaborative

  • North Carolina’s model for successful cross-professional relationship building through NCMERA, which is modeled after the USMERA collaboration. NACPM has recently shared this information with Rhode Island as a model.

  • NACPM frequently shares specific resources from Smooth Transitions in Washington State, which use the Home Birth Summit transfer guidelines. Representatives from Washington have expressed a willingness to bring this program to other states either virtually or in person.

  • Washington, DC is a current example, as is last year’s legislation effort in Hawaii, of including indigenous and religious exemptions in CPM legislation.

  • The NACPM system of chapters is becoming an effective avenue for outreach to state leaders which facilitates direct communication between states and from states to the national organization.

 

Carolina Birth Junkies Third Annual Retreat

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For the third year running, the North Carolina and South Carolina Chapters of NACPM have held a joint Summer Island Retreat near Rock Hill, SC on an island in the Catawba River. This event began as a recertification opportunity for NRP and CPR, and it grew into a vision for midwives coming together to learn, connect, and RELAX! Lori Gibson of the South Carolina Chapter and Christine Strothers of the North Carolina Chapter chose the island location because they sensed a shortage of opportunities for midwives to come together and talk with other midwives in a relaxed atmosphere.  Lori likes to think of it as a “standing appointment with each other every year” that ensures they will step away from the craziness of busy midwifery practice and get to know each other and enjoy some R&R.

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Lori considers this very important for self-care, especially considering the demands of midwifery. Every year they have a massage therapist so that participants can get a 20-minute chair massage to help ease the tension from their busy, stressful work load. The first year they did a three-hour team building event, and last year (when NRP and CPR recertifications weren’t on the docket) there was more down time to walk around the island, breathe in the fresh air, and let their minds rest. Lori says this year was pretty packed with the promised NRP recertification with Karen Strange and several other excellent speakers including Henci Goer, Justine Clegg, Andie Nantz, Christine Strothers, Sakina O’Uhuru, Belinda Leshea, and Susan Smartt Cook from the NACPM Chapter Program. While the quality and value of the educational components were top notch, they were reminded of the importance of protecting down time.  Next year, there will be more time to breathe and connect, and they hope to draw even more midwives from across the country. This year 45 participants registered for NRP and nearly 30 stayed for the entire weekend, including some from Kentucky, Colorado, and New York. You certainly don’t have to be from the Carolinas to join in the fun, so keep an eye out for more info at www.carolinabirthjunkies.com.

Click here to see the full schedule from this year’s retreat

Bigger Table Fund: Financial Awards for NARM Exam and Licensing Fees

NACPM is excited to announce the launch of the Bigger Table Fund!   The Fund will provide financial awards for student midwives of color, indigenous and/or LGBTQ student midwives for the initial NARM examination fee, the fee for retaking the NARM examination when needed, and state licensure fees.

The goal of the fund is to remove some of the significant financial barriers that student midwives of color, indigenous and/or LGBTQ student midwives face when entering the CPM profession. We recognize that there are multiple barriers beyond the NARM exam and state licensure fees that student midwives encounter, and it is our ardent intention to grow this fund in the coming years to help defray some of those additional expenses.

Funds will be distributed quarterly, according to a lottery system, with $3,000 available per cycle. The maximum individual award is $1,000.  We invite you to apply to the Bigger Table Fund. You also can access the application on the NACPM website.

The Bigger Table Fun FAQ can be found here.

2019 Application Deadlines

January 15, April 15, July 15, October 15

2019 Bigger Table Fund Award Announcement Days

February 1, May 1, August 1, November 1

 

NACPM is committed to:

* investing in a strong CPM workforce that is racially, ethnically, and socially representative that can meet the needs of all childbearing people;
* ensuring that native families have access to the services of Indigenous CPMs;
* opposing the oppression of LGBTQ people, including homophobia, transphobia, and violence based on sexuality, gender expression, and family     structure;
* understanding and addressing the compound negative impact of oppression on marginalized childbearing people with multiple intersecting           identities.

NACPM is launching the Bigger Table Fund in partial fulfillment of these commitments.

