| | A Vision for the Global Development of the Midwifery WorkforceBy: Lisa Peña, CPM |
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| Midwifery stands at the intersection of clinical care, cultural tradition, and community trust. Yet, the global development of the midwifery workforce has too often mirrored inequities found across health systems, where Black, Indigenous, and People of Color (BIPOC) are underrepresented in formal leadership, under-resourced in training pathways, and undervalued despite generations of knowledge and practice.
To build a sustainable, effective global midwifery workforce, we must center a BIPOC lens — not as an add-on, but as a guiding framework for equity, access, and justice.
Historically, midwifery has been rooted in communities, with knowledge passed through lineage, apprenticeship, and lived experience. Many of these traditions originate in BIPOC communities that have long safeguarded holistic approaches to pregnancy, birth, and postpartum care. However, colonialism, medicalization, and regulatory barriers have marginalized these models, often displacing community-based midwives while privileging institutional systems that do not reflect the cultural or social realities of the populations they serve. This has contributed not only to workforce shortages, but also to mistrust and disparities in maternal and infant outcomes.
A BIPOC-centered approach to workforce development requires structural transformation. It means investing in accessible and culturally grounded education pathways, including apprenticeship and community-based models that honor traditional knowledge alongside clinical competencies. Financial barriers must be addressed through scholarships, loan forgiveness, and equitable funding mechanisms so that aspiring midwives from historically excluded communities can enter and remain in the profession. Regulatory systems must also evolve to recognize diverse routes of training and to eliminate unnecessary restrictions that disproportionately impact BIPOC practitioners.
Equally important is leadership. Representation within the workforce is only one step; meaningful inclusion in decision-making spaces is essential. BIPOC midwives must be supported to lead at every level — from local health systems to global policy arenas — ensuring that workforce strategies are informed by those most connected to the communities in need. Organizations such as the National Association of Certified Professional Midwives (NACPM) play a critical role in advocating for policies that center equity, protect multiple pathways into midwifery, and elevate community-based care as a cornerstone of maternal health systems.
Strengthening the midwifery workforce through a BIPOC lens also improves care across the full perinatal continuum, particularly during the postpartum period, where gaps in support are most evident. When care is delivered by providers who share cultural, linguistic, and lived experiences with the families they serve, outcomes improve, trust deepens, and care becomes more responsive and respectful.
Ultimately, advancing global midwifery workforce development through a BIPOC lens is about more than numbers; it is about restoring balance to systems that have excluded vital voices for too long. It is about honoring the roots of midwifery while building a future where all communities have access to compassionate, competent, and culturally aligned care. By committing to this vision, we strengthen not only the profession, but the health and well-being of families worldwide. |
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| Moving Forward on Education Pathway & Exam Modernization |
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| The North American Registry of Midwives (NARM) held an informational session on July 29 and announced an upcoming webinar for August 20, both aimed at keeping the midwifery community informed as NARM updates its education pathways and the Certified Professional Midwife (CPM) Certification Exam.
Informational Session Covers MEAC Pathway and Exam Updates On July 29, NARM hosted a session for CPMs, students, and midwifery educators covering two related initiatives. The first was a review of the MEAC-accredited pathway: NARM's provisional recognition period for MEAC-accredited programs takes effect October 1, 2026, alongside a new clinical competency verification process for those programs. Alongside the session, NARM opened a 30-day comment period on its member community forum for questions and feedback on the MEAC pathway review changes.
A second update from NARM's test development program was also presented during this session covering changes to the exam's content outline, which is being revised based on the 2024 Job Task Analysis.
Find the comment form here. You will need to be a NARM member to participate. CPMs, students and public stakeholders can all become members!
Upcoming Webinar to Detail Exam Modernization Looking ahead, NARM is inviting CPMs, candidates, and the broader midwifery community to a free webinar on August 20 at 4:00pm ET focused specifically on modernizing the CPM Certification Exam. This multi-year effort is meant to ensure the exam reflects current entry-level midwifery practice and meets nationally recognized testing standards.
The webinar will walk attendees through the updated exam content outline based on the 2024 Job Task Analysis, an updated reference list aligned with that outline, structural changes designed to support ongoing renewal of the exam's question bank, and ways community members can get involved in test development — from writing and reviewing exam questions to serving on the Test Development Committee.
