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Key ACNM's Projects and Initiatives in the United States
ACNM is involved with various initiatives and activities all across the map! Find out more by checking out our currently ongoing projects below:

    Access to Equity in Midwifery Education and Care
    The field of midwifery is continuously expanding as more women turn to midwives for alternative maternal care. ACNM strongly believes the profession of midwifery should reflect the same level of diversity that exists among the people in midwives’ care. To address disparities in healthy outcomes and structural racism, ACNM has partnered with Johnson & Johnson "Our Race to Health Equity" (ORTHE) to develop the Access to Equity in Midwifery Education and Care Program. This program focuses on increasing midwifery education programs to increase the number of midwifery health care providers.

    The program also addresses the recruitment, retention, and graduation of Black, Indigenous and other midwifery students of color. Furthermore, in increasing the number of pathways and programs close attention will be given to Historically Black Colleges and Universities (HBCUs), indigenous/tribal colleges and institutions serving Spanish-speaking students and regions in the US where the gap in outcome disparities is particularly large. Midwifery education and practice works within a larger community and thus any change needs to engage that community as well. By engaging students, schools, graduates, and clinical sites at the ground level ACNM hopes to synergize its efforts in identifying and addressing barriers and implementing solutions to the complex problem of health equity.



    Midwifery Workforce Study
    Midwifery in the US is underutilized and underfunded (Sakala et al., 2020). Increasing access and integration of midwives throughout the US can improve equity and outcomes (Vedam et al., 2018). Currently the US has approximately 4 midwives employed per 1,000 live births. To reach a similar ratio of other high-income countries with better outcomes than the US, the US should aim for a minimum of 25 midwives per 1000 live births (US Midwife Workforce Far Behind Globally, 2020). With over 3.7 million live births a year in the United States, at least 93,000 midwives are needed to reach that target. Currently, in the US there are approximately 12,000 midwives, resulting in a gap of over 80,000 midwives. The Midwifery Workforce Study will conduct a midwifery workforce analysis and identify policy changes needed to expand the midwifery workforce to optimum capacity.

    The Midwifery Workforce Study researchers will use data collected by the American Midwifery Certification Board (AMCB) and the Accreditation Commission for Midwifery Education (ACME), to provide the most accurate evaluation of the current midwifery workforce size, capacity, and growth trajectory. Surveys and focus groups will collect information on entry to and exit from midwifery practice. These data will be combined with publicly available data to build a model for an adequate midwifery workforce based on maternal child health outcomes. Analysis of the data by states will identify which state polices facilitate an adequate midwifery workforce that can work to full capacity. Finally, this project will synthesize this information into products, issue briefs, state information sheets, and state score cards, that can be used to advocate for policies that facilitate an adequate midwifery workforce. The grant funded three research fellows who are midwives enrolled in PhD programs.



    Alliance for Innovation on Maternal Health (AIM)

    ACNM is a  Core Partner of the Alliance for Innovation on Maternal Health (AIM), a national partnership of organizations with the goals of reducing maternal mortality by 1,000 deaths and severe morbidity by 100,000 incidents, improving uptake and content of postpartum care, and providing guidance and implementation strategies on the consistent content and delivery of well-woman care. The purpose of the AIM Program is to equip and empower every state, perinatal quality collaborative, hospital network/system, birth facility and maternity care provider in the U.S to significantly reduce severe maternal morbidity and maternal mortality through proven implementation of consistent maternity care practices.

    Midwives, in collaboration with representatives from other organizations in the Core Partnership, are developing evidence-based safety bundles focused on the leading causes of maternal morbidity and mortality and working with state leaders, health departments, and perinatal quality collaboratives, and hospital associations to implement these bundles. Additionally, the AIM Program will provide intensive technical assistance and implementation support to states with the highest rates of maternal morbidity and mortality in our nation.


    CDC Immunization Grant

    While the data on the safety and efficacy of vaccines continues to grow, vaccine hesitancy is on the rise. Here at ACNM we believe in the facts and believe that midwives have a moral obligation to promote sound science-based recommendations, this includes the safety of necessity of immunization for mothers and the greater community. For the last 8 years, the American College of Nurse-Midwives has been the recipient of a grant from the Centers for Disease Control and Prevention (CDC) to help improve immunization rates in women. The last two years has been working with the American College of Obstetricians and Gynecologists, American Academy of Family Physicians, and Association of Women’s Health Obstetrics and Neonatal Nurses. Under this grant and through ACNM’s partnerships, ACNM has produced a suite of materials for women and midwives to utilizes in order to make informed decision regarding immunization. Additionally, ACNM’s grant work has produced a curriculum on immunizations in pregnancy. This curriculum is free and available to any health care provider.