The name of the fund is derived from two different sources. One is the quotation: “When you have more than you need, build a bigger table not a higher fence,” the underlying premise being that we need less isolation, more community, and greater abundance for all. We know that sustainability is an issue for many, if not most CPMs; we also recognize that there is an unfair and inequitable distribution of resources for education and entry into practice due to the systemic forces of racism, colonialism, homophobia, and transphobia.

The fund’s name is also a reference to the quotation: “If you’re not at the table, you’re on the menu.” We know that inclusion matters and that the future of midwifery and access to safe, compassionate, and culturally responsive care for all childbearing people depends on who has a seat at the table. So, we’re seeking to expand ours.

Please click the link to donate to the Bigger Table Fund (please write BTF in the note)

We welcome and encourage donations to this fund from our members and wider community!

NACPM: Commitment to Justice for Pregnant People and Their Families

NACPM is committed to justice for all childbearing people, their babies and their families, and to ensuring their health and wellbeing. In this issue we focus on two issues of concern to pregnant people and families in the U.S.: the unconscionable practice of shackling incarcerated laboring prison inmates and the assault on the rights of American citizens by the denial or revocation of passports for people born at home in the U.S. with midwives.

Newly-Licensed CPMs Likely to Change the Economics of Giving Birth in Alabama

On celebratory note, NACPM applauds the September 13th report by Julia Simon of National Public Radio on the program, Morning Edition, highlighting the health and economic benefits coming soon to the people and state of Alabama as a result of the successful efforts by the Alabama Birth Coalition to pass the Childbirth Freedom Act in May 2017. This legislation establishes a board of midwifery and licensing for Certified Professional Midwives. The implementation of this law is about to begin, allowing CPMs to serve families choosing home birth. If you missed the live broadcast on September 13th, download the audio and enjoy this momentous National Public Radio account of the benefits of CPM care!

 

NACPM Joins the Call to End Shackling of Pregnant Inmates

On September 13th, an article in the Washington Post  announced bipartisan legislation, spearheaded by Rep. Karen Bass (D-CA) and Rep. Mia Love (R-UT), to outlaw the shackling of pregnant women in federal prisons. Currently, only 22 states and the District of Columbia have established anti-shackling laws– and even these states lack strict reporting requirements, making enforcement difficult to assess. This House legislation, along with the Senate’s Dignity for Incarcerated Women Act, introduced July 11, 2017 by Senators Cory Booker (D-NJ) and Elizabeth Warren (D-MA), would ban the shackling of pregnant inmates at the federal level. “Shackling women can endanger their pregnancy,” Bass said. “The idea that a pregnant woman is going to escape anywhere when she can barely walk is ludicrous. Shackling women on the wrists, waist and legs is a dangerous practice and a cruel practice.”

In January 2018, the NACPM Board voted to endorse ACOG’s Committee Opinion Statement: Health Care for Pregnant and Postpartum Incarcerated Women and Adolescent Females. With this endorsement, NACPM joins ACOG, the American Medical Association, the American Public Health Association, the American College of Nurse-Midwives and others in calling for an end to the shackling of all pregnant people during labor, and the provision of respectful and safe care to all pregnant inmates. NACPM will support the emerging federal legislation to end shackling and calls on all 28 states and territories with no currently established laws to pass similar legislation.

For decades, international human rights organizations have expressed concern about the use of shackling of pregnant women during labor in the U.S. In 1999, Amnesty International published a report, “Not Part of My Sentence”: Violations of the Human Rights of Women in Custody,” calling for an immediate end to the practice. While international standards restrict the use of physical restraints to preventing escape, injury to self or others, or damage to property, in the U.S. such restraints, including ankle and belly chains and metal handcuffs, are used as a matter of course.

