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Fall 2016 VOLUME 47 | NUMBER 4 QuickeningOFFICIAL NEWSLETTER OF THE AMERICAN COLLEGE OF NURSE-MIDWIVES Quickening Makes the ACNM 2017 Elections Switch in January 2017 Cast Your Vote! he transition to our digital format for Quickening continues. As we ACNM election season is here. This year, we’re selecting President-elect, Vice have shared in past issues, ACNM’s President, Representatives from Regions IV, VI, and VII, and 2 members of Tquarterly, member-only newsletter is switching to an online format to save on the Nominating Committee. To help you choose, we asked the candidates printing and mailing costs and to make (excluding the Nominating Committee hopefuls) to answer the question: ACNM a better a steward of the environ- ment. We thank the ACNM members What challenges to midwifery practice have you observed/experienced either who have already made the transition to nationally or in your region, and what solutions would you suggest or implement digital and no longer receive a paper copy in the mail. Beginning with our winter to eliminate that challenge to midwifery practice? Continued on page 22 CANDIDATE FOR PRESIDENT-ELECT researchers to disseminate their work and Lisa Hanson, to develop collaborations. Ultimately, the Midwifery Works! PhD, CNM, reestablishment of an ACNM staff re- FACNM searcher position will allow the organiza- 2016 Targets tion to collect meaningful data for and The United States about its membership and seek funding to Effective Midwifery needs more midwives support the research agenda. providing primary To grow midwifery to its full potential, Management health care and we need more midwives from under- n less than one month, ACNM will midwifery-attended births to address represented groups to join the efforts to host Midwifery Works! 2016, our pressing health needs, especially among meet the needs of vulnerable populations. premier fall business meeting for vulnerable populations. Midwifery practice To attract women and men from diverse Imidwives. We hope you will be advanced by the elimination of bar- communities to become midwives and will join us November riers to full practice authority. Midwives join ACNM, we need to continue to make 2–6 in beautiful Myrtle can best meet the needs of women and concerted efforts to create an inclusive Beach, South Carolina. families when they can practice to the full organization. The future of the ACNM will Produced by ACNM and extent of their professional preparation. be stronger as we become more diverse midwifery business experts, For example, restrictions to midwifery and inclusive. our conference will enable practice authority prevent new practices you to enhance your organizational and from opening in the most underserved ru- CANDIDATE FOR PRESIDENT ELECT financial prowess, learn new skills that ral and urban communities. Unnecessary Susan E. Stone, will put you on the cutting edge of practice restrictions, such as the requirement for a DNSc, CNM, Continued on page 32 written collaborative agreement, need to FACNM, FAAN be addressed with meaningful legislative Based on my past and What’s Inside change. Efforts to advance full practice present involvement authority need to continue to be a priority and observations, I Affiliate Spotlight: West Virginia ...... 11 for the ACNM. believe there are three Secrets in Your Waiting Room...... 24 Midwifery science guides practice main challenges facing midwifery today at Breastfeeding Benchmarking...... 25 and is critical to advance our profession. national, state, and local levels. Regulatory Ready for Ultrasound...... 26 Research adds to the body of knowledge issues that limit midwives’ ability to prac- that supports the unique approaches mid- Wise Midwives’ Tales ...... 30 tice to their full practice scope without wives use to achieve optimal outcomes. What’s Ahead This Fall?...... 32 unnecessary restrictions, the confusion The ACNM is an ideal forum for midwifery Continued on page 16

Quickening Fall 2016 www.midwife.org 1 LEADER’S FORUM ACNM Welcomes New CEO his month, ACNM is pleased to conducted personal and and with the national office welcome our new Chief Executive telephone interviews senior staff. The search Officer, Frank J. Purcell. Frank’s with multiple candidates committee unanimously Tappointment is the culmination of a who matched the position recommended Frank Purcell 6-month process involving many ACNM profile. Ultimately, ASI to the Board of Directors for members and staff. Last spring, the Board presented a slate of 9 the position of CEO. The BOD of Directors contracted with Association candidates for the Search also unanimously voted to Strategies Inc. (ASI), a DC search firm, to Committee’s consideration. offer the position to Frank. assist with the identification of top-tier After reviewing each The Board and staff look candidates. ASI interviewed board mem- candidate’s profile, forward to working with bers, national office staff, and more than cover letter, and resume, Frank as he brings many 40 other members and stakeholders to de- the Search Committee unique skill sets to the Frank J. Purcell, new ACNM CEO velop a CEO position profile. Concurrently, identified 6 outstanding organization. He joins us the Board approved a Search Committee individuals with whom they conducted from the American Association of Nurse representing a cross section of ACNM personal interviews. At the conclusion Anesthetists (AANA) where he most membership to work with ASI. of the first round of interviews, the recently served as the Senior Director of ASI advertised the position, reached committee brought back its 2 finalists Federal Government Affairs. During his out to more than 175 individuals, and for a second interview with its members 16-year career at AANA, Purcell guided the legislative and regulatory advocacy agenda for the 49,000 member organiza- tion, including work on multidisciplinary Go for the Gold! coalitions within the health care commu- he recent Summer Olympics in Rio bers foremost have resulted in ACNM set- nity. Among his accomplishments, Purcell de Janeiro was a great example of ting new priorities while maximizing our quintupled attendance at the association’s both individual skills and team- resources as much as possible. Continued Washington advocacy conference and Twork. If you had an opportunity to see process improvements in finance, member secured Medicare coverage for all nurse any of the events, it was apparent the customer service, and communications anesthetist services within their scope of participants worked extremely hard for have strengthened the framework of op- practice—a distinction that earned him many years to achieve the highest level of erations. Current analysis of our volunteer “Top Lobbyist in Washington” by CEO success in their sport. Discipline, commit- structure, elevated membership recruit- Update. ment, and passion were necessary for the ment and retention strategies, and ongoing The Board wishes to thank the Search athletes to compete in the world’s most strategic planning implementation ensures Committee members: Janice Enriquez, admired athletic competition, often while our ability to reach goals and fulfill our CNM, WHNP-BC; Lynne Himmelreich, CNM facing great personal challenges in that mission. MPH FACNM; Karen Jefferson, LM, CM; journey. As I complete my position as acting CEO Deborah Kaiser, CNM RN-C; Lisa Kane Low, Organizations also have the same ability at the end of October, I’m grateful for the CNM, PhD, FACNM, FAAN; Ira Kantrowitz- to rise to new heights of achievement and opportunity to have been part of the staff Gordon, CNM, PhD, FACNM; Nancy Jo, success. I’ve observed the same drive to leadership team for the past seven months Reedy, CNM, MPH, FACNM; and Maria move ACNM into a new level of efficiency during this time of transition. Like the Valentin-Welch, CNM, MPH, FACNM for and value for our members through ac- Olympians, I’m confident continued focus their important individual and collective tions of the Board of Directors, our staff, on our members’ needs and building our wisdom as they thoughtfully and and our volunteers. You can see highlights resources will result in “medal-winning” deliberately worked through the search of many of these accomplishments in this excellence! process. issue. By Wendy Scott, CAE, Acting CEO By Joan Slager, CNM, DNP, CPC, Thoughtful consideration and analysis FACNM, ACNM Treasurer and of new ways to do the association’s busi- Search Committee Chair ness while keeping the needs of our mem- [email protected]

