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President Marinah Farrell Reports From the Midwives Alliance Spring Board Meeting

Posted by Midwives Alliance on May 19th, 2015

MANA Board Spring 2015

Spring is the perfect time for renewal and budding ideas. The Midwives Alliance Board of Directors took advantage of this fertile time to hold our annual spring board meeting. Together, we narrowed down our 2015-16 initiatives, including:

  • US MERA. The United States Midwifery Education, Regulation and Association meeting was held the weekend before our Spring board meeting. Our delegates who attended came back optimistic and full of good news for the future of US MERA and collaboration between the 7 organizations. The work of coming together and finding common ground is always challenging and rewarding in equal measure, and there is still much work to be done. MANA will continue to communicate with members about our work with US MERA as we move forward.
  • Our recent decision to make the official policy of MANA to require voting members to be credentialed midwives. MANA has received a warm response to this change and a recognition that this is a celebration of the CPM, honoring the many founders of MANA and the midwives who envisioned and created a credential that would validate the apprenticeship model. MANA is deeply committed to advancing midwifery and moving the CPM forward.
  • The challenges of being a board of working midwives who volunteer by putting many unpaid hours into MANA. The joy of the Midwives Alliance is that it is based on community and grassroots work. Our founders did (and still do, many of them!) so many hours of work that we have found ourselves to be quite a force - many good things have come from MANA since we were born in 1982. We work on behalf of midwives who are an invaluable resource for our society and for change in maternity care, and we take great pride in giving of ourselves to the community. We also recognize, unfortunately, the risk of burn out. While we also recognize the privilege involved with being able to give many volunteer hours, the majority of us actually are NOT privileged enough to stop working to do full time volunteer work. And yet we truly want the voice of ALL midwives to be at the MANA table. As the Midwives Alliance faces the competition of corporate interests that may be better funded, we want to continue our work in advocating for quality research and recognition of ALL midwives. In order to do this, we truly need YOUR help.

There is an opening right now on the MANA Board of Directors! The position of Secretary will be filled by appointment as we accept letters of interest, conduct interviews and strive to find a member midwife with appropriate skills and enthusiasm for the future of the Midwives Alliance. Download the MANA Board Job Descriptions here, and contact Sarita if you are interested. 

MANA strategic directions for 2015-2017

We identified the following areas as key initiatives for the Midwives Alliance, and are working to plan the actions needed for implementation, to be initiated at our Fall 2015 board meeting in October.This is exciting work! Among the directions are:

  • The Division of Research. Funding and furthering the ability of the Research committee members in their organizational capacity. 
  • Organizational development for MANA. Reaching out to membership and working on skill-based board positions as the new board structure of MANA.
  • Professional development for our students and midwives. More webinars and conference/networking opportunities. 
  • Policy. MANA continues planning for training and outreach in the arenas of policy, advocacy, and legislation. By partnering with Elephant Circle for training in legislation and equity work and the creation of a specific board position for policy and advocacy, MANA is working on a vision for how we can better represent midwives at state and national levels and in collaborative endeavors with other organizations. 
  • Conference. MANA conferences are a touchstone for midwives. We are growing into the new age of technology and will be implementing better registration, a new director position that uniquely focuses on conference and events, and coordinated effort between all the MANA Board of Directors to make the annual MANA conferences accessible and full of opportunity (we can't wait to see you in Albuquerque in October!). 
  • Communications. MANA has a stellar communications team that wants to reach out to YOU, our members and friends, to ensure that you are always involved in our work, aware of new research or midwives in the news, and to disseminate the information of policy work or other MANA initiatives. The communications team also ensures that our Division of Research has a voice of advocacy in the face of enormous public pressure. MANA communications is doing great work.

Access and Equity - the overarching umbrella

Finally, and as we have done since MANA was envisioned in 1982, we continue discussion around the necessity of working for inclusion and equity for all midwives to feel at home as members of MANA. The MANA board has come to realize that we are finally at a place where our framework has shifted, and an understanding that social justice is not one unique place in the organization, but is the lens through which we do all of our work. It includes thoughtful consideration of how better to help midwives in states that are not legal, students who don't have access to education, midwives who are in the margins or from vulnerable populations who desire more equity in the profession of midwifery, and midwives who aren't able to make fair wages. MANA has worked hard and shifted more than we ever thought we could to make this happen. 