The critical importance of ending the practice of shackling and providing safe pregnancy care in prisons takes on added significance with the growing attention to the injustices of mass incarceration. In 2018, 2.3 million people were held in U.S. prisons, a rate far beyond any other nation in the world. In addition, the racial, ethnic and social make-up of incarcerated populations is dramatically different from that of the U.S. as a whole. Black people make up 40% of prison inmates, despite constituting only 13% of the U.S. population. Native men  are incarcerated at four times the rate of white men. Nearly one in six transgender people  , including 21% of transgender women, have been incarcerated at some point in their lives—far higher than the rate for the general population

Rates of incarceration are growing faster for women than for men, with 219,000 imprisoned in 2017. Sixty percent of these women have not been convicted of a crime and are in jail awaiting trial. Although there is little reliable data, 1,400 people are estimated to give birth in prison each year, with thousands more who are pregnant passing through our prisons annually. These people are exceptionally vulnerable to “shamefully dangerous prenatal care,” shackling during labor, and separation from their infants after birth. Parent-infant bonding is crucial for the mother herself and for the infant’s development as a healthy functioning adult. Lack of adequate bonding endangers the infant’s mental health and very survival and bodes ill for the post-imprisonment functioning and ability to parent for the mother. Justice demands reform of our policies of mass incarceration, and the end to practices that threaten and endanger the health and well-being of incarcerated pregnant people and their infants.

 

READ THE FULL NEWSLETTER HERE

NACPM Responds to Denial of Passports of People Born at Home

NACPM deplores the most recent instance of the current administration’s assault on the rights of American citizens: denying passport applications from those born at home with midwives, especially along our southern border with Mexico. This denial of the rights of people of color is part of a pattern of racial bias that has grown and become codified in policies of this administration, including separating children from their families at the border, detention of those seeking asylum, migrants funneled into the most dangerous parts of the desert, citizens threatened with deportation, barriers imposed by stricter federal voter identification rules, and now a denial of citizenship.

 
NACPM endorses the Health Policy Statement on Passport Denials issued by the Midwives Alliance of North America (MANA) . NACPM joins MANA in condemning any involvement of healthcare professionals in the provision of fraudulent vital records. Most importantly, however, NACPM shares the deep concern about the egregious and persistent violation of rights based on race or ethnicity. We join MANA in calling for respect for the integrity of midwives and their life-saving care for families choosing and needing homebirth services. We join their call to the Trump administration to abide by the principles of justice and the government settlement in the 2009 case  litigated by the American Civil Liberties Union to end discrimination against those from border states who were born at home.

Meet the Candidates

NACPM is electing two new Board members this summer. If you are a CPM Member of NACPM, you will receive an email with voting instructions. Here are our candidates in their own words:

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Jenny Jahn, CPM, LM, CHD from New Mexico states: “The National Association of Certified Professional Midwives was presented to my class when I was in midwifery school. Thereafter, a fellow midwife endorsed NACPM and I decided to look into it. Doing research, NACPM made an impact on me because it promotes women’s heath through the CPM credential and promotes the CPM as a profession. I appreciate how NACPM is its own entity for my profession as a CPM without comparing the CPM to a CNM, MD or ND, etc. I am running for the NACPM Board because I believe in this philosophy of keeping the CPM profession and because I am in a place in life to make the commitment to the requirements listed.

As a Board member of NACPM, I would like to contribute to the good already going on by the current Board as well as bring myself to the table. It is my hope to continue to promote the CPM to, in turn, better women and families during the childbearing years and overall heath thereof. Far too many CPMs are turning to become CNMs because of the lack of trust, support, financial stability and sustainability of practicing as a CPM. We can do better than to change our profession. This minimizes the CPM credential even further. Furthermore, as a member of the LGBTQ community, I feel I can offer this unique perspective.

If I am elected to the NACPM Board, I hope to experience a broader spectrum of being in the healthcare field as a midwife and to expand my midwifery community. I hope to experience midwifery on a national and, dare I hope, international scale.”

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April Haugen, MSM, LM, CPM from Washington State shares: “I am excited to be running for a position on the NACPM board. I am passionate about increasing access of CPM’s in the US, establishing standards of care/equality in our communities, and providing culturally sensitive care to the family’s midwives are so passionate about. Being on the board will increase my capacity to make a difference in furthering the advancement of midwifery. I want to be a part in making midwifery sustainable by affecting CMP’s on the State and Federal level.

