Updates from ICM and a Joint Statement with ACNM

Updated June 20, 2026: An earlier version of this letter incorrectly spelled out the name of the American College of Nurse Midwives (ACNM). It has been corrected.

Dear Friends and Colleagues,

Greetings from Lisbon, Portugal, where more than 3,000 midwives from around the world have gathered for the 34th Triennial Congress of the International Confederation of Midwives (ICM).

This week has held both profound celebrations and real heartache. The Congress has offered an extraordinary array of learning from plenary sessions, to panels and scientific presentations, alongside workshops and research posters. This collection of work demonstrated the breadth and maturation of midwifery practice, education, regulation, advocacy, research, and leadership in every region of the world.

We came to Lisbon to celebrate our profession, and there is so much to celebrate. And we will. However, right now we are focusing on informing you about this important global issue in midwifery and the solidarity between the U.S. credentialed midwifery professional organizations.

First, we want to address our sorrow that NACPM’s President, Tigist Ejeta, was unable to serve as a delegate this year. Out of legitimate concern for her safety given the current uncertainty surrounding U.S. travel visa processes and the real risk that immigrants face, we supported the difficult decision to not have her travel. These challenges reflect a broader reality that many midwives around the world continue to face, namely significant barriers to fully participating in global spaces. Other associations were unable to send delegates because of visa denials. We are grateful that Meredith Bowden, our longest-standing current board member, and I were able to serve as delegates alongside American College of Nurse-Midwives (ACNM) Vice President, Pandora Hardtman and Immediate Past President, Jessica Brumley. We welcomed one of our newest board members, Autumn Cavender, to be an observer.

Among the matters considered by the Council was a recommendation to suspend the ICM Position Statement on Partnership Between Indigenous and Non-Indigenous Midwives while revisions were being developed. NACPM and ACNM both voted against the measure and worked collaboratively to raise concerns about the subsequent approved suspension. While both organizations support thoughtful review, clarification, and potential revision of the statement, we believe the existing position should remain in place until replacement language can be developed and approved.

This statement was the only ICM policy document that explicitly recognizes the importance of Indigenous midwives, Indigenous knowledge systems, and the contributions of Indigenous communities to maternal and newborn health. Removing it before replacement language exists created a significant gap in ICM policy and has already undermined trust built over years of relationship and engagement with Indigenous midwives and communities around the world.

Just as importantly, we heard and honor the concerns voiced by Indigenous midwives and Indigenous organizations, who expressed clearly that suspending the statement before revision diminishes the visibility of Indigenous leadership and the recognition of Indigenous rights within the global midwifery movement. We stand alongside our Indigenous midwife colleagues and are committed to continue using our position to amplify their leadership rather than substitute our own.

Leadership here and our board members back home helped craft, review, and approve a joint statement we are proud to publish:

Our actions on this issue aren’t over, following the Congress, we will send a letter to ICM that once again details our disappointment with this process and offers a constructive path forward. We will keep you informed as this work continues and will share the ICM follow-up letter on our website once finalized.

We are proud to say we also came ready to live our values when they are tested. Thank you for the trust you place in NACPM to represent community midwifery on the world stage with integrity and care.

In community,

Cassaundra Jah

Executive Director

National Association of Certified Professional Midwives

"The Middle is Neglected": Piece Written by Staysha Quentrill, NACPM Virtual Conference Closing Speaker

I come before you very humbly because I believe many of us feel this tension every single day in our work. We feel the divide within midwifery. We feel the pressure to choose a side.

On one end of the spectrum, there are midwives who are often labeled “medwives.” Midwives who are seen as too clinical, too evidence-based, too medicalized.

And on the other end, there are midwives who identify as traditional midwives or birth keepers, who are often viewed as too spiritual, too intuitive, or somehow disconnected from science.

And what I have noticed is that there seems to be very little room for us to meet in the middle.

Both sides can clearly identify the flaws in the other. But what I would offer tonight is that maybe both sides are only seeing one part of what midwifery truly is.

