How We Advance Midwifery

We are bringing together people from around the state to join our team to move midwifery care to the next level:

  • removing barriers to practice and access midwifery care
  • contributing financially to birth equity in midwifery
  • making substantial legislative and policies changes that support midwifery sustainability
  • educating the public so they know midwifery care is an option

Click below to join our movement and donate to secure midwifery care for generations to come.

Quality Improvement Initiatives

Over the years, CAM has supported CALM's quality improvement initiatives through targeted grants including some of the following.

Covid-19 Response

When licensed midwives (LMs) were struggling with accessing personal protective equipment (PPE) because they are a marginalized and invisible profession, CAM worked with other organizations to distribute appropriate PPE during the early weeks of COVID.

CALM offered two webinars to California midwives as COVID was unfolding to update them on ways to respond while providing care in the community.

For example, the latest recommendations for reducing the spread with patients in their homes and in clinic settings and necessary changes for informed consent that needed to be quickly implemented.

Additionally, CALM put together in very short order, numerous resources on their website to support midwives during this quickly evolving pandemic.

Mailing PPE to midwives around the state
Mailing PPE to midwives around the state

CALM Transitions

Community midwives need the cooperation of other medical health professionals and hospitals in order to facilitate safe care, birth, and outcomes.

CALM Transitions uses a World Health Organization framework of inter-professional collaboration and education.

Containing Education

Regional worships were a series of trainings implemented in 2019 throughout the state of California focused on improving outcomes.

Topics included:

  • Creating a QI Program in Your Backyard
  • Holistic Risk Assessment for Community Midwives
  • Fetal Monitoring in the Community Setting
  • Trauma and Resilience Informed Care
Vacaville Regional Workshop, November 2019
Vacaville Regional Workshop, November 2019

Policy Advocacy

Our policy goals are to ensure access to midwifery care for generations to come and that midwives can sustainably practice without onerous regulation.

Our Next Big Thing

Currently California LMs are regulated by the state Medical Board which is the case in only two other states in the US, including Louisiana.

This creates a multitude of problems because the Medical Board is so large, midwifery is not the practice of medicine, and LMs are constantly being viewed through a biased lens by people who have no training in midwifery.

This has led to expensive futile regulatory stalemates, and stressful unnecessary LM investigations.

Fighting Hostile Bills

CAM and CALM have been there for the midwifery community in times of crisis and times of opportunity.

When CMA and ACOG introduced hostile bills, CAM and CALM's rapid-response team reached out to supporters quickly to mobilize strong and well-coordinated opposition, like with did with SB 457 Bates in 2017 (which would have placed comprehensive restrictions on all out-of-hospital births), and more recently to successfully thwart a proposal by the Medical Board to ban VBAC care with LMs in 2019.

 

The turnout to that Medical Board meeting was significant. You can watch the recording below and fast forward to:

  • 27:54 to witness the community testifying
  • 1:01:31 to understand why this motion was before the Medical Board
  • 1:06:26 for the actual vote

Thank you to CALM who rapidly communicated with the community and organized this advocacy.

Supporting & Initiating Positive Legislation

As we continue to proactively put forth legislation that protects and improves access, CAM is counting on the community's ongoing support -- as they did when we:

  • passed SB 407 Morrell (which expanded LM care under Medi-Cal) and SB 408 Morrell (which defined and protected the status of midwife assistants)
  • passed provisions for further integration of LMs in SB 798 Hill (which included professional corporations and protected peer review provisions for licensed midwives)
  • painstakingly laid the groundwork for legislation to put guidelines back into regulations and for an independent Licensed Midwife Board.

Increasing Medi-Cal Access

Initiated and collaborated with other stakeholders to make recommendations to the California Department of Health Care Services in 2017 for what's called an All Plan Letter which notified managed care plans of their legal obligation to include licensed midwives, nurse midwives, and freestanding birth centers in their networks.

This All Plan Letter was key in advancing access to midwifery for Medi-Cal beneficiaries.

As of 2020, some managed care plans are following the law and thus access has greatly increased. Whereas other plans have not, so there is more work to be done.

As part of our Medi-Cal advocacy, we have been working with policy makers for several years to get qualified birth centers licensed so they can be Medi-Cal birth center providers.

Equity

Black Student Midwife Scholarship Fund

This year CAM launched a campaign to raise and distribute scholarship funds to offset the burden of living and educational expenses of Black student midwives planning to get licensed in California.

Midwife of Color Professional Support

CAM funds 40 annual memberships for BIPOC student and licensed midwives to the state professional association, and our sister organization, California Association of Licensed Midwives (CALM).

Additionally in collaboration with CALM, CAM offers continuing education scholarships for BIPOC student and licensed midwives.

NARM Prep JumpStart: Insider's Guide for Student Midwives of Color

JumpStart brought together nine student midwives of color from around the country for a 4-day retreat in October 2019 focusing on community, knowledge, and how to prepare for the NARM.

Student midwives of color who currently lived, or planned to work, in California were the focus of the retreat.

As one attendee said, "Regardless of the systemic challenges, oppression, and racism in the communities I'm from, I have seen the potential of what is possible through being here and that's invaluable."

Other On-Going Initiatives

  • Work with policymakers to institute Medi-Cal and private insurance policy to comply with federal provider non-discriminatory laws so midwives can receive equitable pay
  • Currently Licensed Midwife Annual Report does not collect demographic data. So we are working with the Midwifery Advisory Council to change that so we know what kind of impact midwifery care is having among BIPOC communities as well as identify the number of BIPOC midwives in the state.
  • Ongoing Board development and training so we can be responsible with public resources.
  • Protect access to community VBAC so more pregnant people can avoid unnecessary cesareans mandated by hospital VBAC bans.