Quickening (ISSN 0196-3805) USPS 514030 is published quarterly provided to members only, by the American College of Nurse-Midwives, 8403 Colesville Road, Suite 1550, Silver Spring, MD 20910-6374; 240.485.1800. Periodicals Postage Paid at Silver Spring, MD, and at additional mailing offices. POSTMASTER: Send address changes toQuickening 8403 Colesville Road, Suite 1550, Silver Spring, MD 20910-6374. This publication is the sole property of ACNM and the information herein may not be transferred or reproduced in any form whatsoever, including electronic databases, without written permission.

2 American College of Nurse-Midwives PRESIDENT’S PEN In Memory of Nivia: The Importance of Our Diversity and Inclusion Work that Lies Ahead s we mourn the loss of Nivia memory, I encourage you to check it out, task force will be able to provide other Nieves Fisch, an amazing indi- as well as the resources on diversifica- levels of assessment and recommenda- vidual, midwife, and mentor to tion and inclusion, at www.midwife.org/ tions that will build on the work of the Amany (see page 37), I have been thinking Diversification-and-Inclusion-Task- Diversification and Inclusion Task Force. about her wisdom and vision as one of the Force. “Listening to Women” is ACNM’s mantra founding members of the ACNM Midwives We recognize that we have hurdles to to capture the uniqueness of midwifery. of Color Committee (MOCC). Through the overcome as we move down a path of We also need to listen to each other collective efforts of committed members of becoming more inclusive and need to meet and take in the many concerns that our color, which included Nivia, this standing head on the challenging subjects of race, students and other members have raised committee was born. One of my priorities identity, privilege, and negative experi- about racism and discrimination in order as ACNM president is to continue having difficult conversations that can help ACNM move forward to become a more inclusive organization throughout our membership, “I look forward to ACNM realizing the vision policies, practices, and events. Members of MOCC, including Nivia, have of the founders of MOCC to create a more been a critical force and have a long and proud 30-year history within the organi- inclusive, diverse association.” zation, resulting in significant contribu- tions to policy statements, organizational priorities, and mentorship for midwives of ences within the College. The evidence is to make effective organizational changes color. While its work has been invaluable, there. within ACNM. The Board recognizes that in some ways, we were guilty of treating A motion was presented at this year’s this work will take patience and hard MOCC as a silo where questions of differ- Annual Meeting outlining the negative work, and we all have to be willing to en- ence and race were addressed, rather than experience of a student member at the gage in the long-term commitment to cre- tackling these topics throughout our orga- prior year’s meeting. The motion was as ate a welcoming, respectful organization. nizational structure. We’ve learned over follows: We move that the ACNM Board of To me, this work is essential to the viabil- time that the presence of this committee Directors establish policies and proce- ity of our organization and our leadership alone is not enough to create an inclusive dures that are both proactive and respon- in women’s health and maternity care. organization. sive to address experiences of racism and/ or discrimination that students encounter Bridging Differences Shifting the Frame at the ACNM Annual Meeting. I will cherish the memories I have of Some important steps have been taken. In response to this motion, the Board Nivia and her quiet, but strong ways of With the support of the MOCC, in 2013 of Directors initiated a task force chaired making me think and ask different ques- ACNM created the Diversification and by Angy Nixon, CNM, APRN, FACNM to tions. I look forward to ACNM realizing the Inclusion Task Force. The work of the task address the experiences of racism and vision of the founders of MOCC to create force and Greater Good Consulting, the fa- or discrimination that our members may a more inclusive, diverse association. We cilitator for this work, resulted in the June encounter at the ACNM Annual Meeting must bridge differences, allow space for 2015 report, “Shifting the Frame: A Report and other events. We have broadened the difficult conversations, and work together on Diversity and Inclusion in the American charge to address all members and all to achieve the goals of making midwives College of Nurse-Midwives.” In combina- types of ACNM events. While this is a very and midwifery care accessible and accept- tion with the release of this report, the large task, it’s a critical first step to having able for all families. 60th Annual Meeting included a number a proactive and timely response when a I hope you will join me in this critical of events to help ACNM begin to take steps member experiences racism or discrimi- journey to ensure a brighter future for to identify issues of race and racism and nation. This is an area where ACNM has ACNM. to face the reality of being an association not been prepared and we need strategic By Lisa Kane Low, CNM, PhD, FACNM, that not all members felt to be inclusive, training and comprehensive approaches to ACNM President but rather exclusive and unwelcoming. If generate effective responses and initiate [email protected] you have not had the opportunity to read proactive, positive change. the report, or if you need to refresh your Over time, we anticipate this new Quickening Fall 2016 3 REGION UPDATES Region I Update Region II Update CT, ME, MA, NH, NY, RI, VT, Non-US Locations DC, DE, MD, NJ, PA, VA, WV, International addresses

