| | The midwifery model of care is rooted in trust, empowerment, and individualized support, fostering a partnership between clients and midwives to embrace the natural journey of pregnancy and childbirth.
Different models have been implemented when it comes to childbirth management. These models had been labeled “Medical vs Social”, “technocratic vs holistic” or “pathological vs salutogenic” models. These models surfaced because there is no clear |
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| consensus on if pregnant women should be perceived as ill or well, especially in Western society. There is much overlap between countries that use a midwifery model framework for example, “Women-with-midwives” in New Zealand and Scotland, “Midwifery at high risk” in Sweden, “Exemplary midwifery practice” in the United States, Woman-centered SA in South Africa and “The primacy of the good midwife”, “Woman-centered Nordic” in Sweden and Iceland (1).
Building a trusting relationship between the client and the midwife is the primary concept that was found to be similar throughout all these models. Providing individualized care, building a long trusting relationship, collaboration, empowerment, and shared decision-making throughout the care are the central themes of all midwifery models. The midwifery model of care is developed from the clients’ and midwives’ experiences of pregnancy and childbirth being a normal life cycle process therefore, it was natural for the building of a non-authoritarian partnership between the client and the midwife to emerge(2,3).
The midwifery model of care is different from medical models of care by emphasizing wellness and normalcy, and recognizing the client as an active partner and decision-maker. During care, the pregnant person’s experience, expectations, perceptions, and beliefs are respected. The focus of this model is on building a trusting relationship while minimizing the use of technology. The goal of midwifery care is not only the health and safety of the dyad but also to keep their emotional, social, and spiritual wellbeing for the whole family. This model also emphasizes the importance of continuity of care ranging from preconception to postpartum, ensuring availability of support when clients need it (4, 9, 14).
Maternal mortality in the US is ten times that of other developed countries and is reported to have increased by 45% between 1999 and 2017 (6,12). Moreover, great disparity in maternal mortality has been observed in the US, where Black women are three to four times more likely to die of obstetric complications compared to non-Hispanic White women (10). A substantial increase in midwife-led maternity care is said to decrease more than 2.2 million overall maternal and neonatal deaths, including stillbirths, by 2035 (13) and can reduce disparities in care.
The midwifery model of care is shown to be different in different parts of the world. Comparing the model between different developed countries with the lowest maternal mortality showed that midwives in most of these countries are autonomous, self employed or independent practitioners with hospital privileges or are well integrated into the healthcare system. In addition, these countries are able to achieve the lowest maternal mortality rate by respecting choices of places of birth, funding midwives to provide care and providing continuity of care ranging from antepartum through postpartum (11). However in the US, the choice of birth place and/or provider is very complex and integration of midwives into the healthcare system varies across different states and hospital and state policies and legislative restrictions hinder the expansion of midwifery practice affecting the autonomy of the profession in addition to lack of insurance coverage for midwifery services. Therefore, our work, as midwives and members of NACPM, must include urging policymakers to dismantle obstacles hindering the adoption of the midwifery care model in the United States. |
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| Note: Sources Cited can be found at bottom of newsletter |  | Words from Birth Center Equity (BCE) CEO and Co-Founder Leseliey Welch
Every day, in communities across the country, Black, Indigenous, midwives of color are caring for families. Midwives touch the lives of birthing people and families, ensuring that they receive expert perinatal care and feel heard, expert perinatal care and feel heard, seen, and supported, physically, emotionally, and spiritually. |
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| Midwives welcome babies as they take their first breath and grow in loving connection that began long before their birth. Midwives show us how safe and loving birth generates wellness for all.
Community birth centers create dedicated space for midwifery-led care and community wellness. A community birth center is a freestanding homelike place where safe, culturally-reverent midwifery care is available to all birthing people. Through birth centers, communities come together to ensure safety and dignity for all birthing people, and to connect with each other in community workshops, gardens, health fairs, and block parties. Through midwifery and birth centers the social nature of birth is restored.
Birth Center Week (September 14-20) celebrates and elevates the impact and potential of community birth centers, and grows the collective cultural, economic, and political power of community birth centers led by Black, Indigenous, people of color. Birth Center Week was launched by Birth Center Equity (BCE) last year; this year’s Birth Center Week theme is Grow Birth Centers; Grow Community.Birth Center Week 2024 is guided by the leadership of a BCE Network Member Committee that includes CPM’s Vanessa Caldari (Centro MAM, San Juan) and Nikki Helms (San Diego Community Birth Center. (Sign up here for Birth Center Week and BCE updates!)
