As a community midwife, educator, and member of the NACPM Board, I hold a deep reverence for the midwifery profession. This monumental work is often a calling rooted in ancestral knowing, advocacy, and often without recognition for the time and weight this profession carries. The profession of midwifery has always practiced life-saving skills and today, I want to recognize midwifery as a life-affirming lifestyle. A midwife’s lens is inclusive of how we exist within systems we have no choice but to transform for the betterment of our birthing ohanas. We as midwives are also balancing the future of midwifery that we are wanting our apprentices/students to carry forth into the future. This heavy torch that pulls into question the unification around a shared vision of equity in midwifery education, and to ensure midwives regardless of race, identity, or background are prepared, supported, and valued.
We cannot reach our collective goals unless we commit to lifting each other up. Equity is not the work of some midwives, it is the shared work of all of us to carry. If we invest in equity, we are investing in the strength, sustainability, and integrity of midwifery itself.
The Stakes Are Too High to Ignore The evidence is clear. According to the World Health Organization, when midwives are educated to international standards and fully integrated into health systems, they can prevent over 80% of maternal deaths, stillbirths, and neonatal deaths. And yet, too many midwifery students, especially those from Black, Indigenous, and LGBTQ+ communities face significant barriers to entering and thriving in our educational institutions even when they cross the threshold completing both their academic and clinical experience.
We cannot continue to build systems of care for birthing ohana without also caring for the people who are called to serve them. If our profession is to endure and thrive, we must be acknowledged and implement without apology our commitment to inclusive, culturally responsive, and patient-centered education.
Building Midwifery Education for the Midwives of the Future I continue to learn from my students, and they are teaching me that midwifery needs constant evolution. This constant is a responsibility in meeting the needs of our birthing ohana, the threads these families are tightly woven into within their communities they represent and the ties they hold within relationships to midwives. Equity in midwifery education means removing systemic barriers and actively creating learning environments where students can succeed. In the words of An Agenda for Midwifery Education, “Midwifery education is the bedrock for equipping midwives with appropriate competencies to provide a high standard of safe, evidence-based care.” This creation of environmental classroom bravery is not new nor old, rather an element of resistance to unlearning how we have been taught to relearn that midwifery is a human connection profession. That often incorporates the spirit of its people, community and spirituality.
Education does not begin or end in the classroom, it exists in the culture of our schools, the accessibility of our programs, the inclusiveness of language, and the safety of our clinical placements.
To move from vision to reality, here are my thoughts on diversifying our workforce:
Support and Retain BIPOC Students
Ensure representation of Black, Indigenous, and other people of color among faculty, leadership, guest speakers and lectures
Offer community-rooted mentorship, affinity groups, and financial aid that address the realities of generational inequity.
Integrate decolonized and anti-racist content into all courses, not as an elective but as foundational knowledge for clinical excellence.
Affirm and Celebrate LGBTQ+ Midwifery Students
Normalize pronoun use, inclusive language, and gender-affirming care across all learning environments.
Expand curricula to include the full spectrum of reproductive health needs, including chestfeeding, queer family planning, and trans pregnancy.
Partner with affirming clinical sites and provide mental health support attuned to the unique stressors LGBTQ+ students may carry.
When we create programs where all students feel seen, respected, and empowered, we strengthen the profession’s ability to serve all communities with dignity and respect
Unifying Across Our Differences As midwives, we come from many paths with some of us trained in birth centers, others in hospitals, homes, or communities. We bring different cultures, histories, identities, and languages to this work. All in our shared calling to serve with compassion, skill, and justice binds us together literally within the threads of sleepless nights advocating between the gates of life and death.
I no longer want to feel this division that is lead by fear and scarcity. I would rather build from a place of abundance and courage. As the WHO notes, “Midwives want better education… to be empowered to take leadership, to know their skills are valued… and to provide better quality of care for women and their newborns”. The same is true of educators, students, and community midwives across this country.
I believe that act of building midwifery education that reflects the communities we serve, from the pain points of a well-represented student body, leadership, educators and culturally responsive educational content is Equity. And we all know this path will not be easy.
Together a Path Forward The WHO’s seven-step action plan gives us the tools: strengthen leadership, prepare institutions, monitor and adapt, and most importantly—educate students in environments where equity is not an afterthought but a foundation.
We must ensure our national and regional policies reflect these priorities, and that NACPM, as a professional home, continues to support midwifery schools, educators, and students in enacting them. Whether through technical support, shared resources, or coalition-building, we must walk
The Reflective Invitation Fellow midwives, educators, students, and organizational partners, this is our opportunity to rise together. To see equity not as a challenge but as an invitation to grow. To remember that the future of midwifery depends not only on what we teach but on how we love, how we lead, and how we listen to understand with one another.
Unification of midwifery will result not only in reducing mortality, but nurturing a profession that reflects the deepest values rooted in love and resistance. Let us lead with courage. Let us teach and receive as heart centered humans where we are not centering in service of systems that are working against us. And let us prepare the next generation of midwives to be not only clinically competent, but culturally responsive, resilient, visionary, and just.
References:
World Health Organization. Strengthening Quality Midwifery Education for Universal Health Coverage 2030: Framework for Action, 2019.
Bharj, K.K. et al. An Agenda for Midwifery Education: Advancing the State of the World's Midwifery. Midwifery, 2016.
Rainbow Health. LGBTQ+ Standards of Inclusion, 2021.