hope you all enjoyed your summer and your fall is now in full s summer draws to a close, the kids go back to school, and the Iswing. In Connecticut, the Yale School of Nursing Midwifery Aevenings get a little bit cooler, I am reminded yet again that no Educational Program is celebrating its 60th year. Yale will be honor- matter what the season, during the school year or during sum- ing and celebrating the retirement of Heather Reynolds, CNM, mer break, no matter what is happening in the world of politics, MSN, FACNM. Heather is a distinguished clinician, instructor, and regardless of how much construction there is on the roads, or policy developer, as well as the minority student coordinator at what the price of gas is, babies continue to come. Sometimes their the Yale School of Nursing. For decades, she has been a leader in entry into our world is difficult and complicated, sometimes the health care delivery to underresourced and minority populations, outcome is not what was hoped for and longed for, sometimes and a valuable mentor to students and colleagues. We are grate- things do go awry. However, the amazing thing is that the vast ful for Heather’s ongoing contributions and representation both majority of the time, we have the awesome privilege of witnessing regionally and nationally. a miracle that is almost always pure joy. Those last moments of Congratulations, New York, on passing a bill that will permit mid- sweat and struggle, and the ensuing immeasurable reward—the wives to open birth centers! New York midwives are waiting for slippery sweet- the governor to sign the bill into law, and are ready to work with ness of the brand the New York State Department of Health on new regulations they new being on “Those last moments have drafted, available at www.nysalm.org. bare skin, the first New York and Massachusetts have added Diversity and Inclusion time those eyes of sweat and struggle Chairs to their affiliate leadership, and are actively recruiting com- open to search for mittee members. The groups hope to support members of diverse the face that goes and the ensuing and underrepresented backgrounds, and advocate for broader with that familiar sweetness… these perspectives in decision-making. Massachusetts Midwives of Color voice, the ecstatic started a Google Group (www.goo.gl/u0EFhz) to help midwives murmurings are the moments and students of color connect and network locally. of the parents, Massachusetts ACNM hosted a “Hearts of Midwifery Birth Story grandparents, and we treasure.” Slam,” an evening of food, drinks, and favorite birth stories on even midwives, September 25 in West Roxbury. Linda Orsi Robinson, CNM from and that first latch when the baby finds its way home—these are Maine and author of Sunday Morning, Shamwana: A Midwife’s the moments that we treasure, and for which we hold the space in Letters from the Field, is featured in a new TEDx talk at www. a way no other profession can match. youtu.be/2v5A3BxU4Uc. She discusses high maternal mortal- As we swing into a new academic year, I would like to remind ity rates, especially for Native American and African American us all to reflect on why we have come to this profession, how our women. You can follow her blog at www.goo.gl/Idp5xp. teachers helped to midwife us to this point, and how critically Congratulations to Rhode Island’s Dr. Deb Erickson-Owens who important it us for us to reach back and offer that same support to is a Rhode Island Monthly award recipient for excellence in nurs- the midwives coming along this year. A record number of student ing. And, for midwifery week, Rhode Island ACNM will be host- midwives will enter our programs, all needing preceptors to initi- ing a screening of Why Not Home? in collaboration with Brown ate them and hold the space for them to take on this unique role. University’s Women’s Center. A panel discussion will follow. With the growing shortage of maternity care providers comes an The 2016 Region I Meeting is Saturday, November 12, 2016 at unprecedented opportunity for midwives to fill a void, and take the Newport Harbor Hotel in Newport, RI (www.bit.ly/2c3asU0). our rightful place as the portal of entry to maternity care for all Special guests include Emily Nagoski, PhD, author of Come as You women. Let’s make sure we have enough midwives to fill those Are, and Lisa Kane Low, CNM, PhD, FACNM, ACNM President. spaces! Please make sure you are registered to vote in the US I am so impressed with the growing education programs in Presidential election on November 8. Vote up and down the ticket every state of Region II. Here’s wishing all of us a fabulous fall, and to support the issues important to you. Make your voice count. a vibrant new crop of students to welcome. Happy precepting!

by Kathryn Kravetz Carr, CNM, MSN, Region I Representative By Máiri Breen Rothman, CNM, MSN, FACNM, [email protected] Region II Representative [email protected]

