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Writer's pictureCNMA.ORG
Feb 5, 20192 min read

Looking for a little light reading?



Here is a list of books on the history of midwifery...


1. "History of nurse-midwifery in the United States" by Sister Mary Theophane Shoemaker, published by the Catholic University of America Press, Washington, DC, 1947.


2. Bulletin of Nurse-Midwifery, which began publication in either 1955 or 1956 -many midwives were working in public health administrative jobs. 


3. Wide Neighborhoods by Mary Breckinridge


4. Midwifery and Childbirth in America by Judith Rooks (1997)


5. Lady's Hands, Lion's Heart by Carol Leonard


6. Arms Wide Open and Blue Cotton Gown by Patsy Harman


7. "Mother and Child Were Saved: The Memoirs (1693-1740) of the Frisian Midwife Catharina Schrader" by a Dutch midwife


8. Labours of Love: Midwives of Newfoundland and Labrador, by Ester Slaney BrownNurses, witches and midwives by Barbara Ehrenreich and Deirdre English


9. A Midwife's Tale: The Life of Martha Ballard by Laurel Thatcher. There's also a website that corresponds to the book - it has the midwife's diary, Martha Ballard, digitally online: http://dohistory.org/


10. Brought to Bed: Childbearing in America, 1750-1950 by Judith Walzer Leavitt


11. Deliver Me From Pain: Anesthesia & Birth in America by Jacqueline H. Wolf


12. From Midwives to Medicine: The Birth of American Gynecology by Deborah Kuhn McGregor-as I recall, the author could have been more critical of J. Marion Sims


13. The Midwives Book or the Whole Art of Midwifery Discovered by Jane Sharp


14. Article: "Downplaying Difference: Historical Accounts of African American Midwives and Contemporary Struggles for Midwifery" by Christa Craven and Mara Glatzel, Feminist Studies Vol. 36, No. 2, RE-INVENTING MOTHERS (Summer 2010), pp. 330-358


15. African American Midwifery in the South by Gertrude Jacinta Fraser


16. A History of Midwifery in the United States: The Midwife Said Fear Not by Joyce E. thompson & Helen Varney


17. Rooted in the Mountains: Reaching to the World by Anne Z. Cockerham


18. Pushed: The painful truth about childbirth and modern maternity care by Jennifer Block


19. Get Me Out: A history of childbirth from the garden of eden to the sperm bank by Randi Hutter Epstein


20. Medical Bondage by Deidre Cooper Owens

Writer's pictureCNMA.ORG
Feb 1, 20196 min read

February 2019 Newsletter



California Nurse-Midwives Association

February 2019 | Newsletter


View this newsletter as a shareable google doc HERE











 

CMQCC CRITICAL ANNOUNCEMENT


There was an important webinar this week on Jan 30th by CMQCC on the topic of BIRTH CERTIFICATE DATA ENTRY. We are involved in a large project to help ensure that midwives are getting added to the birth certificates of our patients we are delivering because our numbers are being largely underreported. See our previous newsletter for more details, or visit CMQCC’s Maternal Data Center page for more information. From the webinar on Wednesday, we wanted to bring to everyone’s attention a crucial nugget from the discussion:


'Importantly, on the most recent CMQCC webinar that addressed reporting of CNM-attended births, it was clarified that if you are supervising a midwifery student or resident, the birth attendant reported on the birth certificate should be the provider supervising the resident or midwifery student. Please distribute this information to your departments, birth clerks, and CNM colleagues.'


Keep your ear to the ground, CNMA will do our best to keep you updated on how you can help. Stay tuned for more information!


 

Governor Newsom announces first ever California Surgeon General



Governor Gavin Newsom announced the appointment of Dr. Nadine Burke Harris, a national leader in pediatric medicine, as California’s first-ever Surgeon General, and Kris Perry, a national leader in early childhood policy, as Deputy Secretary of the California Health and Human Services Agency for Early Childhood Development and Senior Advisor to the Governor on Implementation of Early Childhood Development Initiatives. There is overwhelming consensus in the scientific community around early warning signs and childhood determinants of serious health outcomes. As Surgeon General, Dr. Burke Harris will urge policymakers at every level of government and leaders across the state to consider the social determinants of health, especially for children. Her work will focus on combating the root causes of serious health conditions — like adverse childhood experiences and toxic stress — and using the platform of Surgeon General to reach young families across the state.