Register for the August 20 webinar here.
Source: North American Registry of Midwives, narm.org |
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| | Get Involved in Your State's Perinatal Quality Collaborative |
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| Across the country, Perinatal Quality Collaboratives (PQCs) are transforming maternal and infant health outcomes — and midwives are helping lead that transformation. From the New Hampshire PQC, led by a certified nurse-midwife, to long-standing midwifery leadership in the Washington State and Georgia collaboratives, our profession is proving what we've always known: midwifery care and quality improvement go hand in hand.
Why This Matters
PQCs bring together clinicians, hospitals, public health leaders, community organizations, and families around a shared goal of safer, more equitable pregnancies and births. Midwives serve on these collaboratives as executive directors, steering committee members, clinical experts, and community engagement leaders. Our clinical perspective, our relationships with families, and our commitment to physiologic, respectful care are exactly what these efforts need more of.
Health equity sits at the center of this work. PQCs examine outcomes by race, ethnicity, and geography; elevate patient and family voices; and implement evidence-based practices to close the gaps in maternal morbidity.
How You Can Get Involved
Getting connected to your state PQC is often more accessible than you might think:
• Visit your state PQC's website and subscribe to their newsletter
• Join a learning collaborative or active quality improvement project
• Volunteer for an advisory committee or workgroup
• Represent your hospital, birth center, academic program, or NACPM chapter
• Contribute clinical data, expertise, or lived community perspective
• Support implementation of maternal safety bundles and data review initiatives
Most PQCs actively welcome multidisciplinary participation, and frontline clinicians —especially midwives — are often exactly who they're hoping to hear from.
Take the Next Step
Visit the National Network of Perinatal Quality Collaboratives (NNPQC) to find your state's collaborative and get connected.
Your voice, your data, and your leadership can help shape statewide efforts to improve outcomes for mothers and babies. Our profession has a seat at this table, let's make sure we're the ones sitting in it. |
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| | | Executive Director & Director of State Policy Travel to National Conference of State Legislatures |
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| Team NACPM was on the ground at the 2026 National Conference of State Legislatures’ (NCSL) Legislative Summit in Chicago!
Our goal? To put smart, tested model legislation for CPM licensure directly into the hands of the people who write the laws. |
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| | Some of the most important work we do happens in hallway conversations at events like #NCSL2026. State by state, licensure for CPMs is proven to expand access to perinatal care — especially in rural and underserved communities. This week, we deepened relationships with legislators and staff across the country who are shaping the future of maternal health policy. The work continues! |
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| | A Closer Look at the Beloved Birth 50 by 50 NEXUS Convening |
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| | In our April newsletter, we shared about NACPM Executive Director Cassaundra Jah’s trip to Washington, D.C. for the April 11 convening of “The Promise: Beloved Birth 50 by 50 Nexus Convening.” This was a collaborative effort amongst twenty-five leaders from across the midwifery ecosystem, including John Hopkins University, Black Birthing Futures, Black Midwifery Collective, Birth Center Equity, and NACPM.
The audacious goal at the center of it all: By 2050, half of all babies born in the United States will be welcomed by a midwife.
Here’s a more in-depth look at what happened…
Out of two days of imagination, story-sharing, and hard strategic work came ten culture-change goals to guide the field over the next five to ten years — from 50,000 more midwives practicing by 2050, to a future where every pregnant person knows and can access a beloved midwife in their own community, to a world where midwifery is simply accepted as the gold standard of perinatal care.
We came together not just to talk about the future of midwifery, but to dream it into being. Our gathering made clear that our goal isn't a moonshot; it's a homecoming. Participants affirmed a truth at the heart of our work: Midwifery isn't an alternative model of care to be invented or justified. It's original. It's ancestral. It's ours to reclaim. As one voice in the room put it, "Midwifery belongs to us, and we are reclaiming it."
Just as powerful were the three narrative pillars participants rallied around: Every family begins care with a midwife Healthcare and birthcare are human rights Midwifery is the optimal standard for birth and reproductive health
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| | These aren't slogans. They're a reframing of where trust lives, what safety really means, and who gets to be recognized as an expert in their own care. This is exactly the work we are building together. It's the shared horizon of NACPM and Uplift Lab's Think Big Initiative project, and it beats at the heart of Birth Center Equity's 50x50 initiative. One table, different dishes brought to a shared vision for the perinatal ecosystem: a future where community-based, midwife-led care isn't the exception fighting for legitimacy, but the expectation every family can count on.