One side may be holding tightly to the science. The other side may be holding tightly to the humanity and soul of birth. But true midwifery has always required both.

And I believe that middle space—the place where science and soul coexist—is being neglected.

Physiological Midwifery

I want to offer a term tonight: physiological midwifery. Not simply physiological birth. Not just the physiology of labor.

But physiological midwifery—the act of the midwife itself.

Because just like we say the body knows how to birth, I believe our bodies also know how we are meant to midwife. There is something inside of many of us that recognizes when care feels aligned and when it does not.

When we are forced into these rigid boxes—medical or traditional, evidence-based or intuitive—many of us feel that tension in our bodies. We know instinctively that something about those binaries does not feel right.

Because birth itself is not binary.

Every birth is different. Every family is different. Every mother is different. And therefore, every act of midwifery may need something different too.

Physiological midwifery is the understanding that the midwife must remain responsive, adaptable, observant, skilled, intuitive, and deeply human.

And I would define it this way:

Physiological midwifery is a practice where the midwife integrates both scientific knowledge and ancestral wisdom, standing against rigid binaries and centering justice, equity, and the full humanity of every birthing person.

That is the middle I am talking about tonight.

Why The Middle Matters

So why does this matter? Because I believe this divide is hurting all of us.

It hurts midwives. It hurts students. It hurts organizations. And most importantly, it hurts families.

When we spend all of our energy trying to determine who belongs in which category, we lose focus on the people standing directly in front of us.

The laboring mother. The birthing person. The partner. The baby entering this world.

We cannot fully care for people if we are constantly defending ourselves against one another.

And the truth is, many of our clients do not need us to choose between science and soul. They need both.

They need someone who can recognize an emergency.

And they need someone who can recognize fear in someone’s eyes.

They need someone who understands physiology. And they need someone who can sit quietly in sacredness without disrupting it. Families deserve care that sees them as full human beings.

And when we divide ourselves into extremes, we limit the fullness of what midwifery can offer.

The Larger Systems Behind The Divide

I also believe we have to be honest about the systems underneath these divisions. Many of these rigid binaries are rooted in systems that force people into categories in order to control, rank, and separate them.

And yes, I believe white supremacy culture plays a role in that. Because white supremacy depends on hierarchy. It depends on purity. It depends on proving who is right and who is legitimate.

And midwifery has not escaped that.

We ask one another constantly:

Are you medical enough? Are you traditional enough? Are you evidence-based enough? Are you radical enough? But what if the future of midwifery is not found in purity politics? What if the future is found in integration? Because in many parts of the world, midwifery is not treated as a battle between science and tradition.

In many cultures, midwives are allowed to hold both. Clinical skill and ancestral wisdom.

Education and intuition.

Safety and sacredness.

The science and the soul coexist.

And I believe that is where the true power of midwifery lives.

The Ask

So my ask tonight is simple. I am asking us to stop neglecting the middle. I am asking us to become curious about one another instead of defensive. I am asking us to stop reducing one another into labels and begin recognizing the shared heart underneath all of this work.

Because regardless of our pathways, our credentials, or our philosophies, most of us entered this work for the same reason:

To care for people. To protect birth. To walk families safely through transformation.

Imagine what could happen if we stood together as one united profession instead of fragmented groups fighting for legitimacy. Imagine what could happen if our collective energy went toward improving outcomes, increasing access, supporting families, protecting physiological birth, and preserving the humanity of this work. The middle is neglected. But the middle is also where healing happens.

Why This Matters to Me

And I want to be honest about why this matters so deeply to me personally.

Because every moment we spend divided from one another is a moment we are pulled away from the actual work.

And for me, the work is clear.

The work is creating more Black midwives. The work is eliminating disparities. The work is protecting Black mothers and Black babies.

And I cannot ignore the reality that Black women, during some of the darkest periods of history in this country, survived childbirth at higher rates than they do today.

At a time when Black people were considered worth less than cattle, sheep, pigs, and goats, Black women were still surviving birth better than they are now.