    Fetal Alcohol Syndrome Disorders 

    Fetal Alcohol Syndrome Disorders (FASDs) are a leading cause of birth defects and developmental disabilities in the United States and are associated with the consumption of alcohol during pregnancy. Many people of reproductive age may be unaware of the potential risks of alcohol use to their own health or to the health of a developing embryo or fetus. Fear of stigma may also prevent disclosure of alcohol use, particularly during pregnancy. ACNM encourages all certified nurse-midwives (CNMs), certified midwives (CMs) and other reproductive health professionals, to conduct universal alcohol screening as part of routine preconception and prenatal care. To better serve midwives and mothers, ACNM is working through the University of Alaska Anchorage’s Project entitled Women’s Health Nurses & Midwives Collaboration for Alcohol Free Pregnancy (WHNMCAP).


    Johnson & Johnson: LinkedIn Learning

    The American College of Nurse-Midwives (ACNM) secured a grant from the Johnson & Johnson Foundation in 2020 to create midwifery leadership core competencies and develop 11 courses to test in a digital learning pilot platform: LinkedIn Learning. LinkedIn Learning is a subscription, web-based, asynchronous learning platform that features 14,000 courses and videos from industry-leading experts on a variety of technical topics and power / soft skills. The platform offers content in seven languages and can be optimized for various Wi-Fi connections, including an option to view offline.


    Macy Interprofessional Education Grant

    The American College of Nurse-Midwives (ACNM) and The American College Obstetricians and Gynecologists (ACOG) and their constituents share a commitment to improving the quality and access to maternal care for mothers across the country. As such, ACNM and ACOG understand the importance of collaborative practice as healthcare professionals learn to become more efficient and effective in the medical field. In order to help promote and facilitate high levels of collaboration, The Josiah Macy Jr. Foundation awarded a grant to ACNM to support The American College of Nurse-Midwives/The American College Obstetricians and Gynecologists Maternity Care Education and Practice Redesign Project. The primary goals of this project include:

    1) "Developing and implementing an IPE curriculum that promotes collaborative practice between obstetrician-gynecologists and midwives and includes core modules, skill-based activities, and inter-professional practice opportunities."

    2) "Aligning accreditation requirements and educational competencies related to UPE for midwifery and obstetrics and gynecology."

    3) "Identifying and resolving barriers to implementing IPE within midwifery and obstetrics and gynecology programs."

    4) "Increasing the number of midwifery graduates long term by exploring ways to add midwifery students to obstetrics and gynecology training locations."

    ACNM is grateful for the support and generosity of The Josiah Macy Jr. Foundation, and thankful for the partnership with ACOG as both colleges work to promote fruitful collaboration.


    Reducing Primary Cesarean Project – RPC

    The Reducing Primary Cesareans Project is an ongoing learning collaborative within ACNM's Healthy Birth Initiative (HBI). The RPC Project seeks to reduce the number of Primary Cesarean Births and increase vaginal births. While cesareans can be lifesaving procedures for many who experience abnormalities during labor, there is no substantive evidence that links Primary Cesarean Births to improved health outcomes for birthing parents or their babies. Primary Cesarean Births increase the risk of morbidity and mortality for low-risk women compared to vaginal delivery. The American College of Nurse-Midwives is committed to improving health outcomes for mothers and families across the country. As such, the RPC Project, serves to aid maternity care professionals and health care systems to promote evidence-based practice that supports healthy birth based on each person's unique physiology.


    Yellow Chair Foundation

    At ACNM, our mission is to support midwives, advance the practice of midwifery, and achieve optimal, equitable health outcomes for the people and communities midwives serve through include, advocacy, education, leadership development and research. Our values inform our strategic direction. The ACNM 2021-2024 Strategic Plan puts our shared vision, mission and values into action, positioning ACNM to be a catalyst for midwifery capacity, education, advocacy and practice in the United States. ACNM’s commitment to women and their families is shared by the Yellow Chair Foundation. As such, the Yellow Chair Foundation generously has awarded ACNM $300,000 via the Improving Maternal Health Outcomes by Removing Barriers to Midwifery Care through an Advocacy Lens grant. This grant is being used to help ACNM advance its mission and strategic priorities.




    References

    Avery, M., Jennings, J., Germano, E., Andrighetti, T., Autry, A., Dau, K., Krause, S., Montgomery, O.,
           Nicholson, T., Perry, A., Rauk, P., Sankey, H. and Woodland, M., 2020. Interprofessional
           Education Between Midwifery Students and Obstetrics and Gynecology Residents:
           An American College of Nurse-Midwives and American College of Obstetricians and
           Gynecologists Collaboration. Journal of Midwifery & Women's Health, [online] 65(2),
           pp.257-264. Available at: [Accessed March 2022].

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