As communities learn more about midwifery and birth centers, the number of birthing people seeking community birth grows. According to research from the National Partnership for Women & Families (NPWF), between 2019 and 2020, there was a 30% increase in Black birthing people opting to give birth in community settings, a 26% increase for Native American birthing people, a 24% increase for Latinx birthing people, and an 18% increase for White and Asian birthing people. (Improving Our Maternity Health Now Through Community Birth Settings, NPWF, April 2022.)
Community birth centers create a viable path forward for improving the US perinatal care system – a system that fuels the present perinatal health crisis in communities of color and ranks poorly in comparison to other wealthy nations. Through the Birth Center Equity network of over 40 birth centers led by Black, Indigenous, people of color, community birth centers are growing deep relationships and shared vision, strategy, and opportunity. Through this collective power, community birth centers: Create beloved economies by infusing new resources and energy into communities that have been systematically denied adequate and equitable resources; Generate solutions to racial disparities and inequities in birthing that create unsafe conditions for all birthing people, especially Black, Indigenous, people of color birthing people; and Lead in creating a midwifery-led, people-centered perinatal health care system that works for everyone.
By growing investment in birth centers led by Black, Indigenous, people of color, BCE touches lives and grows wellness in our communities and our nation.
In 2023, Birth Center Equity led the movement to grow Black, Indigenous, people of color-led birth centers by infusing $1.1 M into community birth centers; strengthening community birth center networks & relationships, and growing community birth center visibility.
Moreover, Birth Center Equity is generating creative energy and solutions with the power to transform perinatal health in the US. We are shaping birth center sustainability models through business and leadership development, public-private partnerships, integrated financial models, and economies of scale. We are operationalizing a community-based, values-aligned approach to municipal partner birth center planning. We are exploring innovative ways to aggregate community birth center economic power including revolving loan funds and collective land acquisition infrastructure.
Join with Birth Center Equity’s nationwide network of community birth centers in Birth Center Week 2024, to grow birth centers, grow community, and grow the abundant futures of wellness for all. |  | | |  |  | Together with the American Association of Birth Centers (AABC), the American College of Nurse-Midwives (ACNM), and the National Black Midwives Alliance (NBMA), we are advocating for the implementation of the Transforming Maternal Health (TMaH) Model. This model represents a comprehensive approach to maternity care that prioritizes the rights and well-being of birthing individuals and their families.
The TMaH model emphasizes the following key principles: Midwifery-Led Care: Recognizing the vital role of midwives in providing high-quality, evidence-based care that promotes physiologic birth and respects individual autonomy. Equity and Inclusivity: Addressing disparities in maternal and infant health outcomes by prioritizing care that is accessible, affordable, and inclusive of all communities, particularly those facing systemic barriers. Community Collaboration: Fostering partnerships between healthcare providers, community organizations, and policymakers to create a supportive environment for maternal health and well-being.
We believe that the TMaH model holds tremendous potential to improve outcomes for birthing individuals and their families. To support our advocacy efforts, we have compiled state-specific statistics and information highlighting the benefits of implementing this model within each state’s healthcare system. NACPM is emailing Medicaid leadership with this information and collaborating on a follow-up joint email from NACPM, AABC, ACNM, and NBMA.
Additionally, each organization is encouraging our members and supporters to join us in advocating for the TMaH model by sending letters to their respective state leaders. We are providing you with this sample letter that you can tweak to make your own. Together, we can work towards a future where every individual receives the highest standard of maternity care grounded in human rights, respect, and compassion. |  | In the spirit of collaboration and support during this challenging transition, NACPM continues to extend its assistance with an open heart. Given the legal ramifications in states referencing these materials, NACPM conducted a legal analysis of state references to MANA documents, MANA stats, and/or equivalent statements to “MANA or its successor organization” in all states that recognize direct-entry midwives. This analysis, State Comparative Summary of References in Midwifery Statutes and Rules to MANA or Specific MANA Documents as of April 2024, is now available. Fourteen states will be affected to varying degrees: Alabama, California, Colorado, Florida, Indiana, Kentucky, Maine, New Jersey, Oregon, Tennessee, Texas, Rhode Island, Utah, and Vermont.