The energy in that room was described as urgent, joyful, and deeply hopeful as we continued to uncover all the ways we are "more aligned than divided." There's obviously lots of work ahead, including building shared infrastructure, deepening relationships, and breaking down the silos between story and data, policy, and lived experience. But the momentum is real, and it is ours to carry forward.
Midwives have always known how to hold a vision through labor, patience, and trust that what's coming is worth the wait. The future is already being born. We just have to keep tending it.
This summary draws on "Report Summary: Beloved Birth 50 by 50 Convening," prepared by Gusto Partners, May 2026. Stay tuned for more updates. |
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| | Reflections From the 34th Triennial Congress of the International Confederation of Midwives (ICM) |
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| Last month, we provided an updated from the 34th ICM Triennial Congress in Lisbon, Portugal, attended by NACPM Executive Director Cassaundra Jah and Board Members Meredith Bowden (second delegate) and Autumn Cavender (observer). This month, we wanted to share a few reflections and extra information in case you want to experience more of Congress from your home… |
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| Meredith Bowden (left), Autumn Cavender, Cassaundra Jah |
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| What is it? The ICM Triennial Congress is the largest global gathering of midwives, a unique opportunity to share knowledge, discuss pressing issues, and shape the future of midwifery and sexual, reproductive, maternal, newborn, and adolescent health (SRMNAH). Held every three years, the Congress brings together midwives, midwives’ associations, educators, researchers, and partners from around the world to exchange ideas, celebrate achievements, and collaborate on advancing the profession.
This year, midwives and allies from over 80 countries attended. More than 250 U.S. midwives, including approximately 40 midwives of color, represented the American College of Nurse-Midwives (ACNM) and the National Association of Certified Professional Midwives (NACPM). |
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| Joint Statement Made with the American College of Nurse-Midwives (ANCM) Among 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. 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.
The NACPM Board helped craft, review, and approve this joint statement with ACNM. (Note: An earlier version of this letter incorrectly spelled out the name of the American College of Nurse-Midwives (ACNM). It has been corrected.)
Authors Melissa D. Avery, Melicia Escobar, and Mari-Carmen Farmer also discussed this topic in their article for the Journal of Midwifery & Women’s Health, writing, “Likely the most moving and resonant plenary session came on Thursday, when Navajo midwife Nicolle Arthun boldly exercised her leadership as an Indigenous midwife. She used her platform to represent a coalition of Indigenous midwives, calling on ICM to acknowledge the harmful history of colonialism, to use their power to advance justice for Indigenous peoples, and to ‘stand up in defense of midwifery that is inclusive to all.’ It was a powerful display of collective organizing and Indigenous sovereignty. “
NACPM’s actions on this issue aren’t over. We will be sending 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.
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. |
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| "Gathering with midwives from around the world was a powerful reminder that our strength lies in collective wisdom. Midwifery belongs to the people. The term ‘midwife’ is rooted in the traditions of tribes, Indigenous nations, and communities worldwide who have safeguarded birth for generations. No institution, profession, or country owns that legacy.
I honor the midwives who could not be present, and especially those leading the work to decolonize midwifery and reclaim traditional knowledge. I also honor the midwives who came before us — those who carried generations into life and sustained this work long before it was named.
I see a new generation of midwives rising, ready to lead with justice, love, and equity at the forefront. Our future depends on unity and mutual respect. If existing systems cannot hold the full diversity of the global midwifery community, then we will build our own table — together." — Star August, CPM, Executive Director of Black Midwifery Collective |
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| "Thoughts from ICM: So much of European midwifery appears to be dominated by hospital-based practices. Over the decades, I have observed the dilution of the midwifery model by obstetrics in other countries, and this ICM Congress was no exception. However, I sensed a renewed interest in independent midwifery, and it is here that U.S. Certified Professional Midwives (CPM) have much to offer the international midwifery community. Certified Nurse-Midwives (CNM) and CPMs from the U.S. sat side by side in Lisbon. It is my hope that this camaraderie can continue once we are back home." — Hilary Schlinger, CNM, MS, CPM-retired |
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| “My first excitement of the ICM Congress came when I learned my abstract had been accepted, and I got to present “Reframing the Future: What Behavioral Economics Can Teach Us About Funding, Valuing, and Sustaining One Million More Midwives” to a full room. I wanted to offer something different to a conversation midwives have been having for years, especially around burnout — being asked to do everything for less pay and less respect than the work deserves.