We are justly proud of more than 30 years of work on recognition for all midwives, with inspired midwives who grew the Midwives Alliance to this place where we can say that midwives have created innovative education and associations while protecting and promoting Normal Physiologic Birth and Breastfeeding. We continue to be innovative and progressive and stay attuned to the times. MANA has been diligently rebuilding our structure to be more efficient with our resources, to meet the needs of a younger generation that is wanting more technological access to information, to continue the data collection that is used DAILY by midwives working on legislation, to recognize that the issues of inequities in midwifery (both in access to the profession as well as the families we serve) must be addressed NOW, and also to continue to be the voice at national tables that is thoughtful to the needs of all midwives.

MANA is here to serve you, and we are tenderly reaching out in the spirit of unity and friendship. As the current President of the Midwives Alliance I reaffirm our commitment to you, and ask that you consider joining MANA in our efforts – join as a member, join the board, our committees, volunteer or intern with us. I hope that you will support the initiatives you care about the most in whatever way you can, and in particular recognize that our Division of Research needs your support to continue their dedicated work in data collection and compelling research. As more and more midwives participate in MANA Stats and other organizations wish to collaborate on larger data collectives, I must appeal for your generosity on behalf of MANA's Division of Research to meet the goal of expanding their capacity so that midwives can continue to prove their competence and expertise in natural birth. Please send a donation earmarked for the DOR today.

Thank you for your friendship. With your help we will continue the work of research and advocacy for Every Midwife.

The Midwives Alliance: Unifying Midwives since 1982.

Thank you,

Marinah Farrell

Marinah FarrellAbout the author

Marinah Farrell is a CPM in Phoenix Arizona working in homebirth and birth center practices. She is recognized for her work in public health issues, is a founding member of Phoenix Allies for Community Health, a free clinic in downtown Phoenix, and participates as a human rights activist both in the US and internationally. Marinah is in her first term as MANA President.

Maryland Passes Bill to Increase Access to Home Birth Midwives

Posted by Midwives Alliance on May 18th, 2015

Maryland Midwifery Supporters

(Photo Credit: AIMM)

Becomes 29th state to license and legalize Certified Professional Midwives

Baltimore, MD: On May 12th Maryland's Governor Hogan signed a bill that will license and legalize Certified Professional Midwives, specialists in out-of-hospital birth. The bill is the result of a growing movement of women and families that are calling for greater access to midwifery care at home and in birth centers. Maryland is now the 29th state to license Certified Professional Midwives (CPMs), recognizing the increased need for out-of-hospital care providers in the U.S.

The rate of out-of-hospital birth increased nationwide by almost 60% between 2004 and 2012, according to CDC data. Despite the growing demand, ongoing restrictions on midwifery care options limit the ability of families to decide where, how and with whom to give birth. With the passage of this bill, Maryland joins other states in beginning to open up greater reproductive choice during pregnancy and birth.

Alexa Richardson, President of the Association of Independent Midwives of Maryland (AIMM) which has been working to pass Maryland's bill, says that "Midwifery care at home marks a dramatic departure from the hospital birth experience. In spite of the barriers, more and more women are choosing to birth in settings that offer low rates of intervention and greater autonomy during birth."

The bill, sponsored by Delegate Ariana Kelly and State Senator Mac Middleton, set specific standards for professional education, scope and transfer, and allows for increased collaboration by midwives with physicians, hospitals, and other healthcare providers. Advocates say the new law will now facilitate safer and more transparent care for women and families who choose home birth.

However, Maryland still has work to do to ensure safety and access for all women and families during the birthing process. Out-of-hospital birth is still not covered by most medical insurance plans and remains too costly for many who desire this kind of care. Additionally, women desiring home births who have had previous cesareans are barred from Certified Professional Midwife care under the new law.

The advocacy groups in Maryland will pursue further legislation to ensure access to out-of-hospital birthing care to those with previous cesareans and for families who cannot pay out of pocket for health care.

What Is a Poster Presentation?

Posted by Midwives Alliance on May 18th, 2015

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Please consider sharing your area of expertise or a research project that would be of interest to midwives and others involved in birth with MANA conference attendees by submitting a poster!