Our top priority is regulatory stability. To facilitate this goal, until a successor organization is named, NACPM has created this page for MANA documents so that the midwives affected by the dissolution will continue to have access. |  | Great News! The latest House FY 2024 funding bill ensures continued funding for accredited midwifery education programs in the United States. This includes $8 million for HRSA’s Advanced Education Nursing Maternity Care Nursing Workforce Expansion (MatCare) Program and $5 million for scholarships. This funding is crucial for improving perinatal care and expanding access to midwives. For more details, check out the Bill Text, The Joint Explanatory Statement, and the Bill Summary. |  | From Minesota NACPM | | Minnesota NACPM has been working alongside the general midwifery community for over a year to ensure that Licensed Midwives maintain their access to the medications within our formulary. The original MN Licensed Traditional Midwife law was first put into statute in 1996 and stated a short list of medications (NB Vit K, Rhogam, PPH meds, etc) that LTMs could administer, however in 2022 it came to light that the words "purchase and possess" were missing from the statute. In working with the Board of Medicine (our regulatory body) and the Board of Pharmacy and numerous legislators we were able to pass a stand-alone bill early in the session, unanimously in |
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| both the House and Senate to clarify our original statute and ensure our legal access to purchase, possess and administer the medications we as midwives need to ensure the safety of our clientele. This was a huge community effort and successful in large part due to our lobbyist group, O'Connell Consulting, as well as the fundraising from the community of families, birth workers in MN and beyond. Additionally, we are grateful for our fiscal agent, Elephant Circle for their support.
We are still fundraising the final payments for our wonderful lobbyist team! Please visit mnnacpm.org to donate. | | We are excited about the incredible work midwives are doing across the country. To celebrate and showcase the impactful initiatives happening in each state, we would like to highlight your individual and Chapter achievements, challenges, legislative efforts, fundraising activities, and more in our newsletter , on our website and on our social media platforms. Use the form linked below to let us know any news worth sharing! | |
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|  |  | On Monday, April 15th, NACPM presented Creating Sustainability in Midwifery through a Clinically Integrated Network. View the Recording Here. |  |  | Words from Executive Director of A Mothers Choice Midwifery, Demetra Seriki
After three years of planning, Biking for Black Babies 2023 inaugural cycling tour was a success! We are excited to share our team "look back" Newsletter . A poetry of 5 birth workers, courageously riding their road bikes across 7 states (over 1,000 miles of pavement) to bring awareness to Black Maternal Health and the direct link to improving birth outcomes for Black babies.
Our intention moving forward is to continue this event annually. We ask for all of you to support out newsletter, share our team digital diaries, and come alongside us either financially or physically for our 2024 cycling tour. Our flex is cultivating financial support for community midwives, strengthening community allyship, decreasing poor outcomes, and improving Black infant mortality. Improving Black birth outcomes (Maternal and Infant) requires actionable moves, TED Talks or public health surveillance are simply distractions that continue to perpetuate the lack of financial investments in Black community birth. We do not need more studies, what is needed is an ACE (Action in Capital Equity) for every perinatal community that is impacted by Black infant mortality. In other words, reinvest, restore, rebuild healthy Black communities lead by Black communities, in partnership with Black community midwives.
We once again want to give an extended thank you to the organizations (Nearly all Colorado based) that supported our efforts and the loved ones who sacrificed their time and energy.
We ask for your support in solidarity through action; share, request an interview, and DONATE.
Support Biking for Black Babies 2024 Cycling Tour website: Womb Cycle Donate Link: Matching Miles for Monies |  |  | We are thrilled to share that the recent NACPM Spring Retreat was a resounding success! Held April 25-26th all day online (whew that was a lot of zoom). The retreat gathered all the board members including our two newest as well as the staff for two days filled with inspiring conversations and meaningful connections.
The theme of the retreat organically became, "Conversations of Abundance,”and resonated deeply with attendees. It reflected our collective vision for NACPM's future—a future brimming with possibilities and opportunities for growth. Throughout the weekend, we discussed the importance of developing the policies and infrastructure necessary for NACPM to evolve into a robust organization—a powerful voice for CPMs nationwide.
As we move forward, we are committed to ensuring that NACPM has the resources and support it needs to thrive. We recognize that building a strong organization requires thoughtful planning and dedicated effort. With your continued support, we are confident that NACPM will reach new heights and fulfill its mission of advocating for CPMs and the families they serve. Thank you to everyone who participated in the retreat and contributed to its success. Your passion and dedication are truly inspiring. We look forward to embarking on this journey of growth together, as we work to make NACPM a beacon of excellence in the field of midwifery. |  | Congratulations to Recent NACPM Bigger Table Fund Recipients - Kristin Mejia, Paloma Del Mar Hernandez, and Jehmia Williams! | | NACPM’s Bigger Table Fund is a scholarship initiative to help grow a racially, ethnically and socially representative CPM workforce to meet the urgent needs of childbearing people in our country. This Fund provides financial awards for student midwives of color, Indigenous and/or LGBTQIA2S+ student midwives for: the initial NARM examination fee the fee for retaking the NARM examination when needed one-time initial state licensing fees
| |  | | We’re asking every member to consider a $10 donation for every birth they attend in 2024. Imagine the impact, if every one of their clients also donated $10 to support their midwife’s profession! Help make this campaign a success by making a donation today. | |
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| Each Newsletter features exclusive merchandise, perfect for personal use or thoughtful gifts for your clients. Your purchases contribute directly to our Bigger Table Fund Initiative, enabling us to to help grow a racially, ethnically and socially representative CPM workforce. Join us in making a difference while enjoying quality merchandise that aligns with your passion for midwifery. |  | | Support our work: Donate to NACPM | |
| NACPM’s annual goal for fundraising from individual donors and increasing the volume of our collective voice is $100K. In 2024 so far we have raised $17,863.
