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Bridge Club's Letter to ACOG re: Improper Term "Lay Midwife"

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American College of Obstetricians and Gynecologists
Executive Board
409 12th Street S.W.
PO Box 96920
Washington, DC 20090-6920

March 3, 2006

Dear Colleagues,

We, the members of the Bridge Club, would like to express our grave concern regarding the February, 2006 ACOG “Statement of Policy on Lay Midwifery.”

The Bridge Club is a joint committee of the American College of Nurse Midwives (ACNM) and the Midwives Alliance of North America (MANA). We meet twice annually at the national conferences of both organizations. We strive to open lines of communication between midwives of all backgrounds and practice settings. Our members include Certified Nurse Midwives (CNM), Certified Professional Midwives (CPM) certified by the North American Registry of Midwives (NARM), and midwives licensed through state governments. We speak as professionals with experience and expertise in the midwifery model of care, both nurse- midwifery and direct-entry (non-nurse) midwifery.

In light of that experience, we take exception to your recent policy statement on what you term “lay” midwifery.   First, the term “lay” is vague and has little application to modern midwives.   The large majority of midwives who have been trained in models outside of nursing are licensed and monitored through state government and national professional organizations.   The requirements for education and experience are thorough, clear, and strict. Twenty-four states currently have legal procedures for direct-entry midwifery licensure that is not nurse-midwifery. In addition, the American Public Health Association has recognized the high standards of the North American Registry of Midwives competency-based training and the important role direct-entry midwives play in maternal and child healthcare.

When looking at international standards of care, the United States is in the rare position of pairing the practice of midwifery with nursing. Midwifery is, and has historically been, a profession separate and different from nursing and obstetrics.   The licensure of direct-entry midwives reflects this professional difference.

While other organizations can address those issues directly, we, the members of the Bridge Club, can speak most clearly of our own experiences. We work side-by-side-licensed midwives with certified nurse midwives-and have gained respect for the knowledge and skills of our sister midwives. Regardless of the pathways that midwives have taken to enter midwifery practice, their professionalism and commitment to the women in their care are evident. In addition, research indicates that midwife-assisted maternity care in all settings results in excellent outcomes for mothers and infants.

We urge you, as quickly as possible, to withdraw this statement of policy and further educate yourselves on the licensing processes used all over the country for midwives. We have included contact information for people who can clarify these processes for you. In addition, we hope this will help you understand the important role Certified Professional Midwives (CPM) have within the spectrum of women's healthcare.   And we look forward to you joining us in creating bridges between all of the professionals who strive for excellence in the care of women's health.

Sincerely yours,
The Bridge Club
Representing over 200 midwives nationwide

Contact people:
Gera Simkins, DEM, CNM, MSN
Second Vice President, Midwives Alliance of North America (MANA)
Bridge Club Facilitator
275 Cemetery Road
Maple City, MI 49664

Debbie Pulley, CPM
Board Member, North American Registry of Midwives (NARM)
Bridge Club Communications Moderator
5257 Rosestone Dr
Lilburn, GA 30037

Abby J. Kinne, CPM
First Vice President, Midwives Alliance of North America (MANA)
Chair, International Confederation of Midwives (ICM) Education Standing
58 South Center St
West Jefferson, OH 43162

This Web page is referenced from another page containing related information about Midwifery Advocacy and Statistics


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