To read more, click here.


We’d love to hear from anyone who knows or has worked with Dr. Burke Harris. If so, please contact advocacy@cnma.org.



 

CMQCC: My Birth Matters Campaign



In the last few years, healthcare providers, payers, purchasers, policymakers, and others across California have been working together to ensure that C-sections are only performed when absolutely necessary. Overuse of C-sections leads to serious risks for mothers and babies, and while the nurse midwife model inherently and historically has supported vaginal births, additional stakeholders and providers are also now working to improve clinical care to decrease unnecessary C-sections across the state.


Patient education is a critical part of this effort, and as such, the California Health Care Foundation (CHCF), California Maternal Quality Care Collaborative (CMQCC), and Consumer Reports joined forces to develop and launch My Birth Matters, an educational campaign aimed at informing expectant mothers about cesarean delivery. The goal is to support the statewide effort by educating as many first-time, low-risk pregnant women as possible in California about the overuse of C-sections and encourage meaningful conversations between them and their healthcare team.


In order to create a successful campaign, CHCF, CMQCC, and Consumer Reports needed to remain singularly focused on the issue of C-section reduction and offer clear messaging that resonated with women California-wide.


To read more, click here.


Ready to get started or have questions? You can find all the materials on our outreach page and can email info@MyBirthMatters.org with questions or to share updates.


CNMA TASK FORCE: Birth Certificate Data Reporting


As part of CNMA's push to ensure that birth certificates accurately reflect CNM birth attendants in every hospital, we are creating the CNMA Birth Certificate Accuracy Task Force.


If you would like to participate, or know of someone who would be a good fit for such a project, please let us know. We would love to have CNM leads from across the state as well as others familiar with this problem who are motivated to assist with this project.


Please contact Holly Smith at advocacy@cnma.org.


AGAIN: On the most recent CMQCC webinar that addressed reporting of CNM-attended births, it was clarified that if you are supervising a midwifery student or resident, the birth attendant reported on the birth certificate should be the provider supervising the resident or midwifery student.


Please distribute this information to your departments, birth clerks, and CNM colleagues.

 

CNMA Membership Survey Results




CNMA recently circulated a survey to look at the possible reasons for a notable drop in our membership over the past five years. We wanted to take a broader look our organization, how we are serving our community, and at how the community of midwives views membership.


Here is what we learned from you!


In order to get started, we had looked at other professional organizations in California, like the California Lawyers Association, the California Medical Association, and the California Pharmacists Association to compare their membership numbers, membership fees, mission statements, and stated member benefits to compare what CNMA offers to its California midwives.


1. We found that most professional organizations had over 75% membership participation by their practicing community.

California has over 1100 practicing midwives, of which less than half are active members. 73.5% of survey participants stated they feel a professional obligation to participate in their professional organization. 58% of participants felt like they understood the benefits of belonging to a professional organization like CNMA. CNMA is hoping to increase our membership to match the levels of our sibling organizations to at least 75% of practicing midwives. We have power in numbers. CNMA wants to help give midwives a fair seat at the legislative table and a voice when laws affecting patient care are being passed.


2. Each organization’s mission statement emphasized the organization’s role in advocating for the rights of its members by advocating for the best patient outcomes.

In the past, CNMA has focused primarily on advocacy efforts for bills in California to improve practice laws and access to better maternal child health outcomes. 82.4% of our survey participants were aware that CNMA has funded lobbying efforts for recent bills like AB2682 which was an effort to remove physician supervision from the current language around midwifery practices (this unfortunately did not pass). CNMA is looking to continue our lobbying efforts to improve laws for practicing midwives in California.


