Equity in Birth and Midwifery
NACPM is committed to:
Safeguarding the right to normal physiologic birth for every every childbearing person
Eliminating unconscionable disparities in birth outcomes for people of color, indigenous people, and their infants
Dismantling systemic racism in midwifery and the birth care system
Investing in a strong, racially, ethnically and socially representative CPM workforce to meet the needs of childbearing people
Influencing state and national policy to improve birth outcomes in all settings throughout the United States
Equity in Birth and Midwifery
Since 2012, NACPM has committed to investing in a strong, racially, ethnically and socially representative Certified Professional Midwife (CPM) workforce to meet the urgent needs of childbearing people and to eliminating unconscionable racial disparities in birth outcomes, especially within Black and Indigenous communities. Our 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, all developed with an uncompromising lens on Equity.
Background
As our country has become all too aware, the U.S. ranks 50th in mortality for birthing persons in the world, and 37th in the world in infant mortality. Black childbearing people are up to 4 times more likely to die of pregnancy-related complications than their white counterparts, regardless of level of education and income, and their babies are 2.5 times more likely to die in their first year of life. American Indian and Alaska Natives are 2.3 times more likely to die than white birthing people nationally; in urban settings, they are 4.5 times more likely to die. Perinatal mortality is the tip of the iceberg: approximately 50,000 birthing people annually experience life-threatening complications that too often cause lifetimes of physical and emotional suffering and disability, with Black and Indigenous people affected disproportionally.
Although a key cause of these disparities is unequal access to care, NACPM recognizes that societal and institutional racism, a system of power based on color, is the root cause. NACPM is deeply committed to addressing racial oppression within our organization, the profession of midwifery, and the perinatal care system. A recent report on the demographics of the nurse-midwifery profession showed only 6.85% of CNMs are Black and .58% are Indigenous; although we lack specific data, anecdotal evidence indicates a similar workforce composition of CPMs.
Recognizing the impact of limited access for people of color to CPM care and the acute lack of diversity in the midwifery workforce, NACPM is committed to investing in the systemic changes needed to open pathways for more Black, Indigenous, LGBTQIA2S+, and other midwives of color to enter the profession, and for opportunities for midwives of color to build and sustain their midwifery practices.
Here is some powerful data to help illuminate the history of midwifery in the US:
Georgia
1925: approximately 9000 midwives, the majority Black, Indigenous and immigrant
1944: 2200
Today: approximately 600 midwives, the majority of whom are white
2021: GA ranks 49thin maternal mortality in the U.S. and Black mortality is 6 times the national rate for white people
1917: approximately 9000 midwives, mostly Black
1980: 10 midwives in the state
Today: approximately 350 midwives, the majority of whom are white
2020: NC ranks 30thin the U.S. in maternal mortality
NACPM organization works to:
elevate and center Black and Indigenous midwifery leaders, and leaders from LGBTQIA and people of color communities
effect systemic change through state and federal health policy initiatives
incentivize more midwives of color to reflect the diversity of childbearing families through federal funding and scholarships for midwifery education
provide direct aid through NACPM scholarships and grants to Black and Indigenous student midwives
partner with reproductive justice organizations to grow the Black and Indigenous midwifery workforce to reflect the demographics and most urgent needs of childbearing people in the U.S.
Among NACPM Equity-Focused Initiatives
Bigger Table Fund: Through the end of 2023, this Fund has awarded $60,000 to 75 midwifery students and recent graduates from communities most affected by poor birth outcomes
Federal Recognition of CPMs: Including CPMs in the federal Medicaid program. As of 2018, 43% of all births in the U.S. are paid for by Medicaid. Medicaid coverage of CPM services is critical to access for birthing people to CPM care.
NACPM worked with Congress to include MEAC-accredited midwifery schools for CPMs in the Federal Scholarships for Disadvantaged Students (SDS) Program in 2020 to address the lack of diversity in the midwifery workforce. NACPM hired consultants expert in the SDS program to support MEAC schools in applications for these awards, resulting in an award to Bastyr University’s Department of Midwifery of $3,250,000 for direct student aid over five years.
NACPM consulted with Congress on the development and 2021 introduction of the Midwives for Maximizing Optimal Maternity Services (MOMS) Act, this year in both the House of Representatives and in the Senate and with bi-partisan support both chambers. This legislation will establish significant funding streams for midwifery education, including MEAC-accredited schools training future CPMs. This legislation also has a strong equity focus – priority will be given to schools that train students who plan to work in provider shortage areas, both rural and urban, and that emphasize training a diverse body of students.
NACPM Supports and Centers the work of person of color-led equity initiatives
Center for Indigenous Midwifery:
In 2024 all CPMs who sign up as new NACPM members in November will have 100% of their national dues be donated to CIM!
Black Mamas Matter Alliance (BMMA):
2021, NACPM partnered with BMMA to celebrate Black Maternal Health Week. Donate to BMMA
2024 all CPMs who sign up as new NACPM members in April will have 100% of their national dues be donated to BMMA!
Birth Center Equity (BCE): born in April 2020 during the pandemic to grow BIPOC-led birth centers, BCE has distributed $100,000 direct support through their COVID Rapid Response Fund and $250,000 for capacity and operations support to BIPOC-led community birth centers. Listen to stories of BIPOC-led practices and birth centers. Donate to BCE
National Association to Advance Black Birth (NAABB): read about NAABB’s Black Birthing Bill of Rights and Midwifery Scholarships. Donate to NAABB
National Black Midwives Alliance (NBMA): NBMA’s goal is to have a representative voice at the national level that clearly outlines the various needs of Black Midwives. Donate to NBMA’s funds for student scholarships and support for students with mentees.
In 2024 all CPMs who sign up as new NACPM members in February will have 100% of their national dues be donated to NBMA!
National Perinatal Task Force (NPTF): The NPTF is a grassroots movement to start and grow Perinatal Safe Spots in every Materno-toxic Area in the U.S., to eliminate racial and class disparities in birth outcomes. Read here about how to get involved, and here about Jennie Joseph and Commonsense Childbirth.
Queer and Transgender Midwives Association: QTMA is dedicated to supporting and representing LGBTQIA2S+ midwives and student midwives as they train and grow as providers and people. They provide educational opportunities, advocacy, community and tools, all grounded in an intersectional ideology and framework.
Queer Reproductive Justice: The National LGBTQ Task Force recognizes that everyone has a fundamental right to sexual and bodily autonomy, which includes the right to decide whether or when to become a parent, parent the children we have, and to do so with dignity and free from violence and discrimination.
In 2024 all CPMs who sign up as new NACPM members in June will have 100% of their national dues be donated.