• ana.rapoport

California Nurse-Midwives Association

OCTOBER 2020 | Newsletter



Table of Contents:

National Midwifery Week 2

Recap of 9/26 Annual Meeting And A Farewell!! 3

Support Sarah Davis, LM for CA State Assembly, District 78 5

SB 1237 - What’s Next? 5

Midwives need full medical privileges! 6

Attention lapsed or new members! Flash sale Oct 5th to Oct 8th! 6

CNMA Stands with the Black Lives Matter Movement - Justice for Breonna Taylor 7

CNMA stands with whistleblower Dawn Wooten and condemns forced sterilizations 7

Spotlight on Antiracism 7

Midwives in the News 8

ACOG District IX Antiracism Webinar Series 8

Wisdom of A Midwife Docu-Series 8

Maternal Mental Health 8

Questions? News? Want to get involved? 9

National Midwifery Week

October 4-10th

Thank you to all the midwives and student midwives for your hard work and commitment to supporting birthing persons! We hope that you take time during this week to celebrate yourself and your colleagues.

During National Midwifery Week, CNMA would like to take this opportunity to acknowledge the huge contribution of our Licensed Midwife colleagues in their important role in maternal health in California. We appreciate the incredible dedication and steadfast commitment Licensed Midwives give every day to birthing individuals and their families!

Recap of 9/26 Annual Meeting And A Farewell!!

For those of you who attended the zoom meeting on 9/26, feel free to skip this portion of the newsletter! For those of you who were not in attendance, I wanted to provide a short recap and send a farewell to all of you!

We had approximately 175 individuals register for the meeting and approximately 126 joined. This was the largest Annual meeting we've ever had! If you attended please follow this link to complete the Continuing Education Evaluation, please keep in mind that this evaluation needs to be completed by October 5th to receive your CE certificate. All certificates will be sent out after the October 5th deadline.

If you were unable to make it, you can view the recording of the meeting here. The meeting agenda can be found here. You can still receive CEs for listening to the educational portion of the meeting as long as you complete the Continuing Education Evaluation

by October 5th.

Every CNM in the state should take the time to watch the educational portion by Ana Delgado and the panelists. You can find just Ana's presentation and the panel here. CNMA thanks them for sharing their incredible knowledge and personal stories.

The Meeting was a time for celebration but we began with reflection over the past year. It was important for us to collectively acknowledge the challenges and devastation that the year 2020 has been. These challenges include a pandemic, fire storms raging, police brutality, killing of innocent individuals, ongoing intolerable injustices to black people and communities of color, a toxic political environment, and individuals living in perpetual fear.

We took time to acknowledge some very recent and devastating but not unexpected events. We've witnessed the unwillingness of the Grand Jury to indict the individuals responsible for the murder of Breonna Taylor; we've witnessed the strength and courage of Nurse Dawn Wooten, the ICE whistleblower; and we acknowledged the devastating reality of Ruth Bader Ginsburg’s passing. A moment of silence was shared.

While acknowledging these events, we also recognized the ongoing collective strength & resilience that we have always seen and will continue to see from communities that are most impacted by this ongoing oppression. We thanked the midwives of color who have engaged with CNMA and we will continue to work to earn their trust and listen to their voices. Going forward, if we fail at this in any way, please reach out to one of us.

For all that 2020 has been, it will also always remain the year that we succeeded in removing the grinding and unrelenting weight of physician permission to practice. This is a monumental and unprecedented time for all nurse-midwives, aspiring midwives, & the communities we serve. In this process, given all these difficulties, we have seen the best our team and all of you have had to offer. We also see this in our country with the loud outcries, the calls to action, the protests, and the outrage. This gives me some faith that we have the ability to rise above many of these seemingly unsurmountable challenges; and for that, I am grateful.

Speaking from my perspective as your outgoing President, I could not be more proud of the work we have collectively accomplished. In saying this, I am speaking for ALL the individuals who have fought for change in our organization and their communities for decades. As Holly said, this Board is privileged to be here at this celebratory moment, but this is because of the work of so many who have come before us. I want to take this opportunity to thank all of them.