The Midwives Alliance welcomes submissions of research posters from students and professional researchers. Here's what we mean when we talk about "poster presentations." A poster is created by someone with information to share—for example, preliminary or final results from a research project, a review of best practices for a maternal-child health issue, a history of an outreach project or initiative, or a summary of the evidence on a particular clinical intervention. Posters are usually big! Standard size is 4 feet wide by 3 feet tall. We provide tips and guidelines for making your poster. Posters often look like this:

From the University of Wisconsin-Madison’s Department of Kinesiology; poster by Sarah Delany

Posters are displayed at the conference for attendees to peruse at their leisure, but the conference schedule will also include a time when poster authors are asked to be by their posters to answer questions and interact with readers. That's the "presentation" part of the conference's poster track, and can be a great time to share your enthusiasm and expertise, gain support for an initiative, or get feedback on your project.

Here's a picture of what a poster-presentation session can look like (at a chemistry conference):

From the University of Virginia's Department of Chemistry

If you have a project or information you would like to share, consider submitting a poster to this year's conference. And as of 2014, the Midwives Alliance gives awards for the best poster presentation in each of two categories: student/apprentice poster and graduate/professional researcher poster. Having a poster accepted for presentation is a form of publication. The presenter can add this honor to their CV. See below for details of how to submit.

In the student/apprentice category, the winner will receive a free year of membership to MANA, and the student's advisor and school or preceptor and program will also be recognized.

In the graduate/professional research category, the winner will receive a 30-minute phone consultation on the winning research project with experienced researcher Melissa Cheyney, PhD, CPM, Chair of the MANA Division of Research Coordinating Council and Assistant Professor, Oregon State University Department of Anthropology.

Many people provide guidance on how to create an effective poster. Here are a few resources besides our tips document:

Designing Conference Posters by Colin Purrington

How to Create a Research Poster by the NYU Libraries

Your poster can be created specifically for the conference or a be poster you have already presented for a different purpose. If you are attending the conference this fall, make sure to check out the posters and see what you can learn. Perhaps you will be inspired to create one of your own to submit next year!

Download the MANA 2015 Poster Application.pdf (PDF)
Download the MANA 2015 Poster Tips & Guidelines.pdf (PDF)
About the author

Ellen Harris-Braun, CPM, is the Director of Database Development for the Midwives Alliance Division of Research, and is half of Harris-Braun Enterprises, an experienced Web-development team that wrote the software for the MANA Statistics web site. Ellen is also a midwife, certified doula, and childbirth teacher involved with birth since 1999 and with MANA since 2002.

What Defines a Midwife: The MANA Perspective

Posted by Midwives Alliance on May 7th, 2015

Together with the world, Midwives Alliance of North America (MANA) celebrates the arrival of a new royal baby girl for the Duke and Duchess of Cambridge. While most news reports shared the names of the medical team, the reality is the baby was born into the hands of a midwife. In fact, Kate, The Duchess of Cambridge, was cared for by a pair of midwives, in a health system where midwifery led practice is the standard of care.

Last week, here in the United States, Midwives Alliance was encouraged by the new policy statement issued by American College of Obstetricians and Gynecologists (ACOG) entitled: ACOG Endorses the International Confederation of Midwives Standards for Midwifery Education, Training, Licensure And Regulation. This document, a companion piece to another 2015 consensus document, entitled Levels of Maternal Care, was prepared by ACOG and the Society for Maternal and Fetal Medicine. With this endorsement, ACOG endorses the ICM education and training standards and strongly advocates the ICM criteria as a baseline for midwife licensure in the United States, through legislation and regulation.

As an International Confederation of Midwives (ICM) membership association since 1984, MANA has been an active participant in the development of all the ICM Global Standards, including the three pillars of Education, Regulation and Member Association, with the intention to "strengthen midwifery worldwide in order to provide high quality, evidence-based health services for women, newborns, and childbearing families." MANA also helped to develop and officially recognizes the ICM International Definition of the Midwife.

Midwives Alliance acknowledges multiple learning styles, and values numerous training pathways, including the experiential education model recognized by the ICM emphasis on competency based education. We are proud to be working in collaboration with other national organizations to develop methods of accrediting direct assessment of student knowledge and learning. We support CPM licensure in all 50 states.