4 American College of Nurse-Midwives REGION UPDATES Region III Update Region IV Update AL, FL, GA, LA, MS, NC, SC, TN AR, IL, IN, KY, MI, MO, OH

n Louisiana, many families receiving care from the Birth Center he days are getting shorter, the evenings a little cooler, and Iof Baton Rouge lost everything in the terrible floods there. Tthe students have started back to school. Yes, summer is over, Louisiana affiliate, all of us in Region III are in solidarity with you. and we are headed into autumn (my favorite season!). Region IV is I have been happy to attend some of the affiliate meetings in buzzing with announcements of their upcoming affiliate meetings, Region III. The July meeting in Alabama was rich in information retreats, events, and legislative activities. and opportunities to connect. In addition to the business of the I was excited to see that Arkansas has a fabulous slate of affiliate, Donna Dunn, CNM, the president, invited Ashley Lovell, a candidates and the affiliate is getting back into full swing! Indiana certified doula, to present her work with the Alabama Prison Birth has upcoming elections and has put out a call for nominations for Project. In Alabama, the number of women in prison increased by their open positions. Indiana also hosted its affiliate meeting on 646% between 1980 and 2010, and 25% are currently pregnant or September 21 on the south side of Indianapolis. Missouri is have given birth in the last year. At the meeting, I also had a chance planning its fall retreat along with continuing education units to see Joyce Wiechman, CNM, my former midwifery faculty at the (CEUs). Kentucky had its retreat September 23–25 at the historic University of Mississippi from 1982, and we stood together with Frontier Nursing University in Hyden, and the organizers delivered Cherise Fretwell, CNM, a former student of mine, for a photo of 3 plans for the future and fun! Michigan has several midwifery generations! services hosting events this fall. On October 4, during Midwifery The Florida affiliate has grown to 380 active members, up from Week, Wayne State University Physician Group CNM Service at 351 in 2014! Currently, there are 635 CNMs residing in the state, Hutzel Women’s Hospital in Detroit hosted Penny Simkin, PT when so their goal is to continue to increase membership. Among their she presented Grand Rounds! It was an honor to have Penny come many commitments, the affiliate is a partner organization with to Michigan and share her amazing work and insight from her the Florida Perinatal Quality Collaborative. In 2016, there were perspective as a physical therapist, childbirth educator, birth midwifery representatives on both the Hypertension in Pregnancy counselor, and noted author. In November, the University of and the Postpartum Hemorrhage initiatives. Michigan Health System CNM Service in Ann Arbor will be As its first activity, the Georgia Diversification and Inclusion presenting a 2-day birth workshop. Illinois, meanwhile, will be Committee kicked off the Georgia affiliate meeting with a fasci- hosting their annual Lillian Runnerstrom fall event. The occasion nating panel of CNMs and CPMs who all practice home birth in is especially meaningful this year with Lillian’s recent passing on Georgia. The committee, chaired by Yvonne Green, CNM, is a great June 12, 2016, at age 95. Lillian Runnerstrom, CNM, PhD, FACNM example of the affiliate’s commitment to the core ACNM goal and was a lifetime member of ACNM, serving on many committees and value of diversification and inclusion. as president from 1967 to 1969. A professor and head of the By the time readers view this column, the Mississippi affiliate Department of Maternal Child Nursing at the University of will have hosted a “twin” midwifery retreat with Alabama on the Illinois-Chicago College of Nursing from 1969 to 1980, Lillian beach in Biloxi, MS. The affiliates will be presenting a strong pro- established the college’s nurse-midwifery program in 1972. In gram of updates on hypertension, diabetes, Zika, and much more. 2003, the school’s Department of Maternal Child Health founded The South Carolina affiliate met at the Charleston Birth Place in the Lillian Runnerstrom Institute of Excellence in the Study of July where big, silver balloons printed with the numbers “2000” Women, Children, and Family Health in her honor. We all found the floated in the waiting area. The decorations celebrated the fact tributes and stories about her that were shared on the Illinois that the Birth Center had welcomed 2000 babies into the world! listserv extremely touching. Some were funny, and all captured her I was unable to attend the affiliate meeting in North Carolina, vision and persistence. but hope to see many of the NC midwives at Myrtle Beach in By Katie Moriarty, CNM, PhD, RN, CAFCI, FACNM November at Midwifery Works! Region IV Representative Tennessee affiliate, I will see you in October for your awesome [email protected] education program.

by Jenny Foster, CNM, MPH, PhD, FACNM [email protected]

Quickening Fall 2016 5 REGION UPDATES

Region V Update Region VI Update IA, KS, MN, ND, NE, OK, SD, WI AZ, CO, MT, NM, TX, UT, WY, IHS/Tribal