The Transition of the Board of Directors:

Individuals leaving the Board:

Rebecca Garrett-Brown: So Cal Rep

Ana Rapaport: Nor Cal Rep

Evelynn Dronberger: Student Rep CSUF

Kathleen Belzer: President to Immediate Past President

Individuals joining the Board:

Maria Ramos: Board Representative

Brittany Edwards: Board Representative

Mayra Lizzette Yniguez and Elena Gutierrez: Student Representative (Shared UCSF role)

This will be a voting position going forward

Paris Maloof Bury: Incoming President transitioning to President

Current & Ongoing Board Members:

Jyesha Wren: Reproductive Justice/Anti-Racism Advisory Committee Chair and voting Board member

Ali Young: Secretary

Elizabeth Smith: Treasurer (2nd term)

Jillian Cauley: Nor Cal Rep/Annual meeting planning Chair

Betsy Jenkins: So Cal Rep

Maribeth Claassen: Central Cal Rep

Committee Chairs:

Holly Smith: HP Chair

Liz Donnelly: Vice HP Chair

Emily Carter: Membership

Jyesha Wren: Reproductive Justice/Anti-Racism Advisory Committee Chair

Ana Delgado: Reproductive Justice/Anti-Racism Advisory Committee Vice Chair

Ana Rapoport: SM Chair (Newsletter & Email blasts)

Elizabeth Kicko: Webmaster (CNMA and California Nurse-Midwives Foundation).

Kathy Heilig: Bylaws Chair

I am grateful to our team of talented & brilliant individuals that I have learned so much from. For me personally, the work of CNMA has been my ‘baby’ for the last few years. This work included

the passing of SB 1237, starting our new Foundation and funding essential projects, the birth of the Reproductive Justice/Anti-Racism Advisory Committee, and rewriting our bylaws to begin to address the racism that exists. This work has been my reason to forge on and get out of bed every day through this unprecedented time.

As I transition from this role, it is impossible to express my feelings. It has been an honor and a pleasure; I thank you for this opportunity to serve. This team is the most dedicated and hardworking group of volunteers I have ever encountered and each individual has contributed in such meaningful and impactful ways. I have gained SO much from each of you. I especially GIVE thanks to Holly Smith who has been my ‘CNMA wife’ of the last two years!

I am thrilled to hand over the reigns to Paris who brings such passion, vision, and determination to this role. Your new Board is a much more diverse Board than we have ever seen. In fulfilling our revised Bylaws, we now have three positions that are filled by historically underrepresented groups. It is with great pleasure that I welcome these new Board members. They will bring

diverse voices and perspectives. We will not only LISTEN to their important voices, but we will CENTER our work going forward around their perspectives and guidance.

With Gratitude,

Kathleen Belzer (your CNMA Immediate Past President as of today!!)

Support Sarah Davis, LM for CA State Assembly, District 78

CNMA has officially endorsed Sarah Davis for Assembly District 78 (includes La Jolla, Del Mar, Torrey Pines, San Diego, Coronado, etc). What better way to support National Midwifery Week than to support a Licensed Midwife running for the California Legislature? You don’t have to be from this district to attend – all of California will benefit from Sarah’s expertise and leadership in Sacramento. Join our Virtual Fundraiser and Conversation with Sarah Davis, LM.

When : Thursday, October 8 @ 6:30pm

More Info and Registration Here

SB 1237 - What’s Next?

SB 1237 – the Dignity & Equity in Maternity Care Act – was signed into law by Governor Newsom on September 18! California is no longer a supervision state for CNMs!

Additionally, AB 890 (AKA the “Nurse Practitioner Bill”) was also signed this week. It has truly been the “Year of the Nurse and the Midwife.”

So now what? Well, we have work to do! The law takes effect January 1, 2021. No time can be wasted – everyone must understand what the new law entails in order to operationalize how their practice, hospital, and/or system will ultimately come into compliance. CNMA will be hosting various webinars and meetings, as well as “office hours” to give personalized technical assistance to solo CNMs, medical groups, birth centers, hospitals/systems as needed. Look for upcoming messages regarding dates/times of these events in October, November, and December. In the meantime, you can view the annual meeting here, for a quick primer on the bill; or go here for a short Q&A to serve as your “Quick Start Guide.” This document will be continually updated. If you have questions you would like added to this document, please contact advocacy@cnma.org.


Now that SB1237 has passed, it is time for us to take the next step toward full practice autonomy in this state--and across the country! While SB1237 allows us to practice without physician supervision (permission), it does not guarantee that hospitals will grant us privileges, or that we'll have a seat at the table when decisions are made about policies that affect us. It is time for midwives to be full partners in maternity care in U.S. hospitals.