Another special moment was sitting at the Congress dinner with midwives from the U.S., Tunisia, Jordan, Saudi Arabia, and Peru at my table while the rest of the room filled with midwives from dozens more countries; all of us off call for once, and all of us on the dance floor until they kicked us out. I also reunited with colleagues from Asociación Mexicana de Partería, and celebrated the news that professional midwives are now legal in every state in Mexico.
The flag ceremony brought the room to its feet for midwives working in war zones like Ukraine and Iran, a reminder of what this work actually costs some of our colleagues. And during plenary, an Indigenous midwife panelist stood, joined by Indigenous midwives from around the world on stage, challenging ICM’s decision to suspend its Indigenous midwifery partnership statement. To me, ICM does not see Indigenous midwives — not in its policies, and not in that room. Midwifery comes from Indigenous roots.
All of it is why I hope NACPM keeps international engagement on its agenda, especially initiating funding for CPM researchers. See you at the next Congress!” —Lauren French Hoy, MSM, LM, CPM |
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| "The reality for midwives in well-resourced countries and countries that have a history of colonization and resource extraction are vastly different. However, at the [Congress], I was struck by how similar issues are across countries: How to prepare midwife faculty to be better educators What conditions are needed for midwives to practice to their full scope How to stay clinically active when teaching or doing research How to avoid burnout How to uplift and support the next generation of midwifery leaders How to support midwifery students while they study and train, doing long clinical and on-call hours Where midwives will work and how do we create sustainable working conditions for this demanding profession How to build up the midwifery workforce to grow and sustain one million more midwives
The theoretical frameworks, original research, innovative approaches, lived experience, and ancestral knowledge shared by midwives from around the world working to solve these issues was mind-expanding. So many lessons to take away that we can directly apply to our work at Black Midwifery Collective.
3,000 midwives from across the world in one space. The energy was palpable and the vibes were fire!
This is not to say we agreed on everything. We did and do not. The discussion and the tension: These are what propel our movement for more midwives forward.
I want to give special mention to all the midwives who could not attend because they were on-call and caring for families, who were denied or delayed visas in time to attend, who couldn't afford to attend, and to the Indigenous Midwives who led from the front with resistance to decolonize midwifery.” — Nora Kropp, CPM, MPH |
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| Want to see photos, watch recordings, or read news about what happened each day at Congress? Access it all here. |
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| | Article: What is a Clinically Integrated Network? |
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| A new model for rural care: Across the heartland, many communities rely on small, independent health care practices that have to shoulder rising technology costs, workforce shortages and bureaucracy on their own. The Clinically Integrated Network (CIN) is emerging as a model of how to sustain those independent practices through formal collaboration.
Defining a CIN: A CIN is a group of independent providers—from primary care physicians and certified nurse midwives to pediatricians and OB-GYNs—who share clinical practices, patient information and data infrastructure to deliver coordinated care.
How it works: Providers convene either by geography or practice area and establish governance and legal structures for accountability. Over time, they may mature and reap financial benefits like stronger negotiating power with insurers.
Why now: The federal government’s Rural Health Transformation Program (RHTP) is now rolling out across the country, bringing $4.2 billion across the 20 heartland states in FY2025–26. CINs offer a strategy for regional collaboration, shared infrastructure and long-term sustainability that aligns with that federal effort.
The shift driving adoption: CINs give smaller and rural providers the shared infrastructure and care-coordination capabilities to move from fee-for-service toward value-based care—an approach shown to improve patient outcomes over the long term.
The big picture: As rural and independent providers face growing expectations to deliver coordinated, value-based care, CINs offer a realistic path to modern demands without sacrificing community ties—and states that invest in CIN infrastructure will be better positioned to deliver accessible, high-quality care across the heartland.