ember surveys consistently show that policy and ad- ffiliates in Region VI have been active over the summer plan- vocacy work is the most valued member service. Now Aning fall legislative efforts, forging relationships with other that fall is here, most affiliates are holding their fall professional organizations, giving back to their local and global Mmeetings and talking about their legislative objectives for 2017. communities, and assuring formal roles for their students. Affiliate leaders will be hearing from their region representatives Arizona affiliate representative, Janice Bovee, CNM, MSN is to discuss the state legislative issues and expectations. This will working closely with other state nursing and APRN groups to re- assist ACNM Director of Advocacy and Government Affairs Cara move CNM required collaboration restrictions and to move CNMs Kinzelman ([email protected]) in planning for the coming to a separate category of NPs rather than a sub-specialty of NPs. season. Colorado affiliate members met several times over the summer The two most common state legislative initiatives involve full with updates on upcoming full practice authority legislative issues. practice authority and CPM licensure. We have a group of affiliate Additionally, each month members assemble birth kits for Project leaders working on full practice authority, and Cara will be C.U.R.E. Affiliate members have taken these birth kits on trips to announcing a new group for those working with CPM licensure support global maternal/infant health including Pam Prag, CNM to this fall. The groups meet via affiliate-driven conference calls and Nepal, Amy Nacht, CNM to Guatemala, and Diane Rousseau, CNM their goals are information-sharing and support, affiliate leader to to Haiti. The University of Colorado also welcomed a new director, affiliate leader. Cara joins in, adding her perspective and offering Denise Smith, CNM to its Midwifery Specialty Program. resources. Additionally, members can also receive and share Kalispell Regional Healthcare hospital sponsored Spinning information and advice by joining the state policy listserv. Babies® education for the obstetrical nurses and Montana affiliate Cara also encourages state affiliate leaders to contact her for members Amber Lavin, CNM, DNP, WHNP, and Jana Sund, CNM to assistance with their policy and advocacy work. Services she offers reduce the cesarean birth rate. As a result, their practice, Family include strategic advice, bill drafting, evaluation of legislation, Born Maternity and Women’s Health, with the help of the hospital stakeholder outreach, coalition building, grassroots support, nurses, boasts a 100% vaginal birth rate. research, bill tracking, assistance with talking points, and letters New Mexico affiliate members recovered from their host- of support or opposition. Because Cara’s response time can vary ing of the amazing and successful 61st ACNM Annual Meeting & depending on her work load, affiliate leaders are encouraged to Exhibition. At a summer meeting, members learned more about contact her early, before a situation becomes a potential crisis. possible APRN legislation that would affect CNM licensure, and Shifting gears, I would like to highlight some Region V affiliate they planned to provide education about the implications of these activities. Wisconsin has been working toward full practice changes for APRNs and CNMs. University of New Mexico students authority for some time, primarily with the APRNs, but the affiliate Karoline Kinney and Amanda Maitland are actively involved. is also exploring an option via rulemaking. South Dakota and Iowa A large group of Texas affiliate members gathered at a quarterly are working with the CPMs on licensure legislation. Nebraska statewide meeting in July at The Woodlands where they reviewed APRNs passed full practice authority a year ago, and the Nebraska working with APRN groups and explored legislative efforts affiliate is now working on getting added to that bill. Kansas is in including full practice authority. Chapter leaders include Annette the process of rulemaking for their legislation that gives them full Jones, SNM; Kathleen Donaldson, CNM, MS; Kristi Saxon, CNM, DP; practice authority for normal birth under the Kansas Board of Elizabeth Tombs, CNM, MSN, IBCLC; and Crystal Stewart, SNM. Healing Arts. And Oklahoma is participating in the AIM project. Utah’s Legislative Committee met to plan efforts to assure full Last, but by far, not least. I would like to encourage everyone prescriptive authority for CNMs in alignment with the recently to consider attending Minnesota’s 5th Annual Optimal Outcomes passed APRN legislation. University of Utah Midwifery students in Women’s Health conference on October 28, 2016! The event is and student affiliate members Heather Johnston, Samantha well known as a multidisciplinary conference with great speakers Lawson, and Melissa House are actively involved in the affiliate’s and networking opportunities. Information is available on the Membership Committee. Minnesota ACNM website: http://bit.ly/2d5ex9s. The blossoming Wyoming affiliate, led by Jeanne Peterson, CNM, As always, feel free to contact me with any concerns or issues met in July to establish priorities, including revisions of the where I can be of assistance. Wyoming Birth Center laws.

By Lynne Himmelreich, CNM, MPH, FACNM, By Jane Dyer, CNM, PhD, MBA, FACNM, Region VI Representative Region II Representative [email protected] [email protected]

6 American College of Nurse-Midwives REGION UPDATES

Region VII Update Student Update AK, CA, HI, ID, NV, OR, WA, Uniformed Services, Samoa, Guam