If everyone receiving this newsletter donated $25 or became a member of NACPM we would reach our goal! |
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| Barnawi, N., Richter, S., & Habib, F. (2013). Midwifery and midwives: A historical analysis. Journal of Research in Nursing and Midwifery, 2(8), 114-121. Berg, M., Asta Ólafsdóttir, Ó., & Lundgren, I. (2012). A midwifery model of woman-centered childbirth care – In Swedish and Icelandic settings. Sexual & Reproductive Healthcare, 3(2), 79–87. https://doi.org/10.1016/j.srhc.2012.03.001 Brady, S., Bogossian, F., & Gibbons, K. S. (2024). Defining woman-centered care: a concept analysis. Midwifery, 131, 103954–103954. https://doi.org/10.1016/j.midw.2024.103954 Chapman, S. (2016, March 10). Midwife-led continuity models versus other models of care: review and reflections - Evidently Cochrane. Evidently Cochrane. https://www.evidentlycochrane.net/midwife-led-care/ Combellick, J. L., Telfer, M. L., Ibrahim, B. B., Novick, G., Morelli, E. M., James-Conterelli, S., & Kennedy, H. P. (2023). Midwifery care during labor and birth in the United States. American Journal of Obstetrics and Gynecology, 228(5). https://doi.org/10.1016/j.ajog.2022.09.044 Douthard, R. A., Martin, I. K., Chapple-McGruder, T., Langer, A., & Chang, S. (2020). U.S. Maternal Mortality Within a Global Context: Historical Trends, Current State, and Future Directions. Journal of Women’s Health, 30(2). https://doi.org/10.1089/jwh.2020.8863 Eri, T., Berg, M., Dahl, B., Gottfreðsdóttir, H., Sommerseth, E., & Prinds, C. (2020). Models for Midwifery care: a Mapping Review (“Models for Midwifery care: a Mapping Review” #). European Journal of Midwifery, 4(July). https://doi.org/10.18332/ejm/124110 ICM. (2022, January 30). The Origins of Midwifery. International Confederation of Midwives. https://internationalmidwives.org/the-origins-of-midwifery/ International Confederation of Midwives. (2024, January 5). Philosophy and Model of Midwifery Care. International Confederation of Midwives. https://internationalmidwives.org/resources/philosophy-and-model-of-midwifery-care/ MacDorman, M. F., Thoma, M., Declcerq, E., & Howell, E. A. (2021). Racial and Ethnic Disparities in Maternal Mortality in the United States Using Enhanced Vital Records, 2016‒2017. American Journal of Public Health, 111(9), e1–e9.https://doi.org/10.2105/ajph.2021.306375 Malott, A. M., Davis, B. M., McDonald, H., & Hutton, E. (2009). Midwifery Care in Eight Industrialized Countries: How Does Canadian Midwifery Compare? Journal of Obstetrics and Gynaecology Canada, 31(10), 974–979. https://doi.org/10.1016/s1701-2163(16)34328-6 Niles, M., & Zephyrin, L. (2023, May 5). How Expanding the Role of Midwives in U.S. Health Care Could Help Address the Maternal Health Crisis. Www.commonwealthfund.org. https://www.commonwealthfund.org/publications/issue-briefs/2023/may/expanding-role-midwives-address-maternal-health-crisis Nove, A., Friberg, I. K., Bernis, L. de, McConville, F., Moran, A. C., Najjemba, M., Hoope-Bender, P. ten, Tracy, S., & Homer, C. S. E. (2020). Potential impact of midwives in preventing and reducing maternal and neonatal mortality and stillbirths: a Lives Saved Tool modelling study. The Lancet Global Health, 9(1). https://doi.org/10.1016/S2214-109X(20)30397-1 Rooks, J. (1999). The midwifery model of care. Journal of Nurse-Midwifery, 44(4), 370–374. https://doi.org/10.1016/s0091-2182(99)00060-9 The Early Voices of Midwives. (2021). In connect.springerpub.com. Springer Publishing Company. https://connect.springerpub.com/content/book/978-0-8261-2538-5/part/part01/chapter/ch01
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