I have been supporting families as a birth doula since 2000, then went on to obtain my Bachelor’s Degree in Herbal Science from Bastyr University in 2010. In 2014 graduated with Masters in the Science of Midwifery from Bastyr University. I’ve practicing as a Licensed Midwife and CPM since 2014. My solo practice is in Ellensburg, a rural part of Central WA. I provide home birth services. It has been such a unique experience establishing validation as a medical professional and working to create respectful collegiate relationships with the other practitioners in the area. This has opened even greater opportunities as teaching is my other passion. I preceptor student midwives from many different schools and in 2017 became a preceptor for the Community Health Family Resident Physician program. It has been such a joy guiding resident physicians through the midwifery model of care; client led, supporting physiologic birth and providing family center care. These doctors are going out from this community to work with CPM’s around the US and will be open to creating and establishing relationships with them. This will only increase sustainability and acknowledgment of CPM’s.

Outside of clinical work, I spend a lot of time volunteering in many other ways. I was recently nominated for the Midwifery Advisory Committee in WA State starting in 2019, spend time on the DOH-Maternal Mortality Panel, volunteer on the breastfeeding coalition in Ellensburg and volunteer in Search and Rescue of Kittitas County. I am an avid hiker and keep busy raising my two teenagers as a single parent. I am passionate about birth and finding a way to provide the best care possible with sustainability.”

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Laura Perez, LM, CPM from California writes: “When I learned that I had a womb, I became a feminist. When I learned that there were people actively trying to control and colonize my womb, I became a reproductive freedom and rights activist. And when I learned what a midwife was, I decided to become one. I suppose I need to be mindful about what I learn about since these things tend to shape my life.

Some of the things I’ve done include being a member of the Women of Color Organizing Project with CARAL, being a co-founder of Exhale, a national multilingual after abortion counseling talk line, and being a regional rep for CAM, the California Association of Midwives.

I’ve taught well over a hundred medical students how to do women-centered and comprehensive breast and pelvic exams as a Gynecological Teaching Associate, using my own aforementioned womb and breasts as teaching tools. I’ve done volunteer and paid doula work on and off for the past 13 years. And I’m an apprentice trained Certified Professional Midwife, a Licensed Midwife, with my own practice, and one of only two midwives of color based in San Francisco.

I’m proud to identify as a working class immigrant of Native and Latin American heritage. My partner and I are also parents to a seventh grader who owns our hearts.

Why I want to run for the NACPM board:

Midwives have the ability to affect significant change in maternity care nationally. I think that NACPM may be a resource for midwives who would like to be a part of that significant change. While I believe these are dire times in the U.S., I also believe that mothers and midwives offer much needed hope for families searching for workable solutions, not just to the maternity health crisis, but also larger community health issues. I would like to offer my perspective to the conversations that NACPM is having regarding the current and future role and goals of midwifery.”

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Megan Koontz, MSM, LM, CPM is a midwife, a midwifery educator and is passionate regarding midwifery issues. She currently lives in Anchorage, Alaska having moved in 2016 from Ridgecrest, California, but she is originally from New Zealand.

Megan has worked midwife across a variety of setting including as a home birth, birthing center and hospital midwife. She has attended births in New Zealand, England, Alaska, Utah, and California. The variety of birth place has means that Megan has supported people through a wide range of birthing experiences, from natural home births to hospital births that included epidurals and cesarean sections.

Megan obtained her Bachelor of Midwifery in New Zealand in 2001, and Masters in Midwifery in 2015. She started as faculty with the Midwives College of Utah and currently holds the position of Core Academic Faculty and Academic Dean. Megan is currently completing the Postgraduate certificate in Educational Design and Technology through the University of Memphis.

Megan loves the outdoors including skiing, skating, hiking and biking and is surprising herself by enjoying winter in Alaska almost more than she enjoys summer.

Megan writes: “I am interested in running for the board to support the growth of midwifery in the USA. My midwifery career began in New Zealand where I first trained and spent my early years as a midwife. The experience of working within system where midwifery is fully integrated at a national level is one reason for my enthusiasm for working to advance midwifery. I believe that midwives can be their most effective when they are a respected member of a team the comes together to support birthing people.

I have the daily privilege of working with our upcoming midwives. They constantly challenge me to become the midwife I know I should be. This means working towards a stronger, more equitable system that recognizes midwives for our knowledge, our education and our experience and demands that we examine our role in ensuring quality, appropriate and respectful care for all birthing people. For this to happen we need to eliminate the current systemic racism and remove the existing differences in birth outcomes. If selected I would expect to support the work of NACPM as well as continuing my own personal work in these areas.