reetings, Region VII members. Alaska, thank you for your n collaboration with ACNM Vice President Cathy Collins-Fulea, Ghospitality during my visit in June. I was delighted to see the ICNM, I drafted a letter to the section committees and task forces excellent attendance at the affiliate meeting in Anchorage, where of ACNM requesting outreach to students, so students can become we discussed the birth center movement in the state. I also was more involved at the national level. Students, this is in direct pleased to attend a second affiliate meeting (with fresh salmon!) in response to your charge in the 2016 Student Report to the ACNM Homer, which explored ways to coordinate with the USA affiliate, Board of Directors. Several committees and sections have respond- Alaska’s twin. One outcome of the site visit was connecting CNM ed, and we are in the process of connecting these committees and Marilyn Pierce-Bulger with Clare Lynam, ACNM’s communica- sections with you and your peers. tions director. Marilyn is a consultant on the Centers for Disease I also would like to recognize some of the involvement that Control’s (CDC’s) Fetal Alcohol Syndrome Prevention Program. students are already engaged in with the organization at the na- California: Congratulations to California for making a valiant tional level. At the Board of Directors meeting at the ACNM Annual effort with CA 1306, the state bill that would have removed su- Meeting, a Shenandoah/John’s Hopkins University student, Zoe pervision for CNMs. Thanks to Autumn Burke for representing us, Gutterman, presented information about the deficit in gynecologi- Kim Dau, CNM, MS our legislative chair, and all California affiliate cal care of incarcerated women. The Board approved her report midwives for your tenacious effort. You hung in there, and we will and sent it to the Division of Standards and Practice for further try again! development reguarding related policy. Dede Horvath just com- Hawaii: Zika has hit paradise, and the Hawaii affiliate has re- pleted her term in May as the student representative to the Board sponded with a comprehensive presentation. of Directors and is now a new CNM. University of New Mexico Idaho: Last February, following the annual Idaho Perinatal students made up a significant percentage of the New Mexico Project Annual Conference, the Idaho affiliate hosted a one-day affiliate’s local committee booth, and many students also served conference: Advanced Evaluation and Management of Psychiatric as pages and as PAC student volunteers. Each midwifery educa- Illness in Reproductive-Age Women, which Oregon affiliate mem- tion program has a Student and New Midwives Section (SANMS) ber Adria Goodness, CNM, MS, CMHNP presented. liaison. These liaisons represent their school to the SANMS Nevada: Under affiliate leadership, midwifery students are being leadership and write the Student Report to the Board of Directors. encouraged to volunteer with the Our Moment of Truth™ campaign. What’s more, these are just some of the many ways that students Oregon: The affiliate held its Roving Meeting Weekend in July. are making a difference in ACNM. It is very exciting to see the ways The innovative tradition addresses business and offers comradery. students are involved throughout the organization, and I am eager Washington: The annual tradition, Miles for Midwives Fun Run/ to witness the impact that students can have on this organization. Walk, is coming up in October . I recently had the opportunity to meet with some students from USA Affiliate: Nitrous oxide utilization is a focus, and USA af- Oregon Health Sciences University, and one of their biggest con- filiate is requesting updated information on standard operating cerns was difficulty in finding clinical sites and preceptors. This is procedures. (See Chapter 23 in the 2nd edition of Best Practices in an all-too-common concern of most students I have talked with in Midwifery authored by experts Michelle Collins, CNM, PhD, FACNM, many different programs and areas of the country. If you are not and Judith Rooks, CNM, MPH, FACNM.) currently precepting a student, please consider taking the time. It The second edition of Best Practices in Midwifery: Using the is an opportunity to have a truly lasting impact on midwifery and a Evidence to Implement Change has just been released (Springer chance to grow the practice. For the midwives who have served or Publishers, 2017). Highlights of Region VII participation include are serving as a preceptors, the students thank you for your time co-editor, Judith Rooks (OR), and authors Judith Fullerton CNM, and efforts. PhD, FACNM (CA); Heather Bradford, CNM, ARNP, FACNM (WA); Students, I want you to know that I represent your interests to Mary Barger, CNM, MPH, FACNM, PhD (CA); Laura Aughinbaugh, the Board of Directors. Please feel free to contact me with your CNM, DNP, CRNP (CA); Margy Hutchison, CNM (CA); Melanie comments, concerns, and questions. Thank you for the opportu- Thomas, MD, MS (CA); Jenna Shaw-Battista, CNM, NP, PhD (CA); nity to serve. and Mary Paul Backman, CNM (WA). That’s 10 out of 44 authors. By Andrew Youmans, SNM, RN, ACNM Student Representative Good showing from Region VII. [email protected] By Barbara Anderson, CNM, DrPH, FACNM, FAAN, Region VII Representative [email protected]

Quickening Fall 2016 7 LEADERSHIP IN ACTION New Midwives in Leadership: Ponderings Halfway Through My Term joined the Board of Directors in 2015 As a cisgender femme woman who new midwives when they ask me, “Why do as a new midwife finishing my third identifies as queer, I additionally bal- you serve in leadership?” The number of year of practice. When the Nominating ance aspects of my personal identity with new midwives who have reached out to me ICommittee first contacted me to consider engagement in professional work. I know since I’ve joined the Board is astounding. running for the position of secretary, many midwives are new to conversations They want to know whether the conversa- I spent time reflecting on my possible of transgender and genderqueer, spectrum tions I am able to have are pushing bound- contributions as well as potential impli- of sexual identities, relationship models, aries and are welcomed, and how others cations of choosing to run. Who was I to sex positivity, and interrelationships with could be engaged in similar and different think that I had a voice in the leadership of midwifery scope of practice. Additionally, ways. I share nothing but rave reviews an organization with such a long and deep acknowledging trans and queer midwives about the mentorship I have received as a history, with midwives more experienced in our membership, and seeking ways to new Board member, the support system than I who could provide depth of service welcome and engage with each other, is in place through my co-leaders and in the to an elected role? also an evolving conversation for many volunteer leadership structure, and the Ultimately, I came to two conclusions: members. In being open about myself, I opportunities to expand my own learn- 1) I bring the valuable perspectives of new hope to create a safe space not only for ing and participation. New midwives seek graduates, many of whom, myself includ- other queer midwives to do the same, but opportunities within the College and want ed, represent an increasing community of also to welcome questions and dialogue to be involved in ways meaningful to both midwives engaging in broad discussions of around these topics. their own intentions and the historical reproductive justice, queer and trans care, As a midwife who also works in abortion and future work of ACNM. This is a call to and full-scope practice including abortion care by serving on two other Boards of recognize those people who have already provision; and 2) as a white midwife who Directors which train providers in family sought engagement, to encourage those actively seeks scope of practice to align planning, options counseling, and termina- who are considering doing so, and to chal- my work with the reproductive justice tion provision, I seek to further conver- lenge midwives experienced in the College movement, I might use the opportunity sations about midwifery education and to encourage that engagement. (running against another white midwife practice related to abortion services. on the ballot) to actively identify strategies As a midwife who works for a feder- Creating Space and pathways for increased engagement of ally qualified health center (FQHC) with I hope that my presence on the Board as midwives of color, and to elevate the voices immigrant and black women on the South an easily identifiable new face and thus of those speaking, but not yet at the table. Side of Chicago, I seek to promote discus- new midwife, my openness about my sions about midwifery care in high need identification in the queer community, my Changing Conversations populations, and the challenges midwives vocal work in full-scope midwifery, and my I struggled with being “another white face in settings of high acuity, social sup- intentions to create space for people of woman” in a lead role of an organization port needs, and integration within broken color, will in some way pave the way serving a community of midwives and health care systems. forward for those who have not yet clientele with significant ethnic diversity In my (almost!) year and a half on the considered being involved, but for whom not, in any way, sufficiently represented in Board, I feel incredibly positive about these topics remain vitally important to leadership. Being an active member in an meeting many of the goals I set for myself. their work as midwives, and thus impor- organization currently seeking to foster Beyond my role in writing the minutes, I tant to ACNM. And I look forward to conversation and community along lines have sought opportunities within leader- hearing from membership what other of diversification and inclusion, I balanced ship to align specifically with my inten- work I can do in my remaining time in how my nomination and possible election tions, including serving as liaison to the term! would continue views of a non-diverse Midwives of Color Committee (MOCC) By Stephanie Tillman, CNM, MSN, Board with the work I might accomplish and Chair of the Gender Equity Task Force ACNM Secretary (GETF). I have opportunities to revise, edit, as someone with intentions to actively [email protected] change the conversation. Referencing comment on, and propose position state- the impressive work of the Diversity and ments; and committee conversations with Inclusion Task Force, how might I utilize high-level leadership at ACOG. my role to purposefully “Shift the Frame”? These are examples of change I give to