The National Government Affairs Committee's Subcommittee on Privileging is actively working to seek legislative sponsors to introduce a bill that will mandate full medical staff privileges for qualified certified nurse-midwives in every hospital that receives Medicare reimbursement. This is power! This is a seat at the table! But this means we need your help.

Please use this link to write to your representatives TODAY! Tell them that we're here, we're ready to care for women and families, we just need a guaranteed seat at the table. And while you're at it, ask your family, friends, and other healthcare colleagues to do the same. Let's keep this momentum going!

Attention lapsed or new members! Flash sale Oct 5th to Oct 8th!

We have joined ACNM in offering a 30% discount on dues for joining or renewing from October 5th to October 8th. This means that you will get 30% off both ACNM membership AND CNMA membership! To take advantage of this offer, go to ACNMs website and use discount code NWM30 at checkout. But this offer will only be available from Oct 5th and will expire on Oct 8th, so don’t delay!

Additionally, we are still offering FREE California affiliate dues for midwives of color through December 2020 with discount code CA2020. You may use both discounts by entering the first code and clicking apply, then entering the second code and clicking apply. If you have any issues, please reach out to ACNM directly.

CNMA Stands with the Black Lives Matter Movement - Justice for Breonna Taylor

A grand jury indicted a former Louisville police officer on Wednesday for wanton endangerment for his actions that killed Breonna Taylor, a Black medical worker who was shot and killed by police officers in March during a botched raid on her apartment. No charges were announced against the other two officers who fired shots, and no one was charged for causing Ms. Taylor’s death. (See NYT coverage here or listen to the podcast of their reporting here. Read Tressie Cottom's gut wrenching response here.)

We oppose this grand jury’s decision and stand with Breonna Taylor and the Black Lives Matter Movement in demanding justice be served for the killing of an innocent woman. We recognize this ruling causes further pain and trauma for the black community. We encourage you to support the foundation in Breonna’s honor supporting police reform, black youth engagement, scholarships for black youth seeking medical careers and support for black women business owners.

CNMA stands with whistleblower Dawn Wooten and condemns forced sterilizations

In early September whistleblower Dawn Wooten revealed people held by ICE in the Irwin County Detention Center, privately owned and operated by LaSalle Corrections, in Ocilla, Georgia were subject to forced hysterectomies. CNMA condemns this horrific human rights violation. We recognize reproductive control as a tool of white supremacy and that eugenic practices such as forced sterilizations, and coercive birth control policies and practices have a long history that extends into current day practices. We recognize that this legacy and the current incarnations cause continued harm to our BIPOC clients, colleagues and community members. We encourage our members to: sign the Sister Song Statement, Uplift and support organizing work by Georgia reproductive justice and imigration justice organizations

Spotlight on Antiracism

CNMA is working towards becoming an antiracist organization. In 2019 new bylaws were approved that recognize CNMA’s responsibility to actively address racism and the resulting health inequalities suffered by communities of color. Importantly, we must actively support efforts to increase racial diversity in our profession while engaging actively in self-education. “Spotlight on Antiracism” is a new section of the newsletter where you will find a monthly educational offering. We encourage our membership to check it out and share widely in your workplaces.

So far we have explored white privilege with the classic, White Privilege: Unpacking the Invisible Knapsack, by Peggy McIntosh, and last month we recommended our members go deeper by exploring the tenants of white supremacy culture and their antidotes in Tema Okun’s work: white supremacy culture. This month we are looking to explore how white supremacy culture has harmed people of color and created intergenerational trauma.

Midwives in the News

Check out incoming CNMA Board Member, María Ramos Bracmontes’ feature in Quickening!

ACOG DIstrict IX Antiracism Webinar Series

Sponsored by Section 2. Kameelah Phillips, MD, FACOG, IBCLC will be presenting a talk titled "History of Racism in Gynecology: What You Wish You Learned in Residency" on Thursday, October 8, 2020 from 6-7 pm PDT.

Guest speaker Dr. Kameelah Phillips is the founder of Calla Women's Health in Manhattan, New York. Her interests include Minority Women's Health and health care disparities, lactation, sexual and menopause medicine. Dr. Phillips is leading the way to bring attention to the racist roots of gynecology and why we should rename the Sims instrument as "Lucy."

