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CNMA Newsletter: February 2022



Welcome to Black History Month!


This Black History Month, I invite you to join me in continuing our own antiracism education by listening to Black voices.


As part of their commitment to helping to end health inequities, the California HealthCare Foundation (CHCF) commissioned Listening to Black Californians, a three-phase qualitative and quantitative study to understand the health and health care experiences of Black Californians. The research is being conducted by EVITARUS, a Black-owned public opinion research firm in Los Angeles.


Another important piece from CHCF, In Their Own Words: Black Californians on Racism and Health Care describes the results of Phase I of Listening to Black Californians. EVITARUS conducted individual, hour-long interviews with 100 Black Californians to understand their views on health and well-being, their perceptions of discrimination and bias in the health care system, and their views on what a quality health care system looks like.


And finally, In Birth Justice Denied: The Continued Marginalization of Community Birth Settings and Midwives, Neelu Shruti describes the “historical racist and sexist marginalization of Black, Indigenous, and Immigrant midwives.” An excellent, easy-to-digest read, it explains our systems were designed for racial disparities in maternity care.


At CNMA, we have a long way to go toward becoming an antiracist organization, but we are grateful for the opportunity to learn and do better. We are led humbly by our Antiracism and Reproductive Justice Committee, whose platform guides are advocacy and educational efforts. You can read more about their work (and ours) here.


As always, I’m available by email at parisbury@gmail.com and by text at (805) 415-2553.


In the spirit of service,


Paris Maloof-Bury, CNM, IBCLC

President, California Nurse-Midwives Association



California Health Policy


Policy Priorities for 2022

We entered January without a moment to spare on the health policy front. The Governor's Budget Proposal was released a couple weeks ago, and there is some very good news for midwives.


First, one of our main legislative priorities this year was to reverse Medi-Cal 10% rate reduction to midwives and birth centers that was put into place by the Budget Act of 2011. The Health Policy team and our lobbyists have been in multiple conversations with other stakeholders also affected by this rate reduction, Senate and Assembly budget staff, and even legislators. We assumed this would be a hard climb this year and would require a difficult Budget Change Proposal or new legislation introduced into regular session. However, to our happy surprise, the Governor's own Budget Proposal includes a reversal of this rate reduction! While this isn't final, because it requires the legislature to agree on this change, this is the absolute best place we can be at the moment. Our lobbyists and health policy team will continue to vigorously pursue this through the budget process. Click these links if you would like to understand more about the California budget process versus the typical legislative process.


Secondly, this year we are also pursuing two previous items from our past bills that remain unfunded. The Midwifery Workforce Training Act was created in SB 65 last year. CNMA and coalition partners who worked on this bill are working together to get this funded. We have good support for this in the legislature, and again, the Governor's Budget Proposal also includes 270 million dollar investment in the workforce, and specifically names nurse-midwives as a possible recipient of a portion of these funds (see page 198 of the Governor's Budget Proposal). While this is great news, in order to cover all bases, we are also considering introducing a bill into the regular session in addition to pursuing funding through the budget process.


Also, SB 1237 (the physician supervision removal bill of 2020) created a data collection mandate for community based midwives but was not funded in 2021. Given the momentum on the above topics regarding midwifery training and reversal of the Medi-Cal rate reduction, we also hope that there are sympathetic ears to getting the data collection section of SB 1237 funded through this year's budget process. We believe that showing the superior outcomes of community birth by CNMs will only serve to enhance our integration endeavors in coming years.


Future of Abortion Council

In the last newsletter, we noted that the CNMA participated in the recommendations created by the Future of Abortion Council. There is now a brand new website where you can find all documents and updates. Additionally, in January, The California Women's Caucus introduced 8 bills that will create new laws and regulations that are a direct result of the Future of Abortion Council's recommendations, including a recommendation to enhance the reproductive health care workforce. CNMA looks forward to possibly co-sponsoring one of these pieces of legislation. On the 49th anniversary of Roe v. Wade, CNMA promises to continue our strong support of the FAB Council moving forward. This anniversary stands to be the last anniversary of this landmark decision. In June, the Supreme Court will give its ruling on whether Roe will be overturned.


More Info

Be on the lookout for Advocacy Day information in future newsletters (likely still virtual this year) and other ways you can get involved. Contact advocacy@cnma.org if you have questions, want more info, or simply want to get involved.



National Health Policy