8 American College of Nurse-Midwives Financial Update Actual Year-to-Date Total Revenue* he initial ACNM 2016 budget projected a deficit of $500,000 by year end. The Finance and Audit Committee along with the Board of Directors has worked with na- Ttional office leadership throughout 2016 to reduce the projected deficit. A budget reforecast was performed in March and again in May as adjustments to both revenue and expenses were noted. Due to close management of expenses and revenue, while we are still projecting a loss, we are pleased to report that the current deficit is projected to be lower than originally anticipated. We are currently completing our third reforecast and as more information Actual Year-to-Date Total Expenses* is finalized, details will be shared with the membership. The charts on this page represent our financial position as of July 31, 2016. Revenue Highlights ■■ We are currently less than 10% under budget in projected revenue. Although these projections are annualized over the year, certain revenue, such as membership dues revenue, is cyclical with above average “spikes” typically occurring in the fall. ■■ Global outreach revenue is also lower than anticipated, *As of July 31, 2016 however much of the billable grant hours are expected late in the year and early 2017. July 2016 December 2015 ■■ For the first time in many years, annual meeting expenses will ASSETS not exceed revenue. Cash & cash equivalents $651,005 $458,187 Expense Highlights Investments 1,998,061 1,945,200 ■■ Careful monitoring and reduced spending have led to a Accounts & other receivables 222,831 225,376 reduction in expenses. ■■ As of July 31, there is a projected budget surplus (revenue/ Grants receivable — — expenses) of approximately $80,000, which is on target with the Prepaid expenses 98,137 148,085 revised forecast. Inventory 46,178 46,178 Final Takeaways Property & equipment, net 308,666 347,095 Our future is bright and we are closely monitoring our financial Other assets 19,226 19,226 position. We have taken the necessary steps to decrease spending TOTAL ASSETS 3,344,104 3,189,348 and begin to implement strategies that will increase revenue in the LIABILITIES future. Our improvements have materialized in the following ways: 1. The annual meeting realized a small net profit. Accounts payable 260,568 153,449 2. The line of credit used to manage cash flow in 2015 was paid in Line of credit — — full, and as of the middle of October, we have not needed to draw Accrued salaries & benefits 173,938 207,348 from our reserves to manage the budget deficit. (The original Deferred membership dues 1,018,371 1,033,158 budget projected that a draw from reserves would be necessary Other deferred revenue 213,090 173,704 in August 2016). 3. We continue to examine and implement strategies that will Deferred rent 310,211 313,258 strengthen our financial position while meeting the needs of our TOTAL LIABILITIES 1,976,177 1,880,916 members. NET ASSETS By Alison Brooks, ACNM Director of Finance, and Unrestricted 1,304,270 1,136,582 Joan Slager, CNM, DNP, CPC, FACNM, ACNM Treasurer Temporarily restricted 63,657 171,850 TOTAL NET ASSETS 1,367,927 1,308,431 TOTAL LIABILITIES & NET ASSETS 3,344,104 3,189,348