You can follow her on Instagram @drkameelahsays

Please register for this Zoom webinar at the following link:


After registering, you will receive a confirmation email containing information about joining the meeting.

Wisdom of A Midwife Docu-Series

California Homebirth Midwife Yelena Kolodji has a collection of interviews with midwives sharing their perspective on the role and importance of midwifery care. Check out these inspiring interviews here. One features CNMA Health Policy member and CNMF (Foundation) member, Kavita Noble!

Maternal Mental Health

Do you ever want expert advice when counseling your patients in their mental health needs? You can get Free Perinatal Psychiatric Consultation Services from Dr Miriam Schultz. See HERE.

There is also a Free Zoom Support Meeting offered to your patients and clients.

For Spanish speaking clients: Tuesdays at 1-1:45. See Flyer HERE

For English speaking clients: Tuesdays at 2-2:45. See Flyer HERE.

The services below are provided by Common Spirit Health/Dignity Health

Questions? News? Want to get involved?

Email us at info@cnma.org

That's all for this month's issue. Catch you next time!


Visit us at cnma.org

This newsletter will be archived on our website at cnma.org/news

  • ana.rapoport

Updated: Oct 12




Annual Meeting Update

Membership Update

CNMA Stands with the Black Lives Matter Movement - We Demand Justice for Jacob Blake.

Spotlight on Anti-Racism

Anti-Racist Strategies for White Midwives: Tools for Self-Examination & Action

CDPH Birth Related All County Letters

Frontline Doula Hotline from Black Women's Birthing Justice

Maternal and Child Health Access

California Health Care Foundation: My Birth Matters Materials

New Learning Series on Midwifery-Led Care in Medicaid

Questions? News? Want to get involved?


We are thrilled to inform everyone that SB 1237 was voted on in the Assembly and the Senate on 8/31 and it passed both houses. Thank you to each and every one of you who supported this process. We can all take a deep breath for the moment!! One final step is a signature from the Governor which usually occurs within 30 days of passage. Most bills go into effect on January 1st of the following year.

One immediate and hugely impactful change will be that small business owner CNMs in the community setting will no longer need a supervisory agreement with an MD. It took us 4 bills and 5 years to get here, but WE DID IT!! Your CNMA leadership team knows there is a lot of work to do in the implementation of this legislation and we will work with the BRN and other stakeholders to ensure they understand all the important nuances of CNM practice in CA. Please join us for our Virtual Annual Meeting on 9/26 so we can share more information about this process and celebrate the passing of the bill with all of you!!!

Kathleen Belzer, CNMA President

Holly Smith, CNMA HP Chair

Paris Maloof-Bury, CNMA President Elect

Liz Donnelly, CNMA HP Vice Chair

Annual Meeting Update

Please Note Change of Annual Meeting Date:

September 26, 2020, 10:00 AM - 12:30 PM

!!Mark Your Calendars!!

Registration to Follow Soon

This change was made because Rosh Hashanah is Sept 19th

Our CNMA Annual Meeting will be held virtually this year. We look forward to celebrating the passage of SB1237 (fingers crossed), and doing a deep dive into what the Justice and Equity in Maternity Care Act will mean for midwives in California. We will also be offering an educational component, complete with 1 CEU focused on antiracism in midwifery. We look forward to seeing you there!

Membership Update

Join CNMA today! Being a member has many benefits including access to your local chapter meetings, CEU materials, reduced rates to annual meetings, and most importantly, an entire state-wide group of volunteer midwives working hard every day to improve the lives of all CA midwives and advocate for our profession and our clients! Your dues will directly fund our legislative efforts, specifically the passing of our bill SB 1237 to remove physician supervision, as well as anti-racism efforts to reduce disparities within our communities. Visit https://www.midwife.org/join-acnm to join today!!

CNMA recognizes that engagement by and leadership from midwives of color is integral to the development and advancement of the midwifery profession. Midwives of color use the discount code CA2020 to get free CNMA membership through the end of 2020.

Attention students and retirees! Your involvement in CNMA is truly invaluable. Therefore, we have reduced our student and retiree rates. Student rates have been dropped to $60 and retiree rates have been dropped to $50. Join today!

If you have any questions, please email our membership chair, Emily Carter at membership@CNMA.org

CNMA Stands with the Black Lives Matter Movement - We Demand Justice for Jacob Blake.

