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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.


An Open Letter to ACOG

Posted by MANA Community Manager on April 10th, 2014

The American Congress of Obstetricians and Gynecologists recently released a joint statement with the Society of Maternal-Fetal Medicine on ways to reduce primary cesareans. As a part of our Cesarean Awareness Month efforts, we wanted to share with the MANA community our open letter to ACOG. We welcome your comments.

Dr. Jeanne Conry, President
Dr. Hal Lawrence, Executive Director
American Congress of Obstetricians and Gynecologists

Dear Drs. Conry and Lawrence,

On behalf of the Midwives Alliance, I am writing to congratulate you for the strong commitment to high quality maternity care that ACOG has demonstrated by developing and disseminating the Joint Statement by the American Congress of Obstetricians and Gynecologists and the Society of Maternal-Fetal Medicine, Safe Prevention of the Primary Cesarean Delivery.

In recent studies and commentaries regarding causes for the escalating rate among low-risk patients, experts suggested the increase in cesarean sections was due to maternal health issues, such as gestational diabetes and obesity, fetal issues, such as malpresentation and multiple gestation, as well as malpractice concerns affecting hospital policies and practitioners. However, this new position statement by the nation's maternal and fetal health experts suggests that modification of certain maternity care practices could in fact reduce primary surgical deliveries. The World Health Organization called for the elimination of unnecessary cesarean sections as early as 1996, yet until recently there were few resources to assist maternity care providers in achieving this goal. This new joint statement provides a critical, evidence-based and actionable guideline for both health care providers and consumers. The emphasis placed on accounting for patient preference when making these complex decisions is reflective of the value that ACOG places on patient oriented outcomes.

As you may be aware, in May 2012, MANA, ACNM, and NACPM issued a joint statement entitled Supporting Healthy Normal Physiologic Birth That statement provides a complementary evidence-based guideline for practitioners who seek to facilitate normal physiologic birth and limit obstetric interventions to those that are necessary and evidence-based. We look forward to future opportunities to collaborate across disciplines to endorse evidence-based best practices in maternity care.

I wanted you to know that MANA publicly endorses the Joint Statement on the Safe Prevention of the Primary Cesarean. We are committed to working together—physicians, nurses, midwives, hospital personnel—to strive for an integrated maternal and child health system that provides high quality care for all women and infants in the U.S.

Thank you again for your leadership and vision.

Marinah V. Farrell, President
Midwives Alliance

Marinah V. Farrell is the president of the Midwives Alliance of North America. Politics and traditional medicine is what led Marinah to midwifery, and she has a firm commitment to both political activism and birth work. Marinah has been the president of various non-profit boards, has worked in waterbirth centers and medical facilities for international NGOs, free-standing birth centers in the U.S, and has been the owner of a long standing homebirth practice. Marinah also works with various local grassroots organizations in Arizona such as the Phoenix Allies for Community Health, a free clinic in downtown Phoenix, and assists in collective endeavors with other grassroots groups. Marinah is focused on the issue of lack of access to midwives and the profession of midwifery in communities where health disparities are overwhelming, as well as training in cultural safety.

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