As the US struggles with a rising maternal mortality rate, the highest in the developed world and nearly three times that of the United Kingdom, we might consider that midwives attend 80% of births there, with obstetric care reserved for high-risk specialty cases. Midwife led care is the standard in Britain for all, including members of the royal family. When Prince William presented Royal College of Midwives President Lesley Page with the Commander of the British Empire (CBE) award in 2014, he made it clear to her that he knew about the role and the value of the midwife. Those values were put into practice when his wife Kate, the Duchess of Cambridge, gave birth to both of their children with the care of midwives.

 

About the author

Colleen Donovan-Batson, MS, CNM is the MANA Director of Health Policy & Advocacy.

 

Meet Treesa McLean, Director of Public Affairs

Posted by Midwives Alliance on May 5th, 2015

As a part of our Meet the MANA Board series, we've asked Treesa McLean, Director of Public Affairs, to tell us a bit about how she became a midwife and her goals and vision for MANA.

I am a Licensed Midwife in the San Francisco Bay area, with a homebirth practice, Birth With Treesa and I am co-owner of Bay Area Midwifery, A Community Wellness and Birth Center. I live with my husband Charlie, a game publisher; three dogs; and two cats in the town of Hayward. My son Brian, his wife Justine, my daughter Meghan, and her partner Cam all live nearby in Oakland. I am a California native, as are my mom and grandma.

My first job out of high school was working at a women's health clinic, where I learned about advocacy and autonomy. Not long after, I read the book Choices in Childbirth and learned about midwives. What I learned in that book became the foundation of many choices I made in my life. When I became pregnant at 19 my husband and I decided to have a homebirth with midwives. After my son was born, I trained as a "labor coach" (what doulas were called in 1983!) The long journey to midwifery practice included becoming a doula, having another baby, becoming certified as a childbirth educator and a postpartum doula, training as a breastfeeding peer counselor, and working as a representative for California Association of Midwives. I trained locally with a midwife for over 3 years, and completed a clinical internship in Bali. In 2010 I was licensed as a midwife in California. I have had both a homebirth and birth center practice since becoming licensed. I am also the VP of California Families for Access to Midwives, an active and effective consumer organization.

I am the Director of Public Affairs (DPA) for Midwives Alliance of North America. I am working with Midwives Alliance of North America because I believe it holds a unique place in our country - a bridge to all types of midwives; a volunteer-run organization; and now transforming itself to even better reflect the ideals and values of its members. I personally believe the future of MANA is in the student midwives of today. I think that we need to reach out to a young, diverse, creative body of student midwives and invite them to participate, to invigorate a vibrant Midwives Alliance that will continue to support midwives and midwifery research long into the future.

Public Affairs has its hand in nearly all the communication that the Midwives Alliance has with the public, other organizations and the press. Public Affairs creates and distributes our new twice monthly "MANA News" email newsletter and maintains online communities on Facebook, Twitter and Pinterest. As the DPA it is my goal to establish and maintain transparent communication and create avenues for communication to and FROM the membership. I work alongside Jill Breen, CPM, CLC and Jeanette McCulloch, IBCLC, on the communications team. We have also held online social media workshops and have co-facilitated Town Hall Community Meetings with Amy Smith, LM, CPM, Director of Professional Development.

As with all of MANA the Division of Public Affairs could not function without our volunteers. Our Online Community Managers are the heart of our social media presence and directly interact with Facebook, Twitter and Pinterest.They are the nuts and bolts of these communities, monitoring conversations, adding in new content and facilitating the sharing of information to other groups and organizations. They are amazing volunteers and yet are also almost invisible! We want to thank them so much for their time, energy and support of MANA. Each year we look for new volunteers to train for this work and this is a perfect way to support MANA and learn great skills at the same time.

Also working with the DPA is Marie White, who provides administrative support, actually creating the beautiful MANA News emails you receive. Marie is the person we call and say, "Can you make it happen?!?"

As we move forward, I hope to add student midwife interns to our volunteer team, to work on creating a historical timeline of MANA for our website, to continue to update our Midwifery Law State by State with the Director of Health Policy Colleen Donovan-Batson, and also to archive midwifery and homebirth resources across America. If you are interested in volunteering with MANA in Public Affairs, or in another area please email me - I would love to discuss the opportunities with you! 

About the author

Treesa McLean, LM, is a midwife serving families in the San Francisco Bay area.