Last week, another Black man was shot by police in an act of state-sanctioned, racist violence. Jacob Blake's life matters, and we stand in solidarity with Jacob in his fight to heal, with his children and family as they are dealing with this trauma, and with our Black sisters and brothers across this country. But our thoughts and prayers are not enough.

Here in California, non-Black midwives of all racial identities must work nationally and locally to prevent and mitigate the harm experienced by our Black family, friends, colleagues and community members. We must examine ourselves through reflection, humility, and honesty to recognize how each of us participates in racism, and then interrupt those patterns of white supremacy within ourselves.

We can take simple actions today: remaining vigilant to the obvious or subtle injustices experienced by the clients we serve so that we can effectively advocate for our clients both clinically and within our communities. We can create space for our clients to express their frustration and pain at what is (and has been) happening in our country. We can offer evidence-based strategies to help heal the trauma caused by toxic racism that we know increases risks for mortality and morbidity. We can put our bodies and our time on the line by joining in protests with Black Lives Matter. We can donate money and resources to the Black-led organizations that are doing this work. We must also commit to the long term practice of antiracism work. We must do the hard internal work to uproot unrecognized bias and to commit to diversification of our profession. And we can listen to the voices of Black midwives and follow their leadership.

Michelle Drew, DNP, MPH, CNM, FNP-C, the Chair of the ACNM Caucus of Black Midwives for Reproductive Justice, recently posted the following message on ACNM Townhall.We encourage all our members to read “We're so Tired Thoughts for our Wisconsin Colleagues.”

Michelle and others on the Caucus are working within ACNM to advocate for Black midwives, and for the Black families and individuals we all serve. If you identify as a Black midwife, please consider joining the Caucus. They are leaders in the work that our profession so desperately needs.

Take action today:

Call local officials and demand justice:

Kenosha City Attorney: 262-653-4170

Kenosha Mayor and City Administration: 262-653-4000

Wisconsin Department of Justice: (608) 266-1221

Kenosha Police Non Emergency Line: 262-656-1234

Sign the petition demanding the cops who shot Blake be charged.

Donate to Bail Fund for protestors in WI

Donate to Blake's Family and healthcare fund.

Commit to Long Term Antiracist Action and self reflection:

Spotlight on Anti-Racism

CNMA is working towards becoming an antiracist organization. In 2019 new bylaws were approved that recognize CNMA’s responsibility to actively address racism and the resulting health inequalities suffered by communities of color. Importantly, we must actively support efforts to increase racial diversity in our profession while engaging actively in self-education. “Spotlight on Antiracism” is a new section of the newsletter where you will find a monthly educational offering. We encourage our membership to check it out and share widely in your workplaces.

Last month we explored white privileges with the classic, White Privilege: Unpacking the Invisible Knapsack, by Peggy McIntosh. This month we recommend our members go deeper by exploring the tenants of white supremacy culture and their antidotes in Tema Okun’s work: white supremacy culture. This is again a classic work, first developed in 2001 the concepts continue to be deeply relevant & is also a very quick read.

As you engage with the reading we invite you to explore how you see the tenants of white supremacy culture: perfectionism, sense of urgency, defensiveness, quantity over quality, worship of the written word, only one right way, paternalism, either/or thinking, power hoarding, fear of open conflict, individualism, i’m the only one, progress is bigger/more, objectivity, and right to comfort show up in your family in your practice, in CNMA and in ACNM and consider how you can best shift these tenants when you see them show up!

Anti-Racist Strategies for White Midwives: Tools for Self-Examination & Action

Liz Donnelly, CNM, WHNP-BC, Kara Myers, CNM, MS, FACH, and Signy Toquinto, CNM, WHNP, MS, MA

View the Recording (ACNM membership login required)

Recently, California CNMs, Liz Donnelly, Kara Myers and Signy Toquinto gave the following presentation through ACNM. If you missed it, please plan to watch this presentation. They did an amazing job and this is critical work that all white-identified midwives need to undertake. CNMA expresses our gratitude to them for their depth of understanding and their personal conviction to addressing racism in midwifery, our society and our health care organizations.

CDPH Birth Related All County Letters

Please see an open letter from CDPH regarding changes to the Electronic Birth Registration System (EBRS) and the Certificate of Live Birth (VS 10D) HERE. (There are also many other important referenced CDPH attachments HERE). This is especially important for community-based and small business owner CNMs. Feel free to contact the CDPH to ensure you are getting all the necessary open letters and communications.

