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Writer's pictureBrittany Edwards

CNMA Newsletter- March 2023

















An Existential Moment

Dear Community,


As I’m sure you’ve noticed, CNMA is working hard to become an anti-racist organization. Over the past four years we’ve completely pivoted our health policy approach, following BIPOC-led organizations who’ve taught us to advocate, not just for midwives, but directly for the people and communities we serve. This was an existential flex. Since then we’ve grown our leadership to become a BIPOC-led organization ourselves. And we’ve celebrated win after win at the State Capital, increasing access to sexual and reproductive healthcare for everyone in this state. As it turns out, when you center the margins, everyone benefits.


Along these same lines, it was immensely satisfying for me to vote for and help elect Heather Clarke as ACNM’s first Black president, along with a BIPOC majority board of directors to ACNM last year. Finally ACNM had become a BIPOC-led organization! The possibilities felt endless. Imagine all we could accomplish as an organization when our leadership had the lived experience and values that could help us achieve equity in our college and Reproductive Justice in this country. Unfortunately, these new leaders have inherited ACNM’s long-standing financial instability. Dr. Clarke and the rest of the board have come into power at a time when ACNM is more fiscally vulnerable than ever. To be clear, they did not create this crisis, they inherited it. And as our elected leaders, they are charged with fixing it, but they cannot do this alone. This is an existential moment, an opportunity for existential flexibility, an opportunity to transform a crisis into a re-birth.


In a recent conversation, Dr. Clarke shared with me her vision for what midwifery could be in this country. When things fall apart, we have three choices: we can either let the pieces lie where they fall and accept their demise; we can try to hold everything in place and cling to how things used to be; or we can use the disruption as an opportunity to create something new from the falling pieces. Heather envisions a reorganized, stronger, more unified, more autonomous organization of midwives. An organization that steps into its own power and does the work that our ancestors would want us to do. An organization that represents a profession that doesn’t ask medicine or nursing for permission to exist. An organization that does the work to ensure that every birthing person, every baby, and every pregnancy-capable body has access to safe, affordable, and trauma-informed midwifery care; regardless of the state they live in or the color of their skin. She shared with me some revolutionary possibilities in what this could look like. I was inspired.


As midwives, we have an obligation to the people in our care, and to our profession. In California we’ve seen how powerful an existential flex can be. For us, it’s meant political capacity and momentum that’s brought us to a tipping point where our shared vision will inevitably become the reality in this state. We can do the same thing on a national level. But this will require our support for President Clarke and the rest of ACNM’s board. They, no, WE can’t survive financially without our membership dues; if you’re not a member, join or renew now. WE need us to register for and attend the biggest ACNM fundraiser of the year – the Annual Meeting. WE need to Reimagine and Rebuild, to do what we as midwives are called to do: to push, to re-birth, to advocate fiercely for the people and communities in our care. WE’VE got this. But only if WE do it together.


Dr. Clarke will be joining us at CNMA’s Annual Meeting in August, and I’m so honored and excited to have her support for our state’s work. Let’s reciprocate that support. Can you just imagine how powerful we’d be as a national organization if we brought California’s power and momentum to the rest of the country? Let’s do this.


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


In the spirit of service and solidarity,


Paris Maloof-Bury, CNM, IBCLC

President, California Nurse-Midwives Association

 

Health Policy Updates

CNMA Sponsors Cleanup Bill: SB 667 (Dodd)

CNMA is thrilled to announce that SB 667 (Dodd) was introduced on February 16. See press release here. If passed, this bill will continue the work that was started with SB 1237 in 2020, which was focused on increasing access to midwifery care in order to address the maternal mortality crisis and racism-based disparities in our state. Since 2020, midwives across the state have given extensive feedback on what’s left to do to enhance integration and sustain independent practice. SB 667 seeks to address these issues, including to:

  1. Advance integration and sustainability of independent midwifery care. How: by clarifying that certified nurse-midwives do not have to be “in the same practice with” a physician in order to consult and collaborate.

  2. Strengthen our role as abortion providers and providers for disadvantaged populations. How: by clarifying the ability of certified nurse-midwives to dispense medication directly to patients (especially important for medication abortion).