 

 

Director of Organizational Development

Posted by Midwives Alliance on April 21st, 2015

I live in southern New Hampshire with my husband of 24 years and my three children, ages 23, 21, and 14. I also have an adopted 23 year old son and daughter-in-law, who currently serve in the Army and live in California. I have developed two free standing birth centers with integrated home birth practices here, the second of which currently serves well over 100 families each year and is growing at an unprecedented rate. The Birth Cottage is also an active teaching facility, which helps graduate two or more midwifery students each year in conjunction with a MEAC program or the NARM PEP process. Currently, I am serving my last year as the Chairperson of the State of NH's Midwifery Council, our licensing and regulatory board. In my spare time, I am a firefighter and AEMT, National Ski Patrol, and board member of Guardians of the Ribbon, Southern NH, a group dedicated to raising money and awareness around women's cancers. In other words, I drive a pink fire truck all summer.

My initial plan for life was entirely different. I have a degree in architecture and interior design, and a vast background in business management. The birth of my first two babies, one in 1992 in a hospital and one in 1993 at home, changed my life forever. I have been attending births since 1992 as a doula, childbirth educator, and midwife. I returned to college and completed a degree in Community and Human Services with a concentration in Maternal and Perinatal Health through the State University of New York. My introduction to midwifery political work began with the prosecution of my own midwife just after my daughter was born at home. Being involved in legislative work became a part of my heart and soul early into my career; it certainly wasn't something I sought out. In fact, the first nine years of my midwifery practice I spent looking over my shoulder while living in a state where licensure was unavailable but I was certainly vulnerable, and often crossed into a state where midwifery was completely illegal. Moving to New Hampshire and becoming a part of an amazing group of midwives, who had developed a self-governing and independent board, was an incredible and life changing experience that has fueled my desire to see it replicated for all midwives in all states.

As the Director of Organizational Development, I am tasked with creating a robust business framework to support the operations of the Midwives Alliance. This framework includes financial resources and income, business practice development, marketing strategies, and most importantly, a strong and growing membership. These things are the foundation of a good business model which will sustain itself for the future. My goals include seeing midwifery become a sustainable profession with outstanding revenue sources for midwifery providers, integrated systems in place for both midwives and consumers within a larger healthcare model, and independent practice free from prosecution and restrictive oversight. Supporting the development of our professional organization is vital in obtaining these.

Membership has been my focus for the last several months. Membership and student membership drives have shown wonderful potential for growth this year, and we are now focusing on member retention.

We are planning many new ways for members to stay connected to MANA's work in 2015!

  • Online workshops and webinars with CEUs;
  • More Virtual Town Hall meetings to talk about issues of concern to midwives and to hear the voices of our members;
  • Division of Research updates to share the exciting work of the DOR and to encourage everyone to learn about and contribute to data collection;
  • Ongoing improvements in our website to better reflect your interest in technology and social media as a tool for sharing information;
  • Updating our essential documents and preparing more position papers on topics and issues of interest to midwives and clients;
  • Participation in the global dialogue on midwifery and maternal child health issues, representing YOUR voice at the national and international level.

Is there anything that I can do for you? Would you like to see a membership benefit developed, or a special promotion launched? Please contact me, as I'll happily welcome your suggestions and input. Without you, the members, the Midwives Alliance could not thrive.

 

About the author

Adrian Feldhusen, NHCM, CPM, is the founder and owner of The Birth Cottage in Milford, NH, a free standing birth center offering woman centered care throughout the lifespan. She currently serves as the Chairperson for the state's licensing and regulatory board in New Hampshire, and is a firefighter and AEMT in her community.

Meet Amy Smith, Director of Professional Development

Posted by Midwives Alliance on April 9th, 2015

I live in Phoenix Arizona where I currently attend homebirths. I have three beautiful boys, one courageous husband, amazing parents and wonderful there "in a pinch" friends that make my work and service as a midwife possible. It is my great honor and privilege to serve families during pregnancy, labor, birth and postpartum and like many midwives the calling to serve families has been both joyous and challenging. 