Frontline Doula Hotline

From Black Women's Birthing Justice

Free Virtual Doula Help HERE.

From Dr. Sayida Peprah of Black Women's Birthing Justice: ‘Pregnant Black Mamas! FRONTLINE DOULA HOTLINE GOES LIVE AUGUST 21ST!!!!’

Maternal and Child Health Access

This information is from Lynn Kersey from Maternal and Child Health Access.

As of August 1, eligibility for Medi-Cal or MCAP can be extended an additional ten months for people diagnosed with a maternal mental health condition, such as anxiety, depression, or bipolar disease.

This means that Medi-Cal or MCAP coverage continues for a full year for pregnant patients - experiencing miscarriage, abortion or birth - who have a diagnosed mental health condition during pregnancy or post delivery. MCAP will not charge premiums for the additional ten months of coverage.

Please see more information HERE

California Health Care Foundation: My Birth Matters Materials

The California Health Care Foundation (CHCF) would like to help you reach as many lower-income pregnant people in California as possible with the My Birth Matters materials. To do so, CHCF is currently providing funding to print and ship limited quantities of the campaign's brochure and poster to organizations that reach pregnant women in California.

These materials are available in 11 languages.

Below are the details on how to place your order:

  1. Go to this website: https://www.asbaces.com/newaces/default.aspx?uid=hes-po (You may need to cut and paste the URL.)

  2. Click on "variable print on demand."

  3. Choose the brochure or poster, choose your desired language, accept the "proof," and choose your quantity. Even though a price will be shown, you will not be billed; as stated above, CHCF is funding the printing and shipping.

  4. You can then add additional languages and/or the additional print file that you did not originally choose (brochure vs poster).

  5. When you check out, you'll be asked for your shipping information. You will not be asked for payment information at any point even though a cost is shown.

New Learning Series on Midwifery-Led Care in Medicaid

The Institute for Medicaid Innovation has created a New Learning Series on Midwifery-Led Care in Medicaid, focusing on Leveraging Midwifery-Led Care to address Disparities and Equity in Medicaid.

Please see HERE for details.

Questions? News? Want to get involved?

Email us at info@cnma.org

That's all for this month's issue. Catch you next time!


Visit us at cnma.org

Subscribe to your newsletter.

This newsletter will be archived on our website at cnma.org/news

  • ana.rapoport


SB1237 Townhall 2

Virtual Lobby Day 2

Annual Meeting Announcement. 3

Spotlight on Anti-Racism 3

Welcome New Officers! 4

Birthing People’s Bill of Rights 5

CHCF Health Care Leadership Program 5

Amendments to SB 1237 6

Questions? News? Want to get involved?8

SB1237 Townhall

For general information on the bill and its amendments, and a Q&A session, join us for the SB 1237 Townhall on Tuesday Aug 4 at 7:30-8:30pm. We will address some misinformation that has been circulating about what the bill does and does not do. Register for the Townhall here (note this is NOT lobby day registration, please do that separately).

Virtual Lobby Day

Please join the California Nurse-Midwives Association for Virtual Lobby Day on Thursday August 13th! Like in past years, Lobby Day is extremely important for your legislator to hear about our bill and (hopefully) vote “aye” on the Assembly Floor when the bill gets there toward the end of August!

Registration closes on Thursday August 6th! Register now!

As you probably know, SB 1237 (Dodd/Burke/Mitchell) The Equity & Justice in Maternity Care Act has passed the Senate and is making its way through the Assembly committees! The final lobby day push will be the Assembly Floor Vote expected the week of August 17th. We are so close!! Because we cannot lobby in person this year, we are instead focusing on a virtual event. Luckily this means Lobby Day is even easier than in previous years! We will give you instructions ahead of time, so don’t worry if you don’t have experience. Since this is a virtual event, there is no Lobby Day registration fee. Please consider donating to CNMA or CNMF.

Here’s how it works:

  1. Register for Lobby Day here.

  2. We will assign you to a lobby day visit with other people in your district between 9am-5pm on THURSDAY AUGUST 13th, and will notify you of that visit after it is confirmed.

