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