I come from a science background. I have an undergraduate degree in Biochemistry and a work history in research, clinical diagnostics, biochemical genetics, and analytical biochemistry. I found my way to midwifery through a love of people, children, bonding, breastfeeding, and the wonder of the natural processes of birth and of life. I studied and learned midwifery through a MEAC-accredited school, Midwives College of Utah, and the apprenticeship model. I have learned much from many midwives. But I am most grateful for my primary preceptor Mary Henderson. She is a very experienced midwife who has served Arizona for over 30 years and is known for her compassion and acute attention to detail. The need for willing midwifery teachers and clinical preceptors is greater now than it ever has been. The sense of appreciation I have for those willing to guide, teach, observe, listen, and inspire is immense and in many ways directs my work here at MANA. As your Director of Professional Development I am seeking to support you and the profession of midwifery in functional and dynamic ways.

As Director of Professional Development I work closely with other Board Directors and MANA committees to keep important documents, like the MANA Core Competencies, revised, relevant and up-to-date. We are also working on position statements, practice guidelines, consumer hand-outs, student services, continuing education opportunities and town-hall informational and interactive webinars. An essential role of mine here at MANA is to serve YOU the midwife in the field by providing you with tangible tools for your practice and in ways that advance midwifery both regionally and nationally.

I am excited and honored to serve you as a member of MANA's Board of Directors. I need your help to realize the full potential of the Midwives Alliance. If you have ideas or a desire to serve or contribute in any way please reach out to me at profdevelopment@mana.org! I look forward to hearing from you and I do hope our paths will cross soon.

About the author

Amy Smith, LM, CPM, is a mother, midwife, advocate and activist. Amy is originally from Maine but has spent the last 13 years soaking up the great Arizona sun.

Update from the States: Massachusetts

Posted by Midwives Alliance on April 9th, 2015

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Guest Author: Sarah Whedon, Ph.D

Here in Massachusetts, midwifery supporters have been working for many years to pass a bill that would license Certified Professional Midwives (CPMs). We believe we now have a real shot at passing the bill into law in the current legislative session.

This January we re-filed the bill, An Act Relative To Certified Professional Midwives (SB 1825/HB 2941), sponsored by Representative Kay Khan and Senator Anne Gobi. If passed into law, the legislation would:

  • require all midwives practicing out-of-hospital to be CPMs;
  • create state licensing requirements for CPMs;
  • establish a Committee on Midwifery to issue CPM licenses and regulate CPM practice.

Currently, Massachusetts regulates only Certified Nurse Midwives (CNMs), who do not attend homebirths here. There is no state oversight of CPMs, who provide out-of-hospital care to approximately 500 women and their families across the state each year, a number that is growing annually.

Representative Khan, the House sponsor of the bill has said, "It is critical for the future of maternal health care that we establish oversight for the homebirth midwives practicing in the Commonwealth. Not only will it ensure accountability and offer families secure options for choosing to deliver their child at home, but it will reduce medical costs, promote collaboration among healthcare professionals, and improve public safety for consumers."

Although the bill was originally drafted in 1998 by supporters of Massachusetts CPMs, they quickly formed a coalition with CNMs to advocate for the midwifery legislation. That coalition operated for more than a decade until, for both administrative and policy reasons, the formal coalition was dissolved in 2010 and the bill was cleaved into two, one that would regulate the practice of CPMs and the other which expanded the scope of practice for CNMs. The CNM bill passed in 2012, freeing CNMs from a requirement to work under a supervising physician and allowing them to both write prescriptions and order tests.

The CPM bill has been reintroduced into the Massachusetts legislature multiple times, working its way through various committees. During this time, it has the gained the support of powerful consumer organizations like the Massachusetts ACLU, Amnesty International, Massachusetts NOW, Mass Friends of Midwives, Massachusetts League of Women Voters, Our Bodies Ourselves, and the Massachusetts' Women's Bar Association. However, due to pressure from powerful medical organizations, the bill has been stalled each time.

Judy Norsigian, who for many years was executive director of Our Bodies, Ourselves, wrote to debunk myths about the midwifery bill perpetrated by medical dissenters. She asserted that, "failure to license CPMs will make the several hundred home births that occur in Massachusetts every year less safe by failing to create an integrated maternal health care system with enhanced collaboration among all care providers. This bill would affirm that all Massachusetts maternal health care providers are committed to practicing with state oversight and public accountability."