  3. This visit will be 30 minutes long via Zoom conferencing with others in your district. CNMA leadership will be available for many of these calls. Many of you have done lobby day in the past and are well prepared for this. Others who have not done a lobby day, or are “singles” (e.g. in the cases where we find out that no one else from your district is signing up), you will be paired with a CNMA leader. A Lobby Day Preparation Session will be held August 10th from 7:30 - 8:30pm, link will be included in your confirmation email for your individual visit.

  4. Go to cnma.org/today for information on how to participate in the other virtual events happening on August13th, 14th, and the week after. These events include:

  • Calling your legislator and urging their support for SB 1237 when it gets to the Assembly floor

  • Lifting up SB 1237 on social media and tagging your legislator

Annual Meeting Announcement.

As you all know, our August annual meeting was canceled due to COVID, but according to our Bylaws, we must have a yearly meeting. Thus, we will be scheduling an abbreviated meeting that will contain important and pertinent information, including the introduction of our new Board members.

This is your official **SAVE THE DATE** for the 2020 Annual meeting on September 19th.

This will obviously be a virtual event. Time is yet to be determined. Stay tuned for more details to follow.

We hope to reschedule our in-person event in early 2021 if that is feasible given the world we all live in now.

Spotlight on Anti-Racism

CNMA is working towards becoming an antiracist organization. In 2019 new bylaws were approved that recognize CNMA’s responsibility to actively address racism and the resulting health inequalities suffered by communities of color. Importantly, we must actively support efforts to increase racial diversity in our profession while engaging actively in self-education. “Spotlight on Antiracism” is a new section of the newsletter where you will find a monthly educational offering. We encourage our membership to check it out and share widely in your workplaces.

This month we start with a classic, White Privilege: Unpacking the Invisible Knapsack, by Peggy McIntosh. In an excerpt from McIntosh’s 1988 paper "White Privilege and Male Privilege: A Personal Account of Coming To See Correspondences through Work in Women's Studies", the essay lays out clearly how white privilege manifests in the daily lives of white Americans. It’s a short read! We encourage our white membership to take a look and discuss it with your white colleagues. We challenge you to consider the following statement, just as McIntosh does in her essay: “Describing white privilege makes one newly accountable... having described it, what will I do to lessen or end it?" What will you do to lessen or end white privilege?

Welcome New Officers!

Maria Ramos Bracamontes Brittany Edwards Elizabeth Smith

CNMA is thrilled to announce our new BOD members!!

We are grateful to Elizabeth Smith who will be staying on as our Treasurer. The CNMA BOD would like to thank her for continuing in this role and for her service over the past two years.

We welcome Brittany Edwards (Fresno,CA); and Maria Ramos Bracamontes (Watsonville, CA). They will be starting in the Fall and we look forward to their voices and perspectives with open hearts and minds. We thank them for stepping up to serve on the CNMA Board and represent the CNMs and the birthing individuals in their communities. I wish to express my heartfelt gratitude to both of them.

As the out-going President, I also want to take this opportunity to thank all the incredible Board and committee members for their engagement and hard work over the last few years. We will continue to have important work to do, but we have collectively accomplished so much! This would not have been possible without the overwhelming degree of commitment of all our Board and committee members.

If you would like to get involved in CNMA, please reach out to me personally.

Kathleen Belzer, CNMA President.


Birthing People’s Bill of Rights

CNMA has been working with a coalition of advocacy groups to address equity issues in this time of Covid. The coalition is called the California Covid-19 Birth Justice Group. This group includes many partners who are working to create necessary change.This was started by the amazing Nourbese Flint from Black Women for Wellness. She is tireless and the vision that she laid out includes surveying and collecting the stories of individuals who are pregnant or have given birth during Covid, creating a Birthing People’s Bill of Rights to inform and educate birthing individuals and their families about their fundamental rights. Lastly, the group hopes to make recommendations to policy makers and those in governance. Please distribute the Birthing People’s Bill of Rights to your communities. https://www.bwwactionproject.org/pregnantbillofrights/

CHCF Health Care Leadership Program

Hello maternity colleagues in California---

Just reminding you all of this opportunity before the summer gets away from us! Please consider applying if you have not yet been a fellow and please pass along to others. The CHCF Health Care Leadership Program is a great opportunity for learning and networking! We are especially looking for providers of color and providers in the Central Valley and SoCal (notably LA and Inland Empire).

About the opportunity and eligibility to apply here.

