EXPAND ACCESS TO MIDWIFERY CARE

 Midwives are trained health care professionals who support otherwise healthy pregnant people during labor, birth, and after the birth of their babies. In the US, there are  three types of midwives:

  • Certified Nurse-Midwives (CNM)

     Certified nurse-midwives also have a nursing degree. They’re licensed in 50 states plus the District of Columbia and US territories, and can give patients prescriptions. They are educated in graduate-level midwifery programs accredited by the Accreditation Commission for Midwifery Education (ACME), and must pass the national certification examination administered by the American Midwifery Certification Board (AMCB) before receiving their license. 

  • Certified Midwives (CM)

    Certified midwives are licensed only in Delaware, Hawaii, Maine, New Jersey, New York, and Rhode Island, and are allowed to give patients prescriptions only in New York, Rhode Island, and Maine. Like CPMs, the CM designation requires a graduate degree and for a potential midwife to pass national certification examination administered by the American Midwifery Certification Board (AMCB). 

  • Certified Professional Midwives (CPM)

    Certified professional midwives (CPMs) are licensed in 34 states and the District of Columbia: Alabama, Alaska, Arizona, Arkansas, California, Colorado, Delaware, District of Columbia, Florida, Hawaii, Idaho, Indiana, Kentucky, Louisiana, Maine, Maryland, Michigan, Minnesota, Montana, New Hampshire, New Jersey, New Mexico, Oklahoma, Oregon, Rhode Island, South Carolina, South Dakota, Tennessee, Texas, Utah, Vermont, Virginia, Washington, Wisconsin, and Wyoming as of May 15, 2020. The CPM designation does not require an academic degree, and instead is based on demonstrated competency in specific areas. All Certified Professional Midwives meet the standards for certification set by the North American Registry of Midwives (NARM), which were implemented in 1994. CPMs can gain their certification by completing an  education program accredited by the Midwifery Education Accreditation Council (MEAC) or the Accreditation Commission for Midwifery Education (ACME), or instead they can complete the Portfolio Evaluation Process. CPM is only midwifery credential that requires knowledge about and experience in out-of-hospital settings.

  • As of now, despite requiring twice as much out of hospital birth experience and rigorous practical standards CPMs are not licensed to practice in the state of New York. Despite allowing CPMs to practice during the pandemic, through executive order, CPMs in NY State do not have the ability to put down roots and sustainably provide services do birthing people in New York.

New York State struggles to have adequate access to Midwifery care and is actively criminalizing Community Midwives (CPMs)

  • The easier it is for all three types of midwives to practice and to open birth centers, the easier it is for pregnant people to access the care they need.

  •  34 out of the 50 states have recognized the valuable role that community midwives play in supporting reproductive health and reducing racial inequalities in  outcomes, however in NY State CPMs are criminalized for providing care.

  • CPM’s are midwives that are trained in out of hospital and community birth settings require twice as much experience to be certified as those with nursing or graduate degrees. Therefore CPM’s tend to represent and serve BIPOC communities where the need is most dire.

  • Right now, many pregnant people, especially Black people, are unable to access adequate care while pregnant, during birth, and afterwards.

  • There are lower maternal mortality rate in states with higher numbers of birth centers and more births attended by CMs and CNMs, suggesting that the prevalence of midwives and their ability to practice with minimal restrictions protects the health of pregnant people and reduces risk in pregnancy. 

  • The study “State Scope of Practice Laws, Nurse-Midwifery Workforce, and Childbirth Procedures and Outcomes” found that states which support autonomous midwifery practice and allow CNMs to practice more freely, have a greater proportion of CNM-attended births, which is associated with better birth outcomes, in particular lower odds of cesarean delivery, preterm birth, and low birth weight, compared with women in states without autonomous practice laws.

  • Currently midwives in the US attend only 7% of births, while in other countries in the Global North midwives attend 50-75% of births.

  • During the COVID-19 pandemic, Governor Cuomo briefly lifted these restrictions when the need for community health workers was dire. The pandemic has not ended and New Yorkers continue to demand respectful healthcare that midwives can offer. New Yorkers need and deserve more qualified midwives.

  • In fact, the first Black-owned Midwifery School in the United States was just accredited to offer education for direct entry midwives and under the current New York law, graduates of the school would not be able to practice in New York, despite their experience. In a time where we need more Black and Brown Midwives, it is outrageous that these health care providers continue not just to be restricted but criminalized.

Allowing CPMs and CMs to practice freely in NYS would go a long way toward reducing maternal mortality rates, particularly for Black and brown pregnant people who are most at risk for death and other pregnancy complications due to structural racism. 

CPM:CM:CNM.png

The chart above includes more details on the educational requirements and clinical experience required for licensure for CMs, CNMs, and CPMs.

LEGISLATIVE ACTION


Stop Criminalizing Community Midwives, and instead expand the number and access to Community Midwives who are often of color and serve vulnerable populations.

Permanently create a path for licensure for Certified Professional Midwives by editing Title 8, Article 140, section 6955 of New York's Education Law and Subpart 79-5 of the Commissioner's Regulations. 34 out of the 50 states have recognized the valuable role that community midwives play in support reproductive health and reducing racial inequalities in outcomes. During the COVID-19 pandemic, Governor Cuomo briefly lifted these restrictions when the need for community health workers was dire. The pandemic has not ended and New Yorkers continue to demand respectful healthcare that midwives can offer. New Yorkers need and deserve more qualified midwives. In fact, the first Black-owned Midwifery School was just accredited to offer education for direct entry midwives and under the current New York law, graduates of the school would not be able to practice in New York, despite their experience. In a time where we need more Black and Brown Midwives, it is outrageous that these health care providers continue not just to be restricted but criminalized.

  • Email your State Senator, Assembly Member to introduce legislation to give Certified Professional Midwives the ability for full scope of practice in New York State.

  • Email your City Council Member to sponsor a resolution to ask the State legislature to give Certified Professional Midwives the ability for full scope of practice in New York State.

  • Email Governor Cuomo to use his Executive Authority to permanently create a path for licensure for Certified Professional Midwives by editing Title 8, Article 140, section 6955 of New York's Education Law and Subpart 79-5 of the Commissioner's Regulations.