Welcome to February and to Black History Month! I hope you’ll join me in celebrating those who have come before us, and in honoring the roots of American Midwifery. As a reminder, our profession was not born in Kentucky. If you haven’t yet, be sure to read Into the Light of Day and Listen to me Good: The life story of an Alabama midwife, both by Linda Janet Holmes. And while you’re at it, keep up with the powerful Reproductive Justice work being done today by groups like SisterSong, Black Mamas Matter Alliance, Black Women for Wellness, and ACNM’s Midwives of Color Committee. As I think about Black History Month, I can’t help but also reflect upon our profession, and how much we owe to Black Midwives.

But there is a dark side to the intersection of midwifery and medicine. Collectively, we have just survived the historic year of 2020: the year that the World Health Organization deemed the Year of the Nurse and the Midwife; the very year that a once-in-a-century pandemic brought to a standstill; and the same year that people gathered together in unprecedented numbers to cross color lines in protest of the perpetual murder of Black people by police. 2020 marked the 200th anniversary of Florence Nightingale's birth, a pioneer in nursing whose work was tainted by racism and white supremacy, and whose colonialist leanings have undeniably shaped modern healthcare and contribute to the racism-based disparities that permeate our systems to this day. In Decolonising the Nursing Profession, Timothy Carey explores this legacy, which we as nurse-midwives are heir to.

This is more than our history; it is our debt. We have the duty to look at, to examine, and to dismantle those parts of our profession that still do harm; and to build, strengthen, and uplift every opportunity for equity and for justice. I hope you’ll join me this month--and every month--in doing the work of antiracism, of rebuilding midwifery, and of finally giving birth to the world we’ve been dreaming of. Here’s to Black Midwives.

Paris Maloof-Bury, CNM, IBCLC

President, California Nurse-Midwives Association

CNMA Webinar

The latest SB-1237 webinar is finally finished and ready for you to view! This video is especially helpful for hospitals, administrators, and healthcare leaders who are considering integrating midwives into their systems. Please share widely and help us scale up access to midwifery in California!

CNMA Midwife Survey

As we work to implement SB 1237, we want to make sure we are taking direction from you, the midwives of California. We hope you will take a moment (we think it will take ~10min) to fill out this survey to help us to understand the specific areas where you hope CNMA will take action to better serve you, the midwifery profession, and most importantly the people, families and communities we serve.

COVID-19 Vaccine Updates

COVID-19 Vaccine for Midwives Working in Community-Based Birth

CNMA is actively working with the California Department of Public Health (CDPH) to streamline the process for midwives working in the out-of-hospital setting to receive the COVID-19 vaccine. At this time, CDPH recommends that community-based midwives reach out to their local health department for specific timelines on vaccine distribution as well as healthcare prioritization of vaccines. We have been informed that community-based midwives do indeed fall under Tier 2 of Phase 1a, however, this may still require education and advocacy with each local health department. Please email me directly at parisbury@gmail.com to let me know about your successes/challenges with this process, so that CNMA can continue to advocate for your access to the vaccine.

Find a Vaccine for Yourself or for a Loved One

VaccinateCA is a community-driven effort to help Californians learn accurate, up-to-date, verified information about the coronavirus vaccine, so they can learn when they will be eligible and how to take their place in line. They have put together this website to help individuals find and get COVID-19 vaccines.

Updates on Medi-Cal Rx

Medi-Cal Rx is the transition of all administrative services related to Medi-Cal pharmacy benefits billed on pharmacy claims from the existing intermediaries to the new Medi-Cal Rx vendor, Magellan Medicaid Administration, Inc. This transition goes into effect April 1, 2021.

Please read the following Provider Testing Notification for more information on submitting claims. Information can be found here on Electronic Funds Transfer and Set-Up and Opt-Out.

