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  • Writer's pictureBrittany Edwards

CNMA Newsletter- November 2023



















Message from the President


Dear Community,

The weather is cooling and the leaves are falling, and that can only mean one thing: It’s election season! We are just a few weeks away from announcing results from our annual election. If you haven’t voted yet, please do!


Fall also means that the legislative season has come to an end, and for CNMA, this means we’ve continued our series of wins. Thank you to our fantastic health policy team for working so hard to pass SB 667, SB 345, and AB 571, as well as the entire slate of FAB council bills, all of which were signed by the governor last month. Read more about CNMA Advocacy here.


I hope you’re enjoying the anticipation and sentimentality of the season, and that it brings you much needed time with family and friends, as well as time to nurture yourself. 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

 

The 2023 CNMA Board of Directors Ballot is still open!

If you have not voted, please click HERE to see our amazing candidates and VOTE. For questions about the ballot, voting, or about CNMA, please email alisonnyoung@gmail.com.

 

Health Policy Updates


CNMA is proud to announce that Governor Newsom signed SB 667 (Dodd)!!


This bill will strongly advance access to and sustainability of midwifery in California. CNMA will issue guidance on this bill by the end of November.


In short, SB 667 continues the work that was started with SB 1237 in 2020, which focused on increasing access to midwifery care 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 addresses these issues, including:

  1. Advancing integration and sustainability of independent midwifery care 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. Strengthening the role of CNMs as providers for disadvantaged populations by clarifying the ability of certified nurse-midwives to dispense medication within their scope directly to patients (especially important for FQHCs, community clinics, and free clinics).

  3. Reducing costly barriers to birth center sustainability and start-ups by allowing certified nurse-midwives to be laboratory directors of clinics where waived tests and provider-performed microscopy within the midwifery scope are being performed.

  4. Reducing unnecessary appointments (and thus the cost of care), and improve person-centered care, by allowing temporary disability certification by midwives for health events that occur the entirety of pregnancy, consistent with the certified nurse-midwifery scope of practice (this removes the redundancy of extra appointments and reduces delay for the patient).

  5. Removing costly, unnecessary barriers to midwifery practice by allowing Schedule IV and V controlled substances for the treatment of conditions within the CNM low-risk scope to be furnished without the administrative barrier of a standardized procedure, just as all other medications within the CNM low-risk scope do not require a standardized procedure;

  6. Removing the redundant administrative barriers of the Standardized Procedures for Schedule II and III narcotics. A standardized procedure is no longer necessary but these meds do need to addressed in a mutually agreed upon policy and protocol with a physician if CNMs intended to furnish these medications.

  7. Reducing geographic and economic barriers to reproductive health care and improving the efficacy of the nurse-midwifery workforce by extending nurse-midwives' ability to manage common gynecologic conditions across the lifespan

  8. Improving midwifery integration and collaboration within and between different sites of care by allowing hospitals to grant admission and discharge privileges to nurse-midwives, consistent with CNM scope of practice, and if authorized within the hospital’s bylaws.


Additionally, CNMA was also the proud co-sponsor of SB 345 and AB 571, both of which were signed by the Governor and provide protections to midwives and other providers providing abortion care. More info can be found here.


Anti-implicit bias training results from the DOJ

Last month, CNMA members Mayra Lizzette Yniguez and Charlette Withers attended a press event where Attorney General Rob Bonta announced the results of a California Department of Justice investigation into anti-implicit bias training for perinatal care providers.


Recommendations were given to strengthen compliance with the Pregnancy and Childbirth Act (SB 464) passed in 2019 to address racial disparity in mental morbidity rates. This bill requires hospitals, alternative birth centers and primary care clinics to conduct evidence-based implicit bias training for all health professionals who provide care during a patient’s pregnancy, childbirth, and immediate postpartum period. Click here for more details.


Special Message from CDPH: Administer RSV Vaccine to Your Pregnant Patients!

The California Department of Public Health (CDPH) urges prenatal care providers to provide RSV vaccine for all pregnant patients from September through January during weeks 32 through 36 of gestation. Please see this memo regarding the Nirsevimab shortage for infants.


National News: White House Blueprint for Addressing the Maternal Health Crisis

On September 27, as part of the U.S. Department of Health and Human Services (HHS) Maternal Health Day of Action, HHS announced several new actions to address the nation’s longstanding maternal health crisis. HHS is awarding more than $103 million to support and expand access to maternal health, forming a new task force to address maternal mental health conditions and co-occurring substance use disorders, and launching a national public education campaign, Talking Postpartum Depression, to provide information about and combat stigmatization associated with this significant public health issue.

The actions are the latest steps by HHS and the Biden-Harris Administration to fulfill the President’s Unity Agenda, and continue implementation of the White House Blueprint for Addressing the Maternal Health Crisis - PDF, a whole-of-government strategy to combat maternal mortality and improve maternal and infant health, particularly in underserved communities.


National News: Maternal and Child Health Stillbirth Prevention Act

We are thrilled to let you know the Maternal and Child Health Stillbirth Prevention Act has passed in the United States Senate by unanimous consent. Senate File 2231 passed the Senate via hotline Saturday, Sept. 30. A huge THANK YOU to Senator Jeff Merkley (D-Oregon) and Senator Bill Cassidy (R-Louisiana) for leading this bill in the Senate and helping to ensure this bipartisan stillbirth prevention legislation moves onto the House of Representatives for consideration. Sign the Petition.

 

Education, Trainings, and Webinars

Save The Date! Ultrasound for Women's Health Providers

Speaker: Carolyn L. Gegor, CNM, MS, FACNM (co-author co-author and editor of Varney’s Midwifery)


Are you looking for hands-on education?