3. Each organization has membership dues that seemed to scale with estimated income profiles. For example: CMA charges $1074/yr ($600 for the state fees and $400+ for chapter dues, all this on top of AMA dues), and CPhA was around $450.

CNMA charges an average of $200/year (this is in addition to your membership dues to ACNM) for an active membership. Many survey participants noted dissatisfaction with membership dues. CNMA hopes to help increase transparency with our budget and help our members feel like their money is being put to tangible use.


4. Other comments and feedback from the survey were clustered around unclear purpose statements (we called it your “elevator speech” about CNMA), and the desire for more accessible and regular chapter and state meetings.

CNMA wants you to create your own narratives for how you describe us to your patients and colleagues, but our aim is for you to see CNMA as YOUR professional organization that represents certified nurse midwives, student midwives, and our allied health partners in the state of California, that advocates for better legislation to improve maternal-child health outcomes, and that helps to increase visibility and accessibility to midwifery care to urban and rural patients across the state.


Survey Conclusions


CNMA is working on a revamping of our organization to help broaden our utility for our membership pool. We are devoted to increasing our organizational presence in the California, increasing our visibility online and in the media, and increasing our membership numbers so that we can have the power of all of YOU in order to make great and important changes in California for midwives and our patients!

Visit our new website: CNMA.ORG to learn more about how midwives are taking over the planet.


CNMA.ORG Presents: MEET THE MIDWIVES


CNMA.ORG is undertaking a BIG project, and we need your help! Please send us your bio for our new page: cnma.org/mtm. It’s a project we’re calling MEET THE MIDWIVES, and we are trying to get every midwife in California to participate!

Imagine… one place for patients and community members to find all the midwives of CA!


As our profession gains momentum in California, we need to make it easier for our patients and colleagues to find us.

Please send us: a short bio with your credentials (CNM, LM, NP, PhD, etc), a photo or video (please label the file with your full name), and the name, address, and link to the site for where you practice. We will issue each midwife their own URL (cnma.org/your-name-here!)


A sample bio here: cnma.org/elizabethkicko


CNMA.ORG will try to have your bio up and running within 7 business days! Email your bios to: media@cnma.org


Thank you and please share with all your midwife friends!


-Media Team at CNMA

media@cnma.org



 

Questions? News? Want to get involved?

Email us at info@cnma.org



 

That's all for this month's issue. Don’t forget to post this in your call room at work!


Catch you next time,

CNMA Media Team

Visit us at CNMA.ORG


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

Writer's pictureCNMA.ORG
Jan 30, 20194 min read

Call the midwife! (If the doctor doesn't object)


Jan. 15, 2019, 2:35 PM PSTBy Anna Gorman, Kaiser Health News

https://www.nbcnews.com/health/womens-health/call-midwife-if-doctor-doesn-t-object-n958921



Every morning at Watsonville Community Hospital in Northern California, the labor and delivery team divvies up its patients — low-risk ones go to the midwives and high-risk ones to the physicians. Then, throughout the day, the doctors and midwives work together to ensure that the births go smoothly.


“We kind of divide and conquer,” said Dr. Julia Burke, chair of the hospital’s obstetrics and gynecology department.

The hospital began allowing certified nurse midwives to deliver babies in 2017, part of an effort to decrease cesarean sections and make mothers happier.


It wasn’t an easy transition, Burke said. Some doctors, for example, had been practicing for 30 years and had never worked with nurse midwives, who are registered nurses with a graduate degree. Pharmacy, medical billing and other departments were also hesitant about the change, unsure of what it would take to integrate nurse midwives, she said. “It took a lot of convincing,” she said.


Throughout the country, hospitals and medical practices are battling old stereotypes and sometimes their own providers and employees to bring on certified nurse midwives. To do so, they have to overcome a lack of knowledge about the safety and benefits of midwifery care and the laws and policies that restrict the use of nurse midwives.

Related


Certified nurse midwives are trained to provide women’s health care, including family planning services and maternity care. In childbirth, they typically handle normal births and leave more complicated cases to physicians. There are more than 11,200 certified nurse midwives around the nation, including about 1,200 in California.