Update and Corrections to our Spotlight on Anti-Racism for Black History Month

This month’s spotlight on anti-racism has been updated due to language and inaccuracies that understated the role that descendants of enslaved Africans played in bringing midwifery to the North American continent, and to white women’s role in the displacement of Black midwives for their own financial and social gain. We at CNMA would like to apologize for the use of the offensive term “Granny” in the original piece, as well as for our incomplete narrative that failed to fully represent the significant work done by the Grand Midwives or the level of oppression they were subjected to by members of our own profession.

We would like to thank the ACNM Midwives of Color Committee (MOCC) and Michelle Drew, CNM, MPH, FNP, DNP for taking the time to edit, correct, and addend our original post. Dr. Drew has brought to light additional history we were not aware of and helped us see more clearly how we can do better. We appreciate all that Dr. Drew brings to midwifery, and the wealth of knowledge she has and that she shares.

We acknowledge that the history of nurse-midwifery is steeped in racism and eugenics. ACNM and CNMA have a lot of work to do to atone for that legacy, and to course-correct the path that led to today’s racism-based disparities in healthcare. Our antiracism work as an affiliate is a work in progress, to which we are humbly dedicated.

This post is now housed in Quickening, and the language is available for you to read below.

Black History Month: Honoring Black Grand Midwives and Supporting Black Midwives Today

By Quickening -February 18, 2021

This Black History Month, The ACNM Midwives of Color Committee (MOCC) and Black Midwives Caucus want to uplift and celebrate the importance of Black Grand midwives and the important roles they played in both caring for their communities and keeping midwifery tradition and skills alive in the United States. We encourage you to learn about Mary Coley, Onnie Lee Logan, Margaret Charles Smith, Biddy Mason, and Gladys Nichols Milton. These midwives and the legions of their unnamed counterparts are directly responsible for helping to establish and sustain the science and art of American midwifery. We acknowledge, celebrate, and thank their spirits for their contributions to midwifery and their perseverance and dedication to serving their communities in the face of disruptive, racist, and xenophobic attacks.

In colonial times, reproductive health care was provided primarily by midwives. Notably, midwifery was practiced by Indigenous people native to North America; and midwifery practices were brought to the United States by enslaved peoples of African descent. Trained through apprenticeship by generations of experienced family members or peers, these midwives provided safe and affordable care to pregnant people in their communities. For many years, the practice of medicine did not encompass the work of reproductive health care; however, in the early 1800s the medical field of obstetrics began to develop, and white male physicians often recognized midwives as competition, an impingement on profit and stature.

A concerted anti-midwife campaign developed, playing on racist and xenophobic tropes that painted foreign-born and Black midwives as illiterate, careless, lazy, incompetent, unclean, and dangerous. This resulted in the 1921 passage of the Sheppard-Towner Act, a federally funded statute intended to support and improve outcomes for infants and birthing people, and which required states to regulate their midwifery workforces. The statute funded white male obstetricians and white female public health nurses to “educate” community midwives in normal birth and act as gatekeepers to determine which community midwives were deemed appropriate care providers. As Danielle Thompson notes, “This meant that, in one of the most racially charged eras in American history, the livelihoods of many women of color were placed directly in the hands of White actors already negatively disposed toward them for both social and competitive reasons.”1 Despite these concerted attacks on midwifery and Black midwives, Black Grand midwives continued to serve their communities. As of 1918, almost 90% of Southern Black births were attended by Black midwives. They also attended many births of poor white women who couldn’t afford the fees of white physicians.

Only 21 years later, Mary Breckinridge founded the American Association of Nurse-Midwives (AANM). An active white supremacist, she did not allow membership of African American midwives nor did she educate a Black nurse at the Frontier Graduate School of Midwifery from 1939 until her death in 1965, despite being in direct violation of Brown v Board of Education from 1954 onward. This organization became part of the newly created American College of Nurse-Midwives. Midwifery education programs from Tuskegee, Flint Goodridge, and Tuskegee Movable School (located in Macon County) during the 1930s prepared the 41 Black nurse-midwives that were practicing at the time, but unfortunately, the effects of the medical establishment’s racist and xenophobic smear campaign and the racist foundation of midwifery persisted and continues still today.