  3. Reduce costly barriers to birth center sustainability and start-ups. How: by allowing certified nurse-midwives to perform specific tests within their birth center or independent midwifery practice, consistent with federal CLIA laboratory rules (California still requires physician laboratory directors for birth centers and midwife-led/midwife-owned practices. This is costly for midwifery practices, unsustainable, and misaligned with federal rules).

  4. Reduce health care costs, unnecessary appointments, and administrative barriers to person-centered care. How: allow for temporary disability certification by midwives for the entirety of pregnancy, consistent with midwifery scope of practice (this removes the redundancy of extra appointments and reduces delay for the patient.

  5. Remove costly, unnecessary barriers to practice. How: in the same way that other medications within the CNM low-risk scope do not require a standardized procedure, allow controlled substances for conditions within the CNM low-risk scope to also be furnished without the administrative barrier of a standardized procedure.

  6. Reduce geographic and economic barriers to reproductive health care by improving the efficacy of the nurse-midwifery workforce. How: extend the ability of nurse-midwives to manage common gynecologic conditions across the lifespan (currently nurse-midwives can manage common gynecologic conditions, but only within certain discrete periods of time centered around pregnancy and conception).

  7. Improve midwifery integration and collaboration within and between different sites of care. How: By allowing admission and discharge capability for nurse-midwives with hospital privileges, consistent with CNM scope of practice.

CNMA Co-Sponsors Bill to Prevent Provider Discrimination by Malpractice Insurers: AB 571 (Petrie-Norris)

CNMA is also proud to announce that we will be co-sponsoring a bill specific to abortion and gender-affirming care. This bill would prevent malpractice insurers from discriminating against providers of abortion care and gender-affirming care. For example, the bill would ensure that malpractice carriers cannot increase premiums, impose a surcharge or other additional compensation or cost, institute or increase deductible amounts or other cost sharing payable by the insured, solely based on the fact that the insured provides abortion care or because they had adverse legal or administrative action taken against them in another state for providing abortion or gender-affirming care if such care would have been legal in California. This bill can be viewed here (updated language will be published soon).Other co-sponsors include ACOG, CMA, TEACH, and NARAL.


We’ll keep you updated as these bills movethrough the legislature. Check in frequently with www.cnma.org/advocacy for up-to-date info. Meanwhile, if you want to be involved in CNMA’s health policy work, contact advocacy@cnma.org or consider signing up for this year’s Reproductive Freedom Week (more info on that below)!

Reproductive Freedom Week

Reproductive Freedom Week (RFW) has been scheduled! Save the dates: April 17-21. RFW is a "virtual statewide advocacy event, coordinated by California Coalition for Reproductive Freedom (CCRF), and featuring advocacy training, in-district legislative visits, and other community-building events." For the last three years, CNMA has participated in Reproductive Freedom Week in lieu of an in-person lobby day. This allows us to have a larger reach – we lobby in our own districts and coordinate efforts that advance reproductive freedom as a whole (including midwifery practice issues!) while simultaneously educating policy makers and community partners about midwifery. Participation in RFW also allows us to be a good partner to our supporters at the California Coalition for Reproductive Freedom. More information here.

Health and Human Services Agency Maternal Health Briefing

In honor of Black History Month, the Department of Health and Human Services (HHS) hosted a briefing on maternal health priorities and activities on Friday, 17th, 2023. Secretary Xavier Becerra and other key agency leaders shared new funding authorized by the passage of the federal budget bill (the Omnibus) and other Department activities to advance maternal health outcomes, including addressing inequities.

The key actions and programs that federal agencies have implemented are outlined here by The 2020 Mom Policy Team

HCAI Delivers Annual Report to CA Legislature

HCAI Delivers the Health Workforce Research Data Center’s Annual Report to the California Legislature. Mid-February the Department of Health Care Access and Information (HCAI) presented the California Legislature with the Health Workforce Research Data Center’s (RDC) annual report for 2022. The report, the first publication since the RDC was statutorily established in 2021, collects the data necessary to provide comprehensive, timely, and accessible health workforce information to inform state policymakers and others. Key findings include workforce geographic maldistributions, increases in workforce exits, and areas of demographic underrepresentation. For a visualization of some of this data, see the HCAI visualizations page.


