The US has the worst perinatal outcomes of any developed nation in the world. In countries where outcomes are better, midwives (not physicians) are the primary care providers for the vast majority of pregnant, birthing, and postpartum people.
On April 23, Elephant Circle and the Alliance for Early Success came together for a webinar offering participants an opportunity to think about bipartisan policymaking to increase access to and improve the practice of midwives in the US, especially community-based midwives. We discussed the history of midwifery, the various midwifery credentials currently practicing in the US, and reviewed the difference between the midwifery and obstetric models of care as all of these elements impact current legislative and regulatory policymaking.
We shared stories of successful and challenging policymaking for midwives, which set the stage for participants to begin strategizing for their own communities.
See the slides from the webinar.
Watch the recording of the webinar (the access code is kG+5KI).
Or download detailed notes from the presentation.
The panelists for the webinar were:
Elon Geffrard, BS, CD(DONA), ICCE, CLC, Co-founder and Perinatal Education and Support Director, Birth Detroit
Pia Lea Long, BA, CD, CLC, CPSS, Director of Birth Justice Infrastructure, Elephant Circle
Justina Nazario, CPM, BSM, Founder, Rooted in Midwifery
Heather Thompson, MS, PhD, Director of Research, Training, and Education, Elephant Circle
TheyThe pnelists opened by framing birth as an opportunity for intergenerational support and impact—for both mom and baby. The way people feel when giving birth or being born is important. Improving access to midwives is a bipartisan issue, given midwifery’s role in interrupting infant mortality rate.
Other “why’s” for access to midwifery advocacy include:
- There is a need for policies that support the integration of midwifery care so their work is valued and reimbursed.
- Midwives are the biggest difference between the U.S. and countries with less maternal mortality.
- When midwives are well integrated with physicians, families get the best of both worlds.
The panelists also took a moment to define key terms:
Midwife: A midwife is a trained, licensed, regulated expert in physiologic birth and the midwifery model of care. Midwives provide primary care for pregnant/birthing.postpartum people and their newborns; midwives optimize physiologic birth, center shared decision-making, and collaborate with other perinatal providers when a different level of care is needed.
Doula: A doula provides non-clinical peer support to families during pregnancy, birth, and postpartum. Most doulas are trained; doulas are not licensed.
Physician: A physician is a trained, licensed, regulated expert n the allopathic model of medicine. In perinatal care, obstetricians care for pregnant/birthing/postpartum people, and pediatricians care for newborns.
The panelists argued that policymaking should shift from the expectation that everyone should have a surgeon for their birth. OBs are important for high-risk births. Midwives are appropriate for low-risk cases—and they provide more holistic care and support.
The slides and recording from the presentation (links above) provide a deeper dive into the policies that can improve maternal health and lower the disparities in outcomes by focusing on the right care for families and their situations.