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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


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 2016 Poster Application.pdf (PDF)
Download the MANA 2016 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.