ANA Nurses in Media Day 2023

Welcome back to our second and highly sought-after Nurses in Media Day! We're bringing back some of our favorite self-made nurses plus new media and communications experts in this 3-part conference. Our speakers and panelists will discuss the impact of policy and culture on nurses' opportunities to be in media, share their personal journeys, experiences, and success stories, as well as offer mini-media trainings to help individuals and nursing organizations alike become leaders in the digital healthcare space. Join us on March 15, 2023 10:00 AM – 1:30 PM, RSVP here.

 

Client and Consumer Education Resources

Postpartum Support International: Support groups in Spanish

We are pleased to announce new support groups in Spanish this March:

  • Educational Lactation Support Group. Every last Tuesday of the month at 4pm Eastern. El ABC de la lactancia. Cada último martes del mes a las 4 de la tarde del este.

  • Educational Sexuality in the Perinatal Time support group. Every third Thursday of the month at 1pm Eastern. Educación sexual en el periodo perinatal. Cada tercer jueves del mes a la 1 de la tarde del este.

More information is coming soon! Explore more resources in Spanish here.

 

Education, Trainings, and Webinars

CNMA 2023 Annual Meeting

Join us in Los Angeles for the 2023 CNMA Annual Meeting. Speakers this year include: King Yaa: Queer Reproductive Care, Dr. Anna Glezer: Perinatal Mood Disorders, Gabriela Grant: Care and Evaluation of the sex worker, and more to come! Our site will be updated as presenters confirm. August 26, 2023 at the Omni Hotel in Los Angeles. Get your tickets early–Early Bird registration ends March 31, 2023. 8 CEUs.


CNMA 2022 Annual Meeting Recording: If you weren't able to make the 2022 Annual Meeting in real time this year, here’s another opportunity to purchase tickets and catch up! Janelle Palacios spoke on the Arrive Trial. Ana Delgado spoke on Using Quality Improvement to Advance Equity. Rixa Freeze spoke on Breech Birth Maneuvers. Tanya Khemet Taiwo spoke on Environmental Factors affecting Fetal Development. Paris Maloof-Bury spoke on the Marginalization of Black Midwives in America. 8 CEUs. Register here.

CNMA Online Abortion Training

CNMA is offering online abortion training on Friday, April 28, 2023 from 8 AM - 12 PM PST. This training is open to all APRNs and RNs who wish to learn about abortion care, and will cover values clarification, options counseling, medication abortion prescribing and updates, and telehealth abortion. $100, 4 CEUs. Register here.


ACNM 2023 Annual Meeting

ACNM is delighted to formally invite you to the 68th Annual Meeting & Exhibition, which will be held at the Caribe Royale Orlando in sunny Orlando, Florida. Join us to reconnect with colleagues, build new relationships, and address pressing challenges and opportunities in a candid, interactive format. PRE-CONFERENCE: MAY 5-6, 2023. MAIN EVENT: MAY 7-9, 2023. The ACNM Annual Meeting & Exhibition brings together the largest concentration of certified nurse-midwives (CNMs) and certified midwives (CMs) in the nation, along with other women’s health practitioners, allied health professionals, researchers, faculty, community leaders, policymakers, and midwifery students in support of common goals to advance women’s health and the practice of midwifery. Register now–Early Bird pricing ends March 15, 2023!


MCCPOP 42nd Annual Perinatal Potpourri: Advances in Care

You are invited to register today for the upcoming two-day Live Webinar,

March 23 – 24, hosted by The Mid-Coastal California Perinatal Outreach Program (MCCPOP), in collaboration with The Department of Pediatrics and The Department of Obstetrics and Gynecology at the Stanford University School of Medicine, and The Johnson Center for Pregnancy and Newborn Services, Lucile Packard Children’s Hospital.

Topics to include: * CHAP Study: Intervening earlier in hypertension * Streamlined, team-based care for infants with renal, aerodigestive and airway needs * Addressing racial disparities in maternal health * Considerations for a people-centered, unbiased approach to contraceptive counseling and provisions . Click here to register!


AWHONN 2023 Convention

The 2023 AWHONN Convention, taking place June 17-21, 2023 in New Orleans, will be a transformative event that will help you to develop and hone your leadership skills, empower your team to adopt and adapt new standards in care, reevaluate and inspire change to historically challenging workplace cultures, and understand how playing a part in nursing and patient advocacy can increase delivery of quality patient care while improving the nursing environment. *Members experiencing financial hardship and members of underrepresented groups are strongly encouraged to apply for a convention scholarship.