Read more |
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| | Birth Place Lab Publishes Updated MISS Scores |
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| Ten years after the original MISS assessment, the Birth Place Lab has released updated state rankings reflecting the current landscape of midwifery integration across the United States. The 2024 update captures significant policy changes, new licensure frameworks, expanded scope-of-practice legislation, and shifts in Medicaid coverage that have reshaped access to midwifery care since 2014–2015.
The Midwifery Integration Scoring System (MISS) rates key indicators of midwife integration in each U.S. state on a 50-item scale, with a maximum score of 100. A score of 100 would indicate that families in that state have full access to high-quality maternity care across all settings — homes, birth centers, and hospitals — without payer restrictions, and that all maternity care providers are regulated and practicing to their full scope. No state has yet achieved this standard.
The 2024 assessment reflects a decade of legislative activity, including new licensure in previously unregulated states, expanded Medicaid reimbursement, and updated scope-of-practice laws. The national average MISS score has risen from 35 in 2014–2015 to 51 in 2024 — meaningful progress, though significant gaps in access and equity remain. The highest-ranking state is now Maine (82); the lowest is Nebraska (23). |
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| | | Place Your Bid in the NACPM August Silent Auction |
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| This month’s NACPM Silent Auction is a collection of beautiful textiles. The collection celebrates the connection between textiles, tradition, motherhood, and community care. Curated by Malian midwife and NACPM Board Member Binta Niang, this package honors the ways communities across West Africa carry stories of resilience, creativity, and care through generations.
The collection includes: |
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| | Modern Babywearing Carrier Designed by Community Women in Bamako, Mali This baby carrier was designed and created by community women in Bamako, Mali. Machine-sewn from durable synthetic fabric, it is inspired by the timeless practice of keeping babies close through responsive, hands-free care. It represents the continuation of nurturing traditions while adapting to the practical needs of modern families. |
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| | Kente-Inspired Woven Textile (5 yards) A vibrant woven textile featuring bold geometric designs in orange, blue, and yellow tones, inspired by the beauty and visual language of traditional West African Kente textiles. Purchased in Mali, this 5-yard piece reflects the region’s appreciation for colorful woven fabrics used to celebrate identity, milestones, and special occasions. Its generous length makes it ideal for creating a special garment, ceremonial wear, home décor, or preserving as a statement textile piece. |
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| | Authentic Malian Mud Cloth (Bogolan) from Ségou A handwoven cotton textile created by local artisans using traditional weaving and dyeing techniques. Bogolan, also known as mud cloth, is a celebrated Malian textile art form created through a process using natural dyes and fermented mud. This approximately one-yard piece highlights the skill, creativity, and cultural heritage of Malian weavers and can be displayed as textile art or incorporated into a meaningful creative project. |
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| Together, these pieces represent the many ways communities care for one another — through art, storytelling, and the sacred work of supporting mothers and babies. This collection celebrates cultural heritage while honoring the values at the heart of midwifery: connection, compassion, continuity, and community. |
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| “As a midwife, educator, and NACPM Board Member, I have experienced firsthand the power of community-based midwifery to transform the lives of families. My own journey has crossed continents—from learning within the rich cultural traditions of West Africa to practicing, teaching, and advocating for midwifery in the United States… The textiles I am donating represent more than beautiful craftsmanship; they tell a story of culture, resilience, and the generations of women and birth workers who have carried knowledge, babies, and communities forward. They remind us that while every culture expresses birth differently, the values of compassion, skilled care, and community are universal.
I'm honored to support this month's auction because every bid helps NACPM continue advocating for Certified Professional Midwives, expanding access to community-based maternity care, developing future leaders, and preserving the legacy of our profession. By bidding on Carrying Culture: A Midwife's Gift from Mali, you are investing in something much larger than a collection of textiles. You are investing in the future of midwifery. — Binta Niang, LM |
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| | | Reminder to Submit Your Events! |
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| We welcome all NACPM Chapters and Partners to submit your events, updates, and happenings!
View Our Event Calendar. (If viewing on mobile device, hover over the gray calendar boxes.)
Submit Your Event. If you or others in your network/community are hosting relevant events, or events that offer CEUs to midwives, please share this form with them so we can feature the event on our calendar. |
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| | NACPM is proud to be supported by hundreds of individual donors and these visionary foundations. |
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