This in-person course is for the women’s health provider who: **does very limited scans (find the head, look for the heartbeat) but wants to learn to do more **has learned to scan “on the job” but wants to have more formal education**wants to take the new midwifery certification exam, but does not feel prepared**wants to be able to bill for performing and interpreting scans **ANY midwife who wants to expand their scope of practice to include ultrasound and wants both lecture and hands-on experience together.

We have one & two day hands-on scanning tickets available for:

  • March 14-17 Farmington Birth Center, Farmington MI

  • May 23-26 Farmington Birth Center, Farmington MI

  • July 18-21 Farmington Birth Center, Farmington MI

  • Sept 12-15 Farmington Birth Center, Farmington MI

  • Oct 24-27 The Midwife Center, Pittsburgh PA

  • Nov 7-10 Farmington Birth Center, Farmington MI Register Here

Midwifery Business Consultation

Ready to Have Support Making Your Dreams Become Reality? Ready to work for yourself? If so, click HERE ! The mission and vision of Midwifery Business Consultation is “to increase access to midwifery services, empower midwives to start businesses serving their communities, and provide educational opportunities for the midwifery profession”. Check out their many courses, resources and join their Facebook Group.


Upcoming Trainings from MBC

Our consulting team will be hosting a monthly live training series on various topics around midwifery and business!

  • November 14 at 2pm EST w/ Leslie Cornwell - Power of Passive Income for Midwives

  • December 12 at 2pm EST w/ Deidre DeGrado - Tips for Opening a Home Birth Practice . More Details Here

ACNM: Promoting Vaginal Birth for Those with Obesity; Reducing Iatrogenic Harm

November 15, 2023 | 7 - 8 PM

Speakers: Cecilia Jevitt

This presentation will provide participants with research evidence to support holistic assessment of individuals of size and provide supportive care based on pre-pregnancy health, not solely body mass index (BMI) measurement. This presentation will review the definitions of obesity, its physiology, the multiple environmental and social contributors to obesity, including systemic racism and potential effects on perinatal health. A perinatal adaptation of the Edmonton Obesity Staging System will be used along with case studies to assess obesity-related risk to plan prenatal screening needs, place of birth and prophylactic treatments. Register Here

ACNM First Assist Workshops

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

The First Assist Virtual Clinical Labs fill up fast, so be sure to Register for the date you need NOW!

  • Tuesday, December 12 (10:00am – 3:00pm EST) – Registration closes on Monday, November 27

  • Tuesday, January 23 (10:00am - 3:00pm ET) - Registration closes on Monday, Jan. 8


ACNM Wants to Listen to YOU! CEO Conversations Every Wednesday at 4 PM ET

Michelle Munroe, our interim CEO, will be starting weekly online meetings with members to listen and discuss ideas and concerns. Each week, 10 people can register for CEO Conversations. Please email executiveoffice@acnm.org.

ACNM Speaker's Bureau

If you haven’t heard already, ACNM is starting a national level Speaker’s Bureau. The intent is for ACNM to have a listing of midwives and their expertise. This is a two-fold initiative. One for us to have a list of subject matter experts and their area of expertise. Two, so ACNM can be a conduit for national level speakers. If you are interested send your resume/CV to the executiveoffice@acnm.org and include your topic areas.

Policy Center For Maternal Mental Health: The Latest Developments in Maternal Mental Health for Obstetric Providers


November 30, 2023 | 1:00pm - 2:pm PT

Calling ALL Obstetric Providers: We invite you to register to join us for a live (and recorded) presentation walking through the latest developments impacting obstetric providers in maternal mental health (MMH). This will include a review of the HEDIS prenatal and postpartum depression screening and follow-up measures and Alliance for Innovation in Maternal Health Care’s perinatal depression “bundle.” We will also introduce two new MMH resources (and one refreshed) developed by the Policy Center with you in mind:

  • A screening script (words to use to help expecting and postpartum patients feel at ease)

  • A refreshed menu of treatment options (including zuranolone and more)

  • Billing and reimbursement guidance (derived from the new HEDIS screening and follow-up specifications)

The session will include time for a roundtable discussion. Register here.

Postpartum Support International: Trastornos del Estado de Ánimo Perinatales: (Perinatal Mood Disorders: Components of Care) IN SPANISH!

December 6th & 7th, 2023 | 8:30 am - 5:00 pm CT, via Zoom

Registration deadline: November 24

This two-day course, taught by expert and engaging faculty, uses a thorough, evidence-based curriculum designed for psychiatrists, nurses, physicians, social workers, mental health providers, childbirth professionals, social support providers, and anyone interested in building skills for assessment and treatment of perinatal mood disorders. Your registration includes training manual, handouts, and certification of continuing education credits. Advanced Perinatal Mental Health Psychotherapy Training available on December 8. Register Here

Breech without Borders- Save the Date

California Workshops - January 2024

Just a quick reminder to get registered for our first workshops of 2024! Not only is space limited, but the new policy requires completion of Breech Pro in order to attend the in-person training, so allow yourself plenty of time to get it done.

 

Research Opportunity

UC Davis Study needing input from midwives/nurses

Samantha Sime (She/Her), MPH, PhD Candidate, UCD and California Maternal Quality Care Collaborative (CMQCC) Volunteer is looking to hear from you. She is studying the barriers to the implementation of equitable maternal health care policy and has been following the development of the Medi-Cal doula policy since 2018. Take a moment and scan the QR code below!


 

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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