And an update on deadlines and other program changes during COVID: Given the state of the world and the need for uplifting and visionary leaders, we

believe now may be the best time ever to participate in the CHCF Health Care Leadership Program. While we recognize that it’s an extraordinarily difficult time for clinicians to take on additional responsibilities, we truly believe this program will inspire, transform, and energize. Additionally, the program will provide a robust peer network to help overcome isolation and navigate change and progress. And if financial concerns are top of mind, this year we are able to offer significant tuition assistance. Please share this information. We appreciate your partnership!

Amendments to SB 1237

Most of you are aware that SB 1237 has gone through a few rounds of amendments. These amendments are reflections of our work to hear the concerns of our members, various stakeholders, committee recommendations, as well as making our own improvements to the bill. The bill language can be viewed here.

The following is a list of amendments by section of the bill:

Section 3.

  • Requires the BRN to name the Nurse-Midwifery Advisory Committee. This committee already exists and meets a couple times a year. This amendment would make the existence of the committee mandatory.

  • Increases the number of physicians to 2, and the number of CNMs to 4. Also one public member is required

  • The NMAC will make recommendations to the board on all matters related to midwifery practice, education, appropriate standard of care, and other matters as specified by the board

  • The NMAC will provide recommendations or guidance on care when the board is considering disciplinary action against a certified nurse-midwife.

Section 4

  • Subsection (a) Creates a specific “low-risk” scope for CNMs that requires no written guidelines, policies, or even standardized procedures for furnishing medication

  • Adds “interconception care” to our scope of practice, which is not currently in statute.

  • For patients with conditions that arise from or before the pregnancy, the language gives the CNM autonomy to decide whether a patient’s condition falls within the core competencies of the ACNM in order to determine whether the CNM can address said condition or whether the patient should be transferred from their care, or co-managed with a physician.

  • A recent amendment was added to note that CNMs practicing solely within the scope delineated in subsection (a) of Section 4 are in no way required to have any

  • signed agreements, signed policies or protocols, or any other written document with a physician

  • Subsection (b) Gives all CNMs, regardless of practice location the ability, if they wish, to collaboratively manage and attend the birth of higher risk patients, or to give gyn care that falls out of the delineated scope in subsection (a). To do so, the CNM must have written/signed, mutually-developed policies and protocols with a physician that delineate the parameters for consultation, collaboration, referral, and transfer of a patient’s care (just as CNMs have now for the care of patients who require co-management).

  • Written guidelines for the collaborative care of clients is a standard of professional practice by the American College of Nurse-Midwives. You can find that standard here (see Standard V). These written guidelines are not the same as collaborative practice agreements, and should not be confused as such. The ACNM’s description of collaborative practice agreements can be found here (such a thing is not included in the bill!), and page 2 explains the difference between collaborative practice agreements and written, mutually-agreed upon guidelines with physicians for collaborative management

  • Intrapartum and birth care of patients with a previous cesarean falls under “collaborative management” with a physician, but can occur in any setting. Prenatal care of clients with a previous cesarean falls under the delineated low risk scope described in subsection (a).

  • In the community birth setting, the amendment in subsection (c)(2) allows for certain patients in very advanced labor (e.g., transitioning or pushing) to remain in the care of the CNM even though they may have crossed over the 42 week threshold, but have no other medical conditions that would require transfer to the hospital

  • A patient autonomy section has been added to subsection (e), stating: “This section shall not be interpreted to deny a patient’s right to self-determination or informed decision making with regard to choice of provider or birth setting.”

Section 5

  • Allows for furnishing of medications for the scope of services delineated in Section 4 (a) without standardized procedures (!)

  • Allows for furnishing of medications outside of the scope delineated in Section 4 (a) with standardized procedures, as CNMs are currently have.

  • Standardized procedures are necessary for all scheduled medications (Schedule II-V), regardless of whether it falls within the scope of services in Section 4(a).

Section 6

  • No changes here. Allows for episiotomy and repair of lacerations in all settings, including the home and without standardized procedures.

Section 7

  • Includes the required patients disclosures for out of hospital birth

Section 8

  • The current language for this Section is placeholder language only. This language is being updated to reflect a streamlined data collection for out of hospital birth that will rely heavily on what community CNMs already submit via vital records (birth certificates), and will add some supplemental information about patient transfers to the hospital setting.

Questions? News? Want to get involved?

Email us at info@cnma.org

That's all for this month's issue. Catch you next time!


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