My daily work with a school that exists in a web-based environment, as well as my current studies in Educational Technology, ensure that I am fluent in navigating online spaces and communication. As NACPM is a national body, much of the work involved in being part of the board revolves around creating and distributing online content and my work in this area would complement the work the board is already doing.”

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Kate Hartwell, CM, CPM is a New Hampshire Certified Midwife, a Certified Professional Midwife, and the owner and operator of Concord Birth Center in Concord, NH. She is also the owner of The River Guild, a holistic health center. Her career in birth work has spanned 11 years and she has attended over 600 births. Kate is a member of the New Hampshire Midwifery Council, where she serves as Secretary. She is also a member of the NH Newborn Screening Advisory Committee. Kate and her colleagues at the Concord Birth Center value informed birth experiences and equal access to midwifery care. She is a mother of two daughters, and in her free time enjoys spending time with them in the beautiful Granite State.

Kate writes “I am running for this board position at NACPM because I feel strongly that this organization is capable of securing accessibility to midwives for the majority of birthing people. I am also impressed by NACPM’s commitment to ending the enormous racial disparities that exist in maternity care in this country.”

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Elizabeth Baer, CPM, LDM, from Oregon writes: “Shortly after birthing my first baby in October 2000, I found Ina May’s Spiritual Midwifery at a Barnes & Noble. I’d remembered hearing about midwives in high school history class and was pleased to learn that out of hospital midwives were still a thing. I had always been interested in public health and thought that becoming a midwife would suit my personality and career goals.

At that point, we knew we wanted more children, and I kept putting off midwifery school. I worked for the Baltimore County WIC Program as a Breastfeeding Peer Counselor from 2001-2005. In 2010, I trained as a doula and helped found the Central New York Doula Connection. After attending my first Midwifery Today conference in the spring of 2011, I began midwifery school that summer, through the National Midwifery Institute (a MEAC accredited program), and graduated in 2014.

I live and work in Oregon’s rural Mid-Valley region with my husband and five biological children. I am lucky to work in partnership with another midwife, at Midvalley Birthing Services, a home birth practice. I have been a licensed midwife here in Oregon since 2014.

I first heard about NACPM and its work at the 2013 MANA conference in Portland, Oregon, for which I served on the planning committee. I am a member of NACPM and enjoy what they have to offer their members and midwives as a whole. Like NACPM, since before beginning my midwifery practice, I have envisioned a healthcare system where all mothers have access to midwifery care, are able to birth with a midwife in the location that best suits their family, and have an equal chance to being healthy.

From 2014-16, I served on the Linn Local Advisory Committee, a group that advised our local Medicaid management company on delivering services to members and improving health outcomes in our region.

My goals for my own midwifery practice, and for my time of service on the board, are to improve health outcomes for mothers and babies, encourage safe midwifery practice with good screening and referral guidelines for midwives, and to improve access to midwifery care.

Thank you for your consideration.”

NACPM State Chapter Day May 20, 2018

On May 10th before the start of the CPM Symposium, NACPM hosted the first-ever in-person gathering of NACPM chapter members. We were thrilled to have had representation from 13 of our 18 currently formed state chapters at this seminal event plus guests from 4 additional states. This day was designed specifically for chapter leaders and members with the hope of sending them back to their states with information, skills, tools and connections to put to work for their unique state priorities.

NACPM hopes to build on the conversations and connections that began during the Chapter Day through our quarterly chapter collaboration calls, one of which was earlier this week. We had a total of 30 participants over the course of the call and heard from everyone who wished to share about what’s going on in their state and what they are bringing back to their state and local work from our time together at the Chapter Day.

Overview of the Chapter Day

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We opened our day together in a circle sharing what question we were bringing. The questions centered around the themes of access and equity, inclusion, unity, and accountability, relationships between NACPM national and Chapters and between Chapters and state associations, and how to bring about broader systemic change:

Access and equity: How do we strategically plan to help POC access midwives? Are we working at our own bigotry and racism?

Inclusion, unity, and accountability: How can we overcome divisions in our midwifery profession? How are we going to ensure communications are in place to learn from our mistakes?

