On the Cusp of Change: A Vision for ACNM’s Future


As we close the chapter of one year and move into the next, I am pleased to share with you my background and vision for leading the next stage of change for the American College of Nurse-Midwives (ACNM) and the midwifery profession. For the last 24 years of my professional career, I have chosen to work in organizations on the cusp of change. When healthcare reform was at its peak, I worked with physiatrists to carve out their position in organized medicine. Quality, licensing, and continuing education became intertwined as the cottage industry of healthcare became more vulnerable to regulatory standards. As tax reform took center stage, I worked with enrolled agents (tax experts) to position themselves as resources to their clients when artificial intelligence threatened their livelihood and they were forced to compete with smart software that could prepare your taxes and coach you through understanding deductions in under an hour.

Both the College and the midwifery profession are on the cusp of change, but this effort feels more humanitarian than others I was involved in due to its healthcare focus. The path to change within midwifery begins with making a commitment. From there, it requires a clear path forward and action to dismantle the systems that prevent certain people from having access to power over others. My vision for change in this organization has three tenets: 1) tell the truth, 2) provide the voice, and 3) lead the change.

Acknowledging the mistakes of the past allows for healing. ACNM’s diversity, equity, and inclusion (DEI) plans begin with investigating the history of midwifery and sharing stories of the founding midwives who shaped this profession. Telling the truth sets you free. Where there is a failure to acknowledge the truth, there is an opportunity to make it right. ACNM plans to share this history with members through webinars and in programming at the 2021 Annual Meeting; but it doesn’t stop there. We also plan to develop a broad marketing and communications plan that celebrates midwifery history and gives credit where it is due.

Best practices in DEI strategy dictate that you must have a diverse leadership and membership to ensure all perspectives are included. Diversity means difference. A diversity of thought helps you to not have as many blind spots in decision making. Over the last year, ACNM has increased the number of Black, Indigenous, and people of color (BIPOC) in its membership significantly and celebrates having the most diverse slate of Board members in its history. The work doesn’t stop here, and this only marks the beginning of turning the corner to embrace differences that cut across social, racial, and political lines. The goal is to ensure the door remains open for all to enter. Our future work will focus on more equitable access to leadership positions and criteria to consider when selecting leadership candidates. ACNM will review its decision-making process to ensure that recommendations that come to the Board for approval have been vetted through an equity lens.  

The long game for this organization is to become a model of how to ensure a more diverse profession. We know maternal mortality and morbidity disproportionately impact BIPOC patients. We also know patients are better served by health care providers who look like them and can offer insight and expertise that more effectively meet their needs. Knowing all of this creates a moral imperative to model the way to inspire a future of midwives who enter the profession to meet a higher calling that aligns with a significant healthcare need.

If this year has taught us anything, its that change is inevitable and that it is impossible to predict what the future will hold. As much as we are different, we are also the same. I invite you to join me on this our new path forward.

“Because the people who are crazy enough to think they can change the world, are the ones who do” — Rob Siltanen