That should stop every single one of us in our tracks.

Because that means something is deeply broken.

And while we debate labels, legitimacy, and who belongs in what category, families are still dying. Communities are still suffering. Midwives are still burning out.

We do not have time to keep neglecting the middle when people are asking us to help save lives.

For me, physiological midwifery is not just philosophy. It is survival. It is liberation. It is the belief that we can build a model of care that is both deeply skilled and deeply human.

And I believe that is the work we are being called toward together.

Conclusion

So tonight, I want to leave you with this:

Birth is not one-dimensional. And midwifery should not be either.

Physiological midwifery is not simply a technique or philosophy. It is the embodiment of balance. It is the willingness to hold knowledge and humanity together at the same time.

And maybe that is what our profession is being called into right now, not greater division, but greater integration.

Because when we neglect the middle, we lose each other.

But when we protect the middle, we protect the future of midwifery itself.

Recordings and CEUs Available, Recap: "Centering Midwives, Restoring Care" Virtual Conference

This May, NACPM made history. Our first-ever virtual conference, “Centering Midwives, Restoring Care,” brought together midwives, students, birth workers, funders, advocates, and allies from across the country for two transformative days of learning, connection, and community.

The conference opened with a powerful welcome from our very own board member, Autumn Cavender, setting the tone for everything that followed. Over two days, attendees engaged with eight dynamic sessions spanning the full landscape of community midwifery:

1. Pennie Bumrungsiri challenged us to reimagine the reach of our profession in her session, “A Systems Integration Model for Midwifery-Led Care Across the Lifespan,” presenting the Mana Mama model.

2. Star August Ali and Hilary Schlinger painted a bold picture of what full access to midwifery care could look like in “A Midwife in Every Neighborhood.”

3. Jen Moffitt brought grounding and heart-based data in her talk about embodied mindful practices, which can be leveraged to decrease health disparities.

4. Jill Wodnick took attendees inside the policy arena with “Modernizing Midwifery Regulations,” connecting state-level legislative momentum to the day-to-day realities of practice from a consumer perspective.

5. Audra Post offered a fresh lens on power and investment in “Collaboration Towards Metrics of Participatory Grantmaking.”

6. Dr. Jordana Frost laid out a compelling roadmap for expanded access in “Leveraging FQHCs.”

7. Dr. Melissa Cheyney reminded us why the numbers matter in “Data That Delivers,” exploring how community-centered data has and continues to drive the change we need.

8. While we were sad that Dr. Kanika Harris wasn’t able to join us, Cassidy Spence was able to close out the educational sessions with “The Black Birthing Bill of Rights,” a presentation that left the room (virtual as it was) profoundly moved and called to action.

The conference closed with remarks from Staysha Quentrill, sending attendees off inspired and renewed.

If you missed the conference, we have great news! The recordings are now available and ready for you to explore at your own pace — and earn CEUs! Head over to our new NACPM Leadership Hub. The opening and closing sessions are available at no cost. Individual session recordings are available for purchase at the normal CEU rate ($45 for each 1.5-hour course). NACPM members get a 50% discount. With up to 12 continuing education contact hours available — equivalent to 1.2 MEAC CEUs — completing the full conference series is a meaningful investment in your practice, your clients, and yourself.

If you’re a NACPM member, but haven’t received an email with your membership discount, please email us at zev@nacpm.org. To earn CEU credit, be sure to complete the required evaluation for each session.

Of course, we would be remiss if I didn’t acknowledge with gratitude that none of this would have been possible without the generous support of our platinum sponsors: the Foundation for Health Care Quality's Community Birth Data Registry and Smooth Transitions Programs, Birth Center Equity, Every Mother Counts, Lactation Education Resources, and the Intersectionality Training Institute. We are also deeply grateful to our grant funders the Skyline Foundation, Pritzker Children's Initiative, and the Wagner Foundation, whose belief in this work made it real.

We are so proud of what our community built together at this first conference, and we hope these recordings bring that experience to even more of you! #NACPM26