Submit a Proposal to Present at the 2023 AABC Birth Institute

The AABC Program Committee is accepting proposals to present at the 2023 AABC Birth Institute to be held October 12-15, 2023 in Tucson, Arizona. The conference is themed "Birth Centers - An Oasis in the Desert. Restoration. Nourishment. Sustainability." We welcome abstracts that address clinical issues and administrative challenges for birth center providers/administrators, and others developing innovative solutions in maternity care. Whenever possible, abstract submissions should include content about racism and health disparities, social determinants of health, and diversity and inclusion. Apply by March 3, 2023.


20/20 Mom: Maternal Mental Health FORUM!

First panel: Building Support Systems for Early Parenting Policy and Payment Strategies on Wednesday, March 22, 11:50 am-1:05 pm PT. In this session, key leaders in the field of early relational health and childhood well-being will discuss the intersection of social support and child and maternal mental health, including levers that policymakers and healthcare payors like Medicaid Agencies and Health Plans can take to improve outcomes. Learn more about this forum and upcoming events here.


ANA: Review of the Opioid Overdose Epidemic: How did we get here

On March 9, 2023, 10:00 AM – 11:00 PM, join the American Nurses Assoc. for a discussion on the current state of the drug epidemic, changing views of pain treatment led to more use of opioid analgesics, pressure mounted on doctors to treat any and all pain effectively, faulty research seemed to show low addiction potential for opioids for patients in pain, and so much more. 1.0 CE- Nurses can help with education, advocacy, and treatment. Register here


Pregnancy Options Workshop

All-Options has opened registration for our Spring 2023 Pregnancy Options Workshop (POW). Our Spring 2023 POW will be offered online via Zoom, starting Tuesday, March 9, and running weekly through Tuesday, April 11. This course is facilitated live by All-Options staff members and expert guests, and is for anyone who would like to deepen their self-awareness, expand their knowledge, and practice new skills surrounding pregnancy options counseling. Click here for details and to register - registration will close March 3. If folks have any questions, please email our National Trainings Coordinator at karlie@all-options.org.


The Midwife as Surgical First Assistant

The full schedule of The Midwife as Surgical First Assistant (First Assist) Virtual Clinical Labs for 2023 is now available! First Assist focuses on training midwives to participate and provide continuity of care for patients during a cesarean section.

The Endometriosis Summit

The Endometriosis Summit hosts an annual Endometriosis Summit to train physicians and educate patients. We also host a separate fertility conference, a webinar series, a podcast, and participate in legislative initiatives and research directives. Join us March 24-26, 2023. No one should be lost in the sea of confusion that is endometriosis. For patients and practitioners we want to empower you. Learn more and register here.


Annual Nurse Practitioner’s Premier Women’s Healthcare Conference

NPWH is accepting abstract submissions for posters, podium presentations, and clinical breakout sessions at our 26th Annual NPWH Premier Women's Healthcare Conference, being held October 29 - November 1, 2023, in San Diego, California. For questions regarding research/innovative abstracts, please contact Carol Wiley. For questions regarding clinical abstracts, please contact Donna Ruth. Deadline to Apply: April 16, 2023.


Obstetric Violence: What it is and what community can do about it

This is vital information on obstetric violence presented with trauma awareness for the learner.

Course goals are to:

  • Integrate trauma awareness and trauma-informed practice in ourselves

  • Define, identify, and contextualize manifestations of obstetric violence

  • Strengthen our own advocacy skills and build community to advocate against obstetric violence


Understanding how Trauma affects the Black Community

Racism, whether unconscious or overt, has long-term impacts on the mental and behavioral health of Black communities. While COVID-19 and racial injustice protests may have brought on new trauma, years of systematic racism, discrimination, and microaggressions have forced Black communities to live in a constant state of high alert, causing traumatic stress. Watch our on-demand webinar, What Is Racial Trauma?, to hear Jamila Holcomb, Ph.D., LMFT, discuss how racial trauma affects the Black community and ways both clinicians and organizations can better connect with Black clients. During the webinar, you’ll learn:

  • How racial trauma affects the mental, emotional, and physical health of the Black community

  • The impacts racial discrimination can have on Black youth and emerging adults

  • Strategies to help clinicians and organizations better connect with their Black clients

  • How organizations can help all staff members understand their own implicit bias

To view previously listed educational opportunities, please visit our website at https://www.cnma.org/courses.