Women cared for by certified nurse midwives have fewer C-sections, research shows, which can improve birth outcomes and produce significant cost savings for hospitals. A 2017 study, for instance, also found fewer epidurals and less use of anesthesia among low-risk women with care led by certified nurse midwives, compared with care led by physicians.


Despite the data supporting the use of nurse midwives, they attend fewer than 9 percent of births in the United States. That’s far lower than in some European countries, where more than two-thirds of births are attended by midwives, said Laura Attanasio, assistant professor of health policy and management at the University of Massachusetts at Amherst.


Lack of awareness among patients and other providers is a key reason, Attanasio said. “When people hear the term ‘midwives,’ people think you are really talking about home births,” she said. In fact, she said, most midwife-attended births take place in hospitals.


Attanasio said that to significantly increase the number of births attended by midwives, physicians and hospitals must be willing to bring them on board, and create more nurse midwifery training programs. “Our maternity care workforce reflects the way it’s been for the last 100 years,” she said.


Administrative hurdles pose another challenge in some regions. Six states, including California, require nurse midwives to practice under the supervision of a physician, said Kim Dau, associate professor at the University of California at San Francisco. Yet doctors may be reluctant to assume those supervisory duties because they’re worried about malpractice liability or a bigger workload.


Attempts to change the law in California have so far failed because of infighting between the state’s medical association and hospital association.


To help overcome the obstacles, the Pacific Business Group on Health, a California nonprofit health organization representing employers, is trying to expand the number of hospitals and physician practices that use midwives. It has created guidelines for how to integrate them, and is laying out a business case to convince doctors and hospitals.


The group argues, for instance, that midwives can help reduce OB-GYN burnout and reduce malpractice cases associated with unnecessary C-sections.


Bringing midwives into hospitals and physician practices also can help increase their clientele, said Brynn Rubinstein, associate director of the organization’s maternity care program. “Women are really hungry for lower intervention in birth,” she said. “Midwives are a great option for them.”


More women would use midwives if given the option, according to a recent survey by the California Health Care Foundation. Seventeen percent of women surveyed said they would definitely want to be cared for by a midwife in a future birth, and 37 percent said they would consider it.


But women can’t always find them, or they may harbor misconceptions about the safety of midwife-led care, interviewsconducted by the Pacific Business Group on Health reveal.


Lauren Lockwood, a midwife in Walnut Creek, California, said some of the doctors she works with at John Muir Medical Center also had misconceptions about midwives: “Most OB-GYN physicians don’t know what education I have gone through, what my experience is and what I am qualified to do.”


Lockwood said some physicians also may feel “a little threatened” by competition from midwives, but others see the value.

Some hospitals, including Highland Hospital in Oakland, California, have used midwives for at least 20 years, said Katie McKee, interim nurse manager of the midwifery program. There, the OB-GYN doctors work collaboratively with the midwives, who handle most of the prenatal care, triage and about 70 percent of deliveries, McKee said.


McKee said there is always at least one physician and one midwife at the hospital, and they communicate constantly. “We are always working as a team,” McKee said.


At Watsonville Community Hospital, about 15 miles south of Santa Cruz, administrators knew they had to do something to bring down their C-section rate for low-risk births, which was higher than the state average. In 2016, Burke, the OB-GYN, helped start a hospitalist program there so physicians would always be on site. That allowed women to be in labor longer without doctors intervening with medication to induce labor.


Then Burke, who also directs OB-GYN services at the clinic network Salud Para La Gente, worked to bring in the nurse midwives from the clinic. They’re now at the hospital every weekday from 7 a.m. to 7 p.m.


It’s too early to tell if the nurse midwives have helped reduce the C-section rate, which is now 24.9 percent, but Burke said she expects it to decline.


Now Burke and lead midwife Sarah Levitan want to expand the program so midwives are always at the hospital. “To truly see the value of midwifery, we need to be there 24/7,” Levitan said.


Kaiser Health News is a nonprofit news service covering health issues. It is an editorially independent program of the Kaiser Family Foundation that is not affiliated with Kaiser Permanente.




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