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Maura Larkin, CNM, LM MSN

Candidate for Secretary

See Maura’s CV here

Question: What challenges to midwifery practice have you observed/experienced either nationally or in your region, and what solutions would you suggest or implement to eliminate that barrier?

Answer: One of the most significant challenges to midwifery is the implementation of evidence-based practice in reproductive and maternity health care at the national, state, practice, and provider levels. This challenge presents us with opportunities to:

  • Create systemic support for physiologic processes in labor and birth;
  • Support the midwifery model of care; and
  • Mitigate reproductive justice issues, such as access to appropriate care.

As a practicing public health midwife and service director in an academic medical center, I have the advantage of working within a setting that supports the application of evidence-based research in reproductive and maternity health care. The challenge is that there is much work to do within regional and local systems, including my own setting, to harmonize the range of privileges and oversight to which midwives are subject.

The expansion of midwifery practice must be fostered through the creation of local, state, and national policy, informed by the growing body of evidence supporting the demonstrable quality and value of midwifery care. Practicing midwives need support to integrate evidence-based research into practice guidelines, to strengthen the midwifery model of care, and to demonstrate the value of midwifery within reproductive and maternity health care systems.

Advancement of midwifery practice also implies support for midwifery education and training. Clinical training opportunities for student midwives and support for graduate midwives entering practice is a significant challenge in my region and, I believe, nationally. The creation of graduate midwifery fellowship programs in regional centers could be adopted to support transition to practice, further the study of physiologic labor and birth, and advance education and training in reproductive health care.

National legislative efforts also remain an ongoing challenge. The Improving Access to Maternity Care Act of 2014 addresses access to high-quality maternity and reproductive health care services and, for me, represents one of our most important national issues.

American College of Nurse-Midwives.
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