The midwifery profession today is over 90% white; midwives attend only 11% of births in the United States, with 45% of those births being to Black, Latinx, and Indigenous mothers; and clients of color, especially Black birthing people, suffer hugely disproportionate disparities in health outcomes. As midwives, we must learn about, acknowledge, and make reparations for the specific role anti-Black racism has played in the history of our profession as well as current educational, certification, and practice environments. Either through apathy, implicit bias, or structurally racist policies, many of the 20th and 21st century midwifery leaders and educators have contributed to the oppression and exclusion of racialized people from modern professional midwifery. Whether these past oppressions were intentional or not, there is a growing understanding of the need to respectfully align with racialized midwifery students, educators, and leaders. Truth, healing and reconciliation in our profession must begin with uplifting and celebrating the Black Grand midwives who were foundational in the persistence of midwifery in this country. It is difficult to engender trust and professional collegiality without first removing barriers to diversification of our profession, ensuring that every Black aspiring midwife is aided and supported along their professional pathway.

Adapted with permission from the California Affiliate of ACNM (CNMA), with contributions from ACNM’s Midwives of Color Committee (MOCC) and Michelle Drew, chair of ACNM’s Black Midwives Caucus.

References:

Midwives and Pregnant Women of Color: Why we need to understand intersectional changes in midwifery to reclaim home birth by Danielle Thompson

Further Learning:

Constructing the Modern American Midwife: White Supremacy and White Feminism Collide by P. Mimi Niles and Michelle Drew
ON SALE IN FEBRUARY! Into the Light of Day: Reflections on the History of Midwives of Color Within the American College of Nurse-Midwives by Linda Janet Holmes, MPA – proceeds go to The A.C.N.M. Foundation’s Midwives of Color Scholarship Fund
ACNM’s Diversity, Equity, Inclusion and Belonging efforts, including our Anti-Racism Roadmap for Change
Eliminating the Racial Disparities Contributing to the Rise in U.S. Maternal Mortality: Perspectives from the American College of Nurse-Midwives (ACNM), Black Mamas Matter Alliance (BMMA), and International Confederation of Midwives (ICM)
Racism, Antiracism, and Racial Equity article library in the Journal of Midwifery & Women’s Health
125 Black-Owned Bookstores in America that Amplify the Best in Literature

Spotlight on Anti-Racism (original post)

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.

For Black history month we are going to take a moment to uplift and celebrate the importance of Black Grand midwives and the important roles they played in both caring for their community and keeping midwifery tradition and skills alive in the United States. We encourage you to learn about and celebrate: Mary Coley, Onnie Lee Logan, Margaret Charles Smith, and California’s own Biddy Mason. These midwives and the legion of their unnamed counterparts are directly responsible for helping keep the science and art of midwifery alive in this country. We celebrate them and thank their spirits for their contribution to midwifery. Their perseverance and dedication to serving their communities in the face of racist and xenophoic attacks on midwifery intended to denigrate them and eradicate their role in the community is an inspiration.

In colonial times, reproductive health care was provided primarily by midwives: Midwifery was practiced by Indigenous people native to North America, and midwifery practices were brought to the United States by enslaved peoples of African Descent and by European immigrants. Trained through apprenticeship, by generations of experienced family members or peers, these midwives provided safe and affordable care to pregnant people in their community. For many years the practice of medicine did not encompass the work of reproductive health care; however, in the early 1800’s the medical field of obstetrics began to develop and white male physicians recognized midwives as competition, an impingement on profit and stature.

