The State of Midwifery (Part 3): Advocate for Midwifery

Hello Monday 🙂 You snuck up like you do every weekend.

The last topic in our series (Part 1 and Part 2 are here if you missed them!) on the State of Midwifery is applicable to everyone:

ADVOCATE FOR MIDWIFERY.

You can act on this simple idea from exactly where you are. VOGUE magazine said it best and declared midwives as “The New Front Line.” To me, it’s a pretty awesome goal to rally around.

When it comes to advocating, everyone has to decide how best to advocate from where they are. Additionally, sometimes your phase of life dictates when you’re able to contribute more or less to a cause. When I didn’t have kids and worked 6 days a week (because I loved to work that much), time was a completely different concept to me. With three kids and two spouses working full time, I do a lot of advocating in small spurts of time throughout nap times, after bed time and between laboring mamas. All the minutes add up, but it’s how you decide to use the minutes that counts.

With that in mind, take a look through the list and pick one thing that you can do to help advocate for midwives in 2021.

Want to do more? Decide on one thing a month. It can be as simple as a handwritten letters to your Congressmen about supporting midwifery, supporting women and supporting families and children.

Let’s get to work.

For women….

Seek out midwifery care for your pregnancy, birth and well-woman needs (and know that you may have to pay out of pocket for midwifery birth services).
- Look to see if your insurance covers midwifery care for preconception care, pregnancy care, birth, postpartum visits, well woman exams, and visits for other women’s health concerns (vaginal infections, breast lumps, contraception, cervical dysplasia, menopause…).
- If you birth at a hospital with midwives and physicians, ask for the midwife to care for you during birth! Don’t be afraid to ask.
- Do a simple google search to find midwives in your area or use this site from ACNM: https://www.midwife.org/find-a-midwife.
- It matters where you decide to put your healthcare dollars!
Share your stories of midwifery care and how your midwife compared to other obstetric care you received (check out these stories on the birth stories link at the top of the page).
Follow midwives and women’s health initiatives on social media platforms. Take a look at some of following accounts @amidwifenation for ideas.
Register to vote in your state and keep up with legislation related to healthcare, pregnancy, women, birth and midwives.
Support proactive laws and voice opposition to restricting laws. We live in a democracy and you have a right to share your voice.
- Some great examples recently are the efforts in Virginia and Alabama. See this past Friday Five for how to voice support for autonomous CNM practice in these states!

For aspiring midwives…

Whether you’re in midwifery training now, or just aspire to one day be a midwife, keep up the hard work. Women need you. The maternity care system needs you. Know that midwifery training is a long road and that it is totally worth it. It is a calling. There’s no greater job in the world!
Join professional organizations as a student and stay involved. Go to local meetings and if there isn’t one, start a local meeting.
Find midwives in your community across all birth settings – offer to take them to coffee and ask about their job, their hours, and birth in the community. You would be amazed what you can learn in an hour from someone farther into the journey than you are.
Start brainstorming solutions now. The maternity care system needs repairing. Help find the solutions. What is obvious to you is not necessarily obvious to other people.

For midwives…

Know the hallmarks of midwifery and use those as your benchmark for maternity care. Go back to these and speak about these as often as possible. Midwives are experts at normal birth and should be the managers of the majority of birth settings in the United States. Regardless of how tiresome you may feel about sharing these hallmarks, these are the most important things to share with others about midwifery care.
Keep learning. Healthcare is changing every day. Make sure you’re reading good information that is well cited and educational. Don’t know where to start? Check out the RESOURCES.
Keep being an awesome midwife. Show up, smile, give excellent care. Be there for women, their babies and their families. When women say thank you, thank them for being a part of their birth and for choosing midwifery care.
Precept aspiring midwives. Help make more midwives. Midwife students need approximately 1,000 clinical hours. Every hour counts…every hour helps make a new midwife.
Go back to school. Run for public office. Start a business. We need midwives beyond the bedside. We need midwives as hospital administrators, legislators, mayors, non-profit leaders, community leaders…the possibilities are endless. The point is this: at some point, we need midwives to do more than be with women and their babes. Keep your heart and ears open for these possibilities. Listen to the needs of your community – does your community need to learn more about midwives? Host a table at a local health fair and educate your community about midwives!
Stay involved. Be a member of the national and local organizations. If there’s a seat at the table, make sure a midwife is sitting in it!
Keep reading. Read new evidence. Read new guidelines. Don’t ever stop reading.
Keep believing in midwifery.
And when in doubt, make some placenta prints – mamas love ’em!

For organizations…

Recognize that midwives are a solution and help spread the word. Build business with plans with midwives at the center for pregnancy and birth management.
Publish position statements and statements of support like this position statement on August 29, 2019: March of Dimes Position Statement Midwifery Care and Birth Outcomes in the United States.
Conduct more research. Continue to show that midwives offer the same outcomes as OB/GYNs with fewer interventions.
Collaborate with national midwifery organizations. Collaboration ultimately supports better maternal and infant outcomes.
This was one of the greatest ideas I’ve heard about…Consider a Department of Midwifery as suggested by Hilary Schlinger on this podcast! When I worked at the University of Colorado Hospital, there were two CNM practices that delivered their patients on the two birthing floors. It was amazing. They had autonomous practice and the directors of both programs were fantastic.

There’s a lot of policy work to do for midwifery to advance. But there are a lot of small steps that different people can take along the way to help as well. For practicing midwives, precept when you’re able. For women, seek out midwifery care for your pregnancies, births and well-woman needs. For hospitals, put midwives in charge of labor and delivery floors and while your preterm birth and C/S rates fall, you’ll see your natural birth, intermittent auscultation and labor support rates soar. For midwifery schools, be transparent about how we can help you manage the pipeline – be transparent. A report that is only published every few years doesn’t offer many options for help if the workforce and the public doesn’t know what is going on. For organizations, keep promoting midwifery as the solution (thank you March of Dimes!). If you’re involved in philanthropy, consider giving money to efforts that advance and promote midwifery across your community, state or the country.

One step at a time – that’s how advocacy is done.

Here’s a flyer that promotes everything we chatted about through the series. Share it widely and proudly!