Massachusetts Midwives Alliance and Massachusetts Friends of Midwives continue to collaborate on advocating for the bill. We recently received the good news that Rep. Jeffrey Sanchez will now be the House Chair of the Health Care Financing Committee and Rep. Kate Hogan will be the new House Chair of the Public Health Committee. Both have been supporters of the midwifery bill during prior sessions and have indicated an ongoing commitment to advance this legislation. We congratulate Reps. Sanchez and Hogan in their new leadership roles and look forward to working with them on An Act Relative To Certified Professional Midwifery.

We are hopeful that this session will be the one in which Massachusetts formally recognizes the vital role of Certified Professional Midwives in providing broader birth options for low-risk birthing families.

For more information and to get involved please contact:

Audra Karp, Mass. Midwives Alliance, 617-522-8383

Ann Sweeney, Mass. Friends of Midwives, 617-254-6175/617-901-2777

Follow along with the bill's progress on Facebook and Twitter.

The history of this bill is drawn from an unpublished paper by Molly J. Lawney, "Massachusetts: 'An Act Relative To Certified Professional Midwives'" March 18, 2013.

 

About the author

Sarah Whedon, Ph.D, is a homebirth mom who serves as co-director of the Boston Doula Project and managing editor of Pagan Families.

Update from the States: California

Posted by Midwives Alliance on March 24th, 2015

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California midwives are going to the legislature with three midwifery bills this session. California Association of Midwives (CAM) and California Nurse Midwives Association (CNMA) have each sponsored legislation that will increase access to midwifery care for the families of California.

New California Legislation: Expanding Access To Midwifery Care Through Medi-Cal

California Senate Bill 407 will, if passed, authorize California Department of Health Care Services to recognize licensed midwives as providers in the Comprehensive Perinatal Services Program (CPSP). This is a critical step towards Medi-Cal coverage for licensed midwives in California. SB 407, sponsored by CAM, will add licensed midwives to the list of qualified Comprehensive Perinatal Service Program providers under Medi-Cal, further expanding access to community-based midwifery care in all settings for all women and families in California. The Comprehensive Perinatal Services Program (CPSP) provides educational, nutritional, and psychosocial support to pregnant women, as well as childbirth and breastfeeding education, services already provided within the scope of LM practice and fully in line with the midwifery model of care.

The Comprehensive Perinatal Services Program became a Medi-Cal benefit in 1987. Licensed midwives are not currently, but should be, recognized as eligible providers of these benefits, which fall squarely within their scope of practice. The passage of this bill would allow licensed midwives who work in clinics providing CPSP services to bill Medi- Cal.

This bill is a part of a larger legislative strategy spearheaded by the California Association of Midwives (CAM). "All women in California deserve to be able to choose midwifery care," said Sarah Davis, LM "Our goal is to expand the option of midwifery care to all women in California by making care with licensed midwives Medi-Cal eligible."

If passed SB 408 will expand midwifery care – particularly in rural and other underserved areas – by allowing 'midwife assistants' to legally assist licensed midwives at out-of-hospital births. Typically, two providers attend each birth, but licensed midwives are scarce in some areas of the state. This bill would allow a specially trained 'midwife assistant' to legally assist a licensed midwife, expanding the reach of existing providers.

California Assembly Bill 1306 removes physician supervision from the law governing CNM practice. It also authorizes a certified nurse-midwife to manage a full range of primary health care services for women from adolescence beyond menopause in all settings, including, but not limited to, a home, without direct supervision of a physician. The bill, sponsored by CNMA, would provide for consultation, collaboration, or referral as indicated by the health status of the client and the resources of the medical personnel available in the setting of care, and would provide that the practice of nurse-midwifery emphasizes informed consent, preventive care and early detection and referral of complications to a physician and surgeon. This bill would authorize a certified nurse-midwife to provide peripartum care in an out-of-hospital setting to low-risk women with uncomplicated singleton-term pregnancies who are expected to have uncomplicated birth. It would also allow nurse- midwives to furnish medications and devices within the scope of her practice, and to make repairs of the perineum for 1st and 2 degree lacerations.

Regulatory Process Still Underway

Physician supervision is no longer required for licensed midwives, thanks to the passage of California bill AB1308 in 2013. That bill also called for a number of changes to be determined through regulation (as opposed to legislation). CAM, alongside the consumer group California Families for Access to Midwifery (CFAM) have been participating in the regulatory process.