A concerted anti-midwife campaign developed; playing on racist and xenophoic tropes painting foreign-born and Black midwives as illiterate, careless, lazy, incompetent, unclean and a danger. This resulted in the 1921 passage of the Sheppard-Towner Act. The federally funded statute intended to provide funding to improve outcomes for infants and birthing people required that states regulate their midwifery workforces. The statute funded the white male obstetricians and white female public health nurses to “educate” community midwives in normal birth and act as gatekeepers to determine which community midwives were deemed appropriate care providers. As Danielle Thompson notes, “This meant that, in one of the most racially charged eras in American history, the livelihoods of many women of color were placed directly in the hands of White actors already negatively disposed toward them for both social and competitive reasons.” Despite these concerted attacks on midwifery as a profession and Black midwives in particular, Black Grand midwives continued to serve their communities. As of 1918, almost 90% of southern Black births were still attended by Black midwives.

Only 21 years later, Mary Brekenridge founded the American Association of Nurse-Midwives (AANM). An active white supremist, she did not allow membership of African American midwives. This organization became part of the newly created American College of Nurse-Midwives founded by Hattie Hemshemeyer with the aim to create a professional midwifery organization open to all nurse-midwives regardless of race. Unfortunately, the effects of the medical establishment’s racist and xenophoic smear campaign and the racist foundation of nurse-midwifery persist today. As of this writing, the midwifery profession is still over 90% white; we attend only 11% of births and our clients of color, especially Black birthing people, suffer hugely disproportionate disparities in health outcomes. As nurse-midwives we must learn about, acknowledge, and make reparations for the specific role anti-Black racism has played in the history of our profession. We must uplift and celebrate the Black Grand midwives who were foundational in the persistence of midwifery in this country. We must remove all barriers to diversification of our profession ensuring that every Black aspiring midwife is aided and supported along their path.

In honor of Black History Month and in celebration of Black Grand Midwives, we offer the following readings to learn more about the history of midwifery in the United States.

Constructing the Modern American Midwife: White Supremacy and white Feminism Collide by P. Mimi Niles and Michelle Drew

Midwives and Pregnant Women of Color: Why we need to understand intersectional changes in midwifery to reclaim home birth by Danelle Thompson

Education, Trainings, and Webinars

Preterm Labor Management During a Public Health Crisis

This free webinar will cover the management of pregnant patients with symptoms of preterm labor during the COVID-19 pandemic. He will highlight the tools available and how providers can effectively use them to assess a patient's risk of delivering preterm. This program will also cover the importance of screening for STIs, which are associated with an increased risk of preterm birth. Two opportunities to attend: February 2, 2021 at 9:00 AM and February 3, 2021 at 1:00 PM.

Perinatal Psychiatry CME Series, Session 2: Depression

The second webinar in the Perinatal Psychiatry CME Series will be offered on February 10, 2021, 12:30 – 1:30. Presented by Miriam Schultz, MD, will focus on Depression. For more information and to register, click here.

Caring for the Sexually Assaulted Patient when there is No SANE in Sight: A training for all healthcare providers

This two hour course is FREE and open to everyone! Get more information and register here.

Course Outline:

The Neurobiology of Trauma
The Coordinated Community Response
The Medical Forensic Examination
Courtroom Testimony

CNE and CME credits are available at no cost upon completion of the course through IAFN.

Grant and Scholarship Opportunities

Sister Song

SisterSong is launching a one-time RJ for Black Lives grant opportunity to make substantial investments in Black women and trans-led organizations working at the intersection of RJ and other social justice movements and facilitate collaboration among them. To submit an application, please complete the grant questionnaire by the application deadline, February 8, 2021. There will be two optional information sessions for applicants to answer questions about the grant on February 1 at 3PM EST and February 2 at 10:30AM EST. Webinars will be recorded and shared with any applicants who are interested but cannot attend.

ACNM Foundation

The ACNM Foundation’s grant and scholarship season is in full swing, with deadlines fast approaching!