 

Volunteer Opportunities

Call for Stories about Abortion Care Post-Roe

UCSF is launching a study that aims to document poor-quality care post-Dobbs due to new restrictive abortion laws. Health care providers can anonymously submit stories about care that deviated from the usual standard at CarePostRoe.com. Some examples of cases we’re hoping to document include:

  • Delayed provision of abortion care for people whose health may be compromised by continuing the pregnancy (including young adolescents)

  • Delayed management of ectopic pregnancy

  • Delayed treatment for spontaneous pregnancy loss and preterm premature rupture of membranes

  • Difficulty providing standard-of-care treatment due to the concern of causing an abortion, regardless of whether the patient was pregnant or not (e.g., chemotherapy, methotrexate, or misoprostol for a non-abortion indication)

Providers can submit either a written narrative or leave a voice memo with details of the case. The submissions are anonymous but if providers would like to be contacted for an interview, they can leave their contact info, which is not linked to their submission. The study is approved by the UCSF IRB.


Request for ACOG's Labor of Love Podcast Guest Recommendations

This spring, ACOG launches a new podcast series, Labor of Love. In its upcoming second season, ACOG’s Labor of Love podcast will shift from focusing on the COVID-19 pandemic experience of new mothers to the pandemic experience of clinicians. Our host, Dr. Veronica Pimentel, will hold conversations with maternal health clinicians regarding the challenges and triumphs they experienced during the COVID-19 pandemic. Each of the five 20-minute episodes will focus on the following themes:

  1. Midwives' Mental Health and Wellness

  2. Midwives-Patient Trust during the Pandemic

  3. Building COVID-19 Vaccine Confidence with Patients

  4. Midwives’ Role in Addressing Disparities and Promoting Health Equity

  5. Workforce Capacity Building During and After a Pandemic

We are looking for dynamic clinicians to be guests on each episode of the podcast. We’re looking for guests that represent other clinician types such as midwives, mental health practitioners, nurse practitioners in women’s health, and labor and delivery nurses. If you know any practicing clinicians in these categories, please feel free to send us their information. If anyone comes to mind who you believe would be well-suited to speak to one or more of the topics above, please respond to this email with the nominee's name, job title, contact information, episode(s) they would be well suited for, and 1-2 sentences on what makes them a good fit. Please submit your recommendations to calonso@acnm.org.

Learn more and apply for these or other volunteer position openings today!

 

Scholarships, Grants, Funding, and Awards

Los Angeles Maternal Mental Health Access Program Opportunity

The University of Washington Department of Psychiatry and Behavioral Sciences and the Community Clinic Association of Los Angeles County are leading a multiyear effort to implement the collaborative care model for maternal mental health in Los Angeles community clinics. Elevation Health Partners, Maternal Mental Health NOW, and Concert Health are collaborating partners. The effort, known as the Los Angeles Maternal Mental Health Access (LAMMHA) program, is designed to support health centers in Los Angeles to identify and treat common perinatal mental health disorders. Co-developed with community stakeholders, the LAMMHA program offers Los Angeles County providers and community clinics support to improve perinatal mental health care. Apply here.

 

Job Opportunities

To view previously listed educational opportunities, please visit our website at https://www.cnma.org/jobs.

 

Medi-Cal Rx

Sign up for the Medi-Cal Rx Subscription Service to be notified when new information is posted!

See additional updates below:

 

Midwife Crush Mondays!

Do you know an amazing Midwife who is doing revolutionary work? We want to feature them on our social media platforms!


CNMA is looking for submissions for our new social media series “Midwife Crush Monday” where we highlight the stories of trailblazing midwives across the industry who are making a difference in the midwifery profession. You can even submit yourself!

Here’s what we’re looking for:

  • Midwife’s name (include pronouns)

  • Affiliated organization(s)

  • Why you became a midwife (and anything awesome you’d like to brag about)

  • Headshot/Photo if available

  • Bonus: Please include social media handles for tagging!

Please send submissions to sm@cnma.org for consideration!

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