The new regulations dictate a physician referral for preexisting maternal diseases or conditions likely to affect a pregnancy and significant diseases arising from pregnancy. At issue is the complete list of those conditions. The regulation has been the source of some confusion (it calls for exams, not a required transfer of care to a physician). It has also sparked concern, particularly from consumers concerned that a physician may be unwilling to address their desire for a home birth with a licensed midwife.

"Consumers of California want the option of using a midwife, either at home for birth or in clinics, birth centers and hospitals. California Families for Access to Midwifery is very excited to support the three midwifery bills introduced to our legislators! We were a part of the process from the passage of AB1308 (the removal of physician supervison for LMs), to the regulatory process, and now we are supporting SB 407 and 408 and again supporting the removal of physician supervision from the nurse midwives of California AB 1306. " -Tanya Smith-Johnson President CFAM

To keep up-to-date with changes in California, visit CAM's website here and CFAM's website here.

About the author

Sarah Davis, LM, IBCLC, is the Policy Chair of California Association of Midwives and a midwifery advocate in San Diego, California. She has practiced in home, birth center, and clinic settings and is the mother of an amazing 2 1/2 year old.

Our Treasurer Midwifes MANA

Posted by Midwives Alliance on March 23rd, 2015

MANA Treasurer Vicki Hedley shares her background and her passion for The Midwives Alliance, our mission, health and growth

I live in Montvale, NJ and have a busy homebirth practice. I have five children ranging in age from 32 down to 13. I also have two grandchildren, whom I had the privilege to receive into my hands in October of 2012 and October of 2014. I have been attending births since 1996, first as a doula, doula trainer, and childbirth educator, and since 2008 as a CPM when I graduated from the National College of Midwifery. In 2010 I also became a CM. My learning occurred through the apprenticeship model in many different settings with beautiful and wise midwives who taught the art of midwifery through their example. I continue the tradition of mentoring others through study groups and apprenticeship. Midwifery is the most difficult and the most rewarding work I have ever done, and I am honored to have the title "midwife".

Before becoming a midwife I had a private accounting practice for sixteen years. I feel as if I midwifed my clients through the stresses of finances and taxes. I have been a member of MANA since 1999, many years before becoming a midwife. MANA has been the home for all midwives for over 30 years, the mother of the CPM and NARM, and an organization with integrity that I have great respect for. I have served on the Board of Directors as treasurer for nearly two years. I have a feeling there aren't too many midwife/accountants out there, so it seems that I am a good fit for the job. It is a challenge working with a small budget, but we spend our money wisely, always thinking of our membership and how you would benefit most from the available dollars.

I see my role as treasurer as more than just a number cruncher. There is certainly importance in the day-to-day bookkeeping that is required to run our operation; but the treasurer is involved in virtually every aspect of the organization. I oversee conference finances, create budgets, work closely with the Division of Research helping them with their finances, assist in writing grants, and work very hard to strategize ways of increasing our income. Our membership is our most valuable asset. It is you, the members of MANA who keep the operation going. Grants are not used for operations, so we count on your membership dollars to pay for all things operations such as upkeep on our websites, our wonderful conference coordinator, our amazing membership support staff, communications, and more. Without you we could not do the important work that we do.

With your help we can achieve our goals:

  • To engage midwives in dialog and to encourage solidarity across North America
  • To recognize the diversity among midwives and to foster inclusive community building
  • To build an identity as a cohesive organization representing the profession as well as the tradition of midwifery at regional, national and international levels
  • To position midwives as acknowledged authorities, working to improve perinatal health in collaboration with other professionals
  • To collect and disseminate high quality research about midwifery care
  • To promote excellence in midwifery practice
  • To sponsor continuing education opportunities for midwives
  • To increase access to midwives in all settings
  • To endorse the Midwives Model of Care™ as the gold standard for childbirth
  • To affirm the rights of pregnant women to give birth where and with whom they choose

The Midwives Alliance promotes professional development and continuing education of midwives so all women and babies will have access to practitioners who can provide excellent prenatal care, safe and empowering births, comprehensive postpartum care, and privacy during the critically important bonding period of mother-infant attachment.

Thank you for the privilege of serving on your Board of Directors. I look forward to seeing you in Albuquerque in October for our annual conference. Contact me at treasurer@mana.org.

About the author

Vicki Hedley, CPM, CM, is a mother, grandmother and midwife in Montvale, NJ.

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