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Honoring our Past

The First 60 Years: A Retrospective

Take a journey with us through the first 60 years of ACNM history, from the initial spark toward organization in 1955 to the blazing future of US midwifery today.

Lighting the spark, finding an identity

1955: The signing of the American College of Nurse-Midwifery Articles of Incorporation. From left to right: Sister Theophane Shoemaker (Agnes Reinders), CNM; Pat Simmons, CNM; Anne Fox, CNM; and Sister Judith (Rita) Kroska, CNM.

The first annual meeting of the American College of Nurse-Midwifery was held in Kansas City, and attended by 17 CNMs.

1956: ?We have a pioneer job to do, and if we work as well and as constructively in a group as we have in the past as individuals, we can help to improve professional competence, provide better service and educational programs, and make fuller use of resources. The future looks bright.? Hattie Hemschmeyer, CNM, ACNM's first president, in the first Bulletin of the American College of Nurse-Midwifery.

The Bulletin later became the Journal of Nurse-Midwifery, which changed its name in 2000 to the Journal of Midwifery & Women?s Health. Learn more at, and access the special 2005 ACNM 50th anniversary issue for free all year at

1963: Philosophy of the ACNM was released, stating the foundational principles of ACNM.

1965: Congress created Medicaid and Medicare.

1966: Functions, Standards, and Qualifications, the first document to define scope of practice, standards for practice, and education requirements for CNMs was issued.

1969: American College of Nurse-Midwifery merged with American Association of Nurse-Midwives, forming the current American College of Nurse-Midwives.

The seal of ACNM, designed in 1955 by Rita Kroska, CNM, and updated in 1969, reflects basic philosophical beliefs of nurse-midwifery.

1970: ?I became a CNM in 1970, graduating from Columbia University. We were the first class to take the national certifying exam. I was then employed by Columbia University to work at Harlem Hospital?I enjoyed especially the teens and the first time mothers. We were encouraged to participate in ACNM and to be active in the NYC Chapter. There I met many great legends like Dorothea Lang, Betty Carrington, and Mary Sweeting? Freda M. Bush, CNM,MD, FACOG.

1971: The birth of the exam: certification for entry into the profession and proof of competency to practice was shifted from verification from education programs to certificates issued via examination.

?I became a midwife in 1971. It was to be thought of only in terms of Charles Dickens? midwife. There were few role models. There was total ignorance of midwifery on the part of most obstetrical personnel. Midwifery was unheard of by the rank and file of mothers and families. A midwife was someone only those who could not afford a doctor would even think of using. My sister was pregnant at the time and frankly told me ?Why would anyone who had insurance and money ever chose a midwife??? Sister Angela Murdaugh, CNM, former ACNM President.

1978: Core Competencies in Nurse-Midwifery was first developed and published, providing a standard approach to midwifery education.

Controlling the burn

1980: The first distance-based midwifery education program, the basis for our current education structure, was established. 

1980s: ?Our survival during the years when there was a liability insurance crisis [was an extremely memorable time in the last 60 years of US midwifery history]. It was a time where CNMs could not get professional insurance. Eventually we overcame this obstacle, which then led us 

on to become a stronger and more independent profession.? Sister Angela Murdaugh, CNM, former ACNM President.

?I remember the time when the midwives of color met clandestine in hotel rooms to build relationships with each other and help each 

other assimilate into the ACNM. Now the Midwives of Color is a recognized group by the ACNM and have many opportunities to fully participate in all levels of the College.? Freda M. Bush, CNM,MD, FACOG.

1983: ?Still wanting to practice nurse-midwifery in Mississippi as I had been trained, I became a physician in 1983?I served as back-up to CNMs who were in private practice. Two of the CNMs did home deliveries. Today I am still a practicing physician in Jackson, MS at EastLakeland OBGYN Associates, a 10 woman group. Our motto is Healthcare by Women for Women.? Freda M. Bush, 

The Code of Ethics for Certified Nurse-Midwives was established.CNM,MD, FACOG.

1992: The ACNM Mission Statement was released, to reflect changes over time and state the purpose of the organization.

1994: The mechanisms to educate and credential certified midwives (CMs) were approved. This alternative, direct-entry path to midwifery, which does not require a midwife to be a registered nurse, meets all the same standards as CNM education. Individuals choosing this career path are pioneers in the profession, much like the early nurse-midwives who practiced in the United States. The first program to offer CM education took its first class of students in 1996. Those midwives graduated and took their exam in 1997.

1995: Independent Midwifery Practice, the document defining independent midwifery practice in accordance with the ACNM standards of practice, was released. Midwifery scope of practice was also expanded to include primary care.

Stoking the flames

2000s: ?[I have felt most proud] for the profession?[as] invitations for ACNM?s presence, wisdom, and input on national committees for the government, other health care professions, and international health [have increased].? Sister Angela Murdaugh, CNM, former ACNM president. 

2002-2006: ?Of course, I think any midwife is most proud anytime she helps a mom bring a life into this world.That is what we do. Outside of this?I am most proud of the midwifery service that was built at Madigan Army Medical Center.The team of midwives there is amazing and continue to make military midwifery an example for all practices to emulate.? Col. Michelle Munroe, CNM. 

2005: ACNM?s 50th anniversary.

Jane Dyer and Felina Ortiz (center) present the 50th anniversary time capsule to Deanne Williams (then-Executive Director, on far left) and Katherine Camacho Carr (then-President, on far right) at the ACNM 50th Annual Meeting in Washington, DC. The time capsule is filled with items ?representing the state of midwifery and women?s health in 2005.? The capsule is at the ACNM national office, and is to be opened in 2055.

2010: Passage of the Affordable Care Act. ?[The biggest challenge I have seen US midwifery overcome is] payment for midwifery services.The Affordable Care Act has brought APRNs as a whole a long way in recognizing independent practice and payment.? Col. Michelle Munroe, CNM. 

2012: Launch of the Our Moment of TruthTM consumer awareness campaign. ?[Our] biggest challenge has been educating the public on who CNMs are and the scope of our practice, which helps them to understand the wonderful talents we have to offer the maternal/child health and well-woman scene.? Sister Angela Murdaugh, CNM, former ACNM president. 

2014: ACNM 59th Annual Meeting & Exhibition was held in Denver, CO, and attended by 1800 midwives and other women?s health care professionals.

Igniting the nation

2015: Midwifery and ACNM explode into the major national media landscape, thanks to an onslaught of groundbreaking evidence-based research. 

The Next 60 Years

?Public opinion of midwifery in the United States is shifting?I feel that we are making the most memorable history now. The relationship building and efforts between ACOG, ACNM, and AWHONN as well as other professional organizations can only build a stronger union and resources for women's health care.? Col. Michelle Munroe, CNM.

?I am excited that we can look at all our successes of the last 60 years and know that those successes give us strength and hope for the next upcoming 60 years. Everything that went before us brought us to this moment, where we are now standing on the threshold of a brand new day.? Sister Angela Murdaugh, CNM, former ACNM President.

?One of the biggest challenges I have watched facing US midwives is acceptance into the health care team as partners in patient care. Prejudice is an experience I know a lot about. When I was at the [the University of Mississippi Medical Center], there were times I did not know if the feelings and actions expressed toward the nurse-midwifery program were because we were women or because we were midwives. With time, persistence, professionalism, and excellence in practice, those prejudicial barriers have definitely gone down.? Freda M. Bush, CNM,MD, FACOG.