President’s Pen: Wrapping Up the Year of the Nurse and the Midwife

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The Year of the Nurse and the Midwife began with such promise and evolved into a year that was both uncertain and challenging. ACNM developed a variety of initiatives for to celebrate this monumental year, along with a broad communication strategy to raise public awareness of midwifery. When the COVID-19 pandemic took center stage, our profession and our organization was forced to respond by placing many of these initiatives on the backburner and focusing instead on the immediate needs of our members.

ACNM shifted quickly to provide members with several COVID-19 resources, including webinars that were free to members and non-members and a COVID-19 Connect community. The pandemic put a strain on our already fragile system and midwives became the forgotten front line, in many cases without sufficient PPE and struggling to provide safe and appropriate care to those we serve. We, the midwives, took a stand to protect the rights of childbearing families while dealing with personal exhaustion and illness. We persevered despite being furloughed as elective services and surgeries were cancelled and have learned a lot throughout this challenging year.

Another hallmark of this year has been an intensified lens on systemic racism and inequality in the United States. Since the establishment of the ACNM Diversity and Inclusion Task Force in 2012, we have come a long way toward broadening and deepening the conversation about diversity, equity, inclusion, and now belonging, within our organization and the profession. However, we were moving at a snail’s pace. The civil unrest following the death of George Floyd focused a spotlight on systemic racism and the white supremacist system in our country, within the College, and within midwifery. This was more than a call to action; it was a hard slap in the face that we must do better to make a more equitable society for all. We had some difficult conversations with our members at several listening sessions. It is not easy to hear the stories of years of harm and pain. So many of us were blind to the day-to-day reality of our BIPOC members and students. However, we finally listened and heard, and this informed our Anti-Racism Roadmap for Change. The roadmap is more than a checklist to placate; rather, it is a representation of the College’s commitment to our members to change our culture.

One piece of the roadmap was the creation of the ACNM Task Force on Racism in Midwifery Education to identify the issues surrounding racism for our students and to offer solutions. While we continue to focus on reducing maternal mortality and morbidity in this country, especially critical for Black, Indigenous, and persons of color (BIPOC), we are making progress by raising awareness of known disparities. We know that care received from a provider who looks like the population they serve is a critical factor in improving outcomes and to that end we are focusing on recruitment of more BIPOC people into the profession.

ACNM leadership stands accountable to make the changes needed to make this a safe place for all. Change will not happen overnight. It will take all of us committing to do the learning, to examine our biases and to want to change. We have done so much this year along our path to becoming an anti-racist organization, but it is not enough. We must continue into 2021 and beyond.

If this wasn’t enough, during 2020 there were the fires out west and the hurricanes in the south. But we are resilient and resourceful. Each of you stepped up to continue to provide care and to be the voice for the people you serve. The College stepped up to provide resources and to be your voice on a national level. Here are some of the highlights of our work in 2020:

  • COVID-19 webinars and resource page
  • Revised Core Competencies for Basic Midwifery Practice
  • Our first virtual Annual Meeting
  • Our first Inclusion Conference
  • Our first LEAD Leadership Development Programs for midwives and students
  • Our first Student Awareness Month in March
  • Enhanced efforts to address racism in our organization/profession
    • Roadmap for change
    • Webinar series
    • Committee/task force work (Racism in Midwifery Education Task Force)
    • Racial Equity Lens tool
    • Volunteer pledge
  • Reduced dues for student members
  • National Midwifery Week: Midwives for Equity
  • Bylaws change to allow voting of appointment members (MOCC chair and Student Representative)
  • Bylaws change to add a consumer member and a midwife of color at-large member to the Board of Directors
  • California passed the Justice and Equity in Maternity Care Act (SB 1237), removing the requirement for physician supervision
  • Oklahoma passed legislation to recognize Certified Midwives (CMs), and four other states are working on similar bills
  • New ACNM Strategic Plan for 2021-2024
  • Position statement on Postgraduate Midwifery Fellowship Programs
  • Position statement on Mental Health During Childbearing and Across the Lifespan
  • Position statement on Immunization in Pregnancy and Postpartum
  • Issue brief on The Language of Midwifery
  • Formation of the Black Midwives Caucus for Reproductive Justice and Birth Equity
  • Established a task force for Innovative Models of Midwifery Education
  • Established a task force on Core Competencies for Midwifery Doctoral Programs

I cannot predict what new challenges 2021 will bring. None of us have clarity for what lies ahead. I do know that we must continue to fight for reproductive justice and health equity. To fight for legislation that ensures full practice authority, medical staff privileges, and increased funding for midwifery education. To fight for physiologic birth. To fight to dismantle systemic racism in our profession, in our schools, and in our college. I believe in every one of your capacities and in our joint capability to be the change we want to see.