Basic Midwifery Student Scholarships – $3,000 – Apply by February 15, 2021
Fellowship for Graduate Education – $2,500 – Apply by March 1, 2021
Dianne S. Moore Midwifery Research Scholarship – $2,500 – Apply by March 1, 2021

Learn more and apply here at the ACNM Foundation’s website.

Events

Let’s all GET OUT AND RUN while raising money for a fantastic cause! Miles for Midwives proceeds go to the California Nurse-Midwives Foundation (CNMF) and Every Mother Counts. Afraid of attending an event? No worries! This is virtual and done on your own time. Registration extended until 2/5/2021. Register here.

Job Opportunities

Santa Rosa Birth Center

The Santa Rosa Birth Center is hiring an additional CNM to join our team! We are celebrating our 28th anniversary of full-scope reproductive health, prenatal, postpartum and lactation support within several different clinical environments. We attend births at our free-standing, fully licensed and CABC accredited birth center and at 2 local hospitals. Our population is primarily publicly funded, with ~80% of all clients receiving MediCal. The position is for a full-scope CNM. Position includes medical, dental and vision benefits and paid time off. New grads are welcome to apply. Willingness to relocate to Santa Rosa preferred. Our practice is collaborative and BUSY. Each CNM plays an integral role in the functioning of the birth center. This is an excellent opportunity to work in a joint, in-and-out of hospital setting, but isn't for the faint of heart. We seek a candidate with a desire to promote midwifery care in the community and who will help us grow our practice. Please send a letter of interest & CV to esmith@santarosabirthcenter.com

Editor-in Chief of the Journal of Midwifery & Women’s Health (JMWH)

The American College of Nurse-Midwives (ACNM) is currently inviting applications for the position of Editor-in-Chief of the Journal of Midwifery & Women’s Health (JMWH). The society is looking to select a new Editor-in-Chief to start on July 1, 2021, building in a six-month transition period through the end of 2021 with the journal’s current Editor-in-Chief Frances E. Likis, DrPH, NP, CNM, FACNM, FAAN. All candidates must be a certified nurse-midwife or certified midwife.

Please visit the application website (https://www.midwife.org/editor-in-chief-application) for a job description, candidate qualifications, and application requirements. All applications must be emailed to Julie Nash at julie@jjeditorial.com by February 19, 2021 to be considered by the selection committee.

Editor-in-Chief of the Journal Nursing for Women’s Health

AWHONN is seeking applications from nurses for the editorship of Nursing for Women’s Health (NWH), the term for which could begin as early as mid-2021. NWH editor Mary C. Brucker, PhD, CNM, FACNM, FAAN, has announced her plan to retire from the role at the end of 2021. The deadline to apply is February 26, 2021.

Applications shall include:

• A one‐page cover letter stating your reason for applying to the role, and how your unique experience and vision will shape the journal under your leadership, including

addressing your impressions as to the journal’s current shortcomings and strengths as a thought leader in clinical scholarship and nursing practice.

• A 450‐word editorial that would serve as a model for how you would write an editorial for each issue of the journal on a topic of your choosing. In addition to the editorial, please include a list of three other topics about which you may want to write editorials during your tenure as editor.

• Two published writing samples of your choosing.

• Three letters of reference: Letters of reference should address the author’s opinion of your abilities to serve as editor and shall be emailed directly from the letter writer to NWH senior managing editor, Jennifer Hellwig, at jhellwig@awhonn.org.

All applications should be emailed to NWH senior managing editor, Jennifer Hellwig, at jhellwig@awhonn.org. For further questions and a full list of qualifications and job responsibilities, call Jennifer at 202-261-1467.

Job openings to share?

If you have a job opening, please post it at www.CNMA.org/jobs! We will happily share your listing in our newsletter and on social media.

Questions? News? Want to get involved?

Email us at info@cnma.org

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

-CNMA MEDIA TEAM

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

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California Nurse Midwifery Association February 2021 | Newsletter

Black History Month