Relationships between NACPM national and Chapters, Chapters and state associations: How can Chapters and state associations work together? How can NACPM support licensed states? Unlicensed states?

Bringing broader systemic change: How does this fit with transformation of our maternity care system overall? How can we support what is coming up?

Chapter Day Presentations

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Facilitator Cari Caldwell presented on “Building effective state teams.” Cari shared with us about how to create high performing teams, including asking important questions like why does the team exist? Is there trust within our team? What are our goals? What is our level of commitment? She encouraged us to focus not just on the work we’re doing, but also on how we are building what we’re building. She taught us that it is crucial to get really explicit about the kind of culture we’re creating together and to construct mechanisms for accountability within our organizations.

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Saraswathi Vedam from the Birth Place Lab gave a presentation called “Mapping Integration of Midwives Across the United States: Impact on Access, Equity, and Outcomes” in which she described the background and approach of the research behind the work being done at the Birth Place Lab around the importance of integrating midwives into the maternity care system in order to improve perinatal outcomes. She emphasized that understanding the credibility of this research is the basis from which we can bring this information back to our local communities and that the lens for all of their research is ACCESS for families to care, not convenience for midwives.

She reported on the clear correlation between increasing integration of midwives, density of midwives, and access to midwifery care and a decrease in preterm birth and neonatal death. States with a higher population of black babies have poor integration, low density of midwives, and lack of access to care, compounding the unconscionable disparities in outcomes across racial lines with an added layer of risk due to lack of access to the Midwifery Model of Care which we know improves these outcomes. Saras and her team’s research shows how dire the need is to scale up midwifery in the US, where access to midwifery care is significantly lower at around 10% than in other high-resource countries, which typically have 50-75% of births attended by midwives.

This session was packed full of high value, evidence based research and was designed as preparation for the last session of the day in which we applied the State Mapping Tool to our individual state contexts through review of our state report cards, which can be found on the Birth Place Lab website.

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Silke Akerson from the Oregon Midwifery Council presented on “Tackling Quality of Care Issues at the State Level / The Oregon Experience” in which she described quality improvement measures taken in Oregon and how these improvements might be applied in other states. Silke defined quality improvement as the “combined and ongoing efforts of a group of people to understand problems and make changes that will lead to better outcomes in a particular system.” She noted that with quality improvement there is a focus on looking at problems and solutions within the system rather than placing specific blame. She taught us about how quality improvement MUST begin with cultural humility and co-creation with the communities they impact.

Some of the specific quality improvement steps that they have taken in Oregon include improving data collection, transport improvement, targeted continuing education, mentorship for new midwives, guidelines for peer review and case review, and midwife participation in public health efforts. Having taken these measures, the perinatal mortality rate of intended community births in Oregon was reduced from 3.9/1,000 in 2012-2013 to 1.005/1,000 in 2015-2016.

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Kathryn Moore, Director of State Government Affairs at ACOG shared ACOG’s perspective on CPM State Licensure and Policy and spoke to ACOG’s involvement with the US MERA collaboration.

In addition to reviewing ACOG’s statements and positions on out-of-hospital birth, Kathryn described for us the membership and governing structure of ACOG, how ACOG sets policy nationally, the leeway state ACOG groups have to set their own agenda, priorities and tactics, and the influence state medical societies have on ACOG on the state level.

She pointed to a few examples where ACOG and CPMs collaborated on legislation, including Maine with its year-long professionally facilitated negotiation among stakeholders, Maryland which underwent a collaborative process before the bridge certificate was available, and Florida’s recent legislation on adverse incident reporting.

Chapter Day Evaluation Results:

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We largely received very positive feedback from the Chapter Day evaluation that went out after the event. Participants reported that the content was of high value to them, that they made important connections, and that they would eagerly attend future in-person chapter events. We also received some great suggestions including ideas for affinity groups that could take place before a future Chapter Day, such as an opportunity for people of color or states at similar states/chapters at similar stages of development to meet and strategize.   There were requests for focus on how to get state legislation passed, how to hire a lobbyist, what to do and not do as a grassroots movement, and also ways to collaborate with the NACPM national office for states with existing regulation. Many shared that they would have appreciated more time to network and connect with one another, which is a wonderful testament to the richness of our growing community and the need for more of these gatherings.

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