Quickening Fall 2016 9 Why a Step toward Value-Based Payment for Maternity Care is Good News he Health Care Payment Learning elevated risk due to defined and predict- on episode-of-care prices as if the births and Action Network (HCPLAN) able conditions might also be included. were all hospital births, and let them recently finalized a white paper ■■ The episode should begin 40 weeks manage how that care is delivered. They Ton clinical episode payment models that before the birth and end 60 days then work with the payers to educate and constitutes an important step toward postpartum for the woman and 30 days incentivize women insured under those value-based payment for maternity care post-birth for the baby. plans, who are appropriate candidates, to services in the United States. This devel- ■■ The services included in the episode choose to use the birth centers, with the opment has important ramifications for would consist of all those provided hospital agreeing to be back up in case any midwifery. Various payers and provider during the pregnancy, labor and birth, of the women need to be transferred. Costs groups, including state Medicaid pro- and postpartum period, and newborn in the birth center are significantly lower grams, are likely to adopt the recommen- care for the baby. Certain high value, but than in the hospital setting. By transition- dations in this white paper in an effort to typically underutilized services, such ing a sufficient percentage of patients to a move away from the fee-for-service (FFS) as doula care or prenatal and parenting birth center setting, the provider organiza- model of reimbursement. Midwives need education courses, should be consid- tion reduces costs sufficiently to pay the to understand this shift and how they can ered for inclusion. Exclusions should be birth center a reasonable fee and ensure take advantage of it. limited. that the hospital’s costs are met with an In a FFS model, providers receive ■■ Engaging women and their families appropriate margin. At the same time, the payment for each discrete service. should be a critical part of any episode- provider organization is able to save the Reimbursement models based on clini- based payment design. payer and the patients money. cal episodes typically provide a single ■■ Episodes should be priced to recognize Alternatively, a hospital could choose payment for a broad range of services efficiencies by providers that have to create or expand a midwifery service, associated with a given condition over already been gained, a level of perfor- partnering with laborist physicians, if it a set period of time and across multiple mance that is feasible to attain, and the determines that lower costs from mid- settings of care. For example, global cost of services that help achieve the wifery services will allow it to negotiate payment for birth can be considered an goals of the program. an episode-based payment that generates episode-based payment to an extent, but ■■ The accountable entity should be able to savings for the payers, while also ensuring the HCPLAN paper takes this approach share in any potential savings, but also stable or perhaps increased profit margins much further down that path, including a be subject to risk if its costs are higher for the hospital. These increased margins broader range of services in the episode. than targeted. Methods for transitioning for the hospital would be based on lower It also recommends that clinical episode- to this risk-based approach should be rates of costly intervention under mid- based payment incorporate consideration incorporated into the design. wifery care, or lower overall compensa- of quality, costs, and patient outcomes and ■■ Quality metrics should capture out- tion costs in a maternity service that has a experience of care. comes associated with the goals of the higher proportion of midwives. program. Outcomes should be used to By appropriately partnering with hos- Better Outcomes impact payments, track performance, pitals, physician groups, and birth centers, Research on clinical episode payments inform decisions, and engage patients midwives could see demand for their has shown this model results in greater and other stakeholders. services increase in an episode- and value- coordination of care among providers based reimbursement world. Such demand and across settings, better quality of care, Two Clear Examples may also contribute to stakeholder deci- lower costs, and better outcomes. Two examples may help show the sions to remove key barriers to midwifery The white paper provides recommenda- importance of this shift. Say a commercial practice. It is a trend to watch closely. tions for three episodes of care: elective payer typically pays out $12,500 for all To read the white paper, visit: www. joint replacement, maternity care, and services associated with a normal vaginal hcp-lan.org/2016/08/final-cep-white- coronary artery disease. The specific delivery in a hospital. Imagine the hospital paper. recommendations for the maternity care partners with two birth centers, and the episode include: three entities approach a set of payers. By Jesse Bushman, MA, MALA, former Director of Advocacy and ■■ The episode should be defined in a way They explain they will jointly accept a 10% Government Affairs that includes the majority of births, as reduction in that average rate of reim- well as newborn care. Women who have bursement if the payers pay them based 10 American College of Nurse-Midwives AFFILIATE SPOTLIGHT West Virginia’s Journey to Full Practice Authority ith the passage of “the APRN in collaborative relationships Bill” (HB 4334) in March, West may continue to do so. Virginia’s CNMs celebrated a Wlong-awaited victory. On June 10, the bill A Hard-Fought became law and opened the pathway for Battle Won http://bit.ly/2d6iSLq CNMs to full practice authority. Reaching our full practice The final bill contained 4 components: authority goal took nearly a 1. The repeal of outdated code explicitly decade of persistence. During requiring physician collaboration for CNM that time, we spent countless licensure; 2. Inclusion of APRNs’ ability to hours educating legislators apply for prescriptive authority without and, year after year, adapting a collaborative agreement, after they un- our strategies to the shift- dergo 3 years with such an agreement; 3. ing legislative landscape. We 2.0, CC & Norm Lenburg Bunny by Capitol Virginia West Credit: Photo APRNs’ expanded prescribing of Schedule weathered dramatic twists III drugs for up to 30 days; and, 4. APRNs’ and turns including changes ability to sign documents within their in key players, a shift in the scope. state legislature’s partisan The bill also included a clause creat- control, and the emergence ing a Joint Advisory Council on Limited of legislative champions. Prescriptive Authority, comprising 6 We raised funds to hire new APRNs, 4 physicians, 1 pharmacist, 1 lobbyists, built momentum consumer, and 1 representative from an with networks of consum- accredited school of public health. West ers, activated nurse leaders Virginia’s governor, Earl Ray Tomblin, ap- according to state Senatorial pointed Anna Kent, CNM, of Martinsburg, districts, gained new biparti- WV, to the council. san (and nonpartisan) allies, and finally joined forces with New Opportunities AARP. Virtually every midwife TOP: West Virginia’s midwives won full practice authority through Full practice authority makes West in the state contributed to our focused lobbying at the state capital in Charleston. Virginia a more attractive state for mid- effort in some way. BOTTOM: Advocates (second from left) Toni DiChiacchio, NP; wives seeking work, and impacts recruit- Kendra Barker, NP; Stacey Archer, CNM, MSN, RN; Gail Rock; CNM, ment among growing practices or those Staying in Solidarity IBCLC; Angy Nixon, APRN, CNM, FACNM; and Moira Tannenbaum, poised for growth. It also opens opportuni- Importantly, we maintained CNM, IBCLC; tried their best, but could not persuade West Virginia ties for midwives considering independent goodwill with our direct- State Senator Robert D. Beach (far left) to support the bill. or rural practice, and it brings eligibility entry midwife colleagues and for compact licensure (licensure portabil- received considerable consumer support state. But having to take the long haul ity among different states). As a downside, from the home birth community. We also earns legislators’ respect and sympathy. the new law may mean increased fees stayed in solidarity with our APRN col- The message is to stay focused and don’t and an increased difficulty in establish- leagues, so we could demonstrate strength give up! ing a midwifery board. However, few in numbers, despite the slightly bitter- Our state journey continues as we of our state’s CNMs are entrepreneurs. sweet loss of our unique and separate ensure that the spirit of the new law is Most practice in hospitals, private offices, identity as midwives under the new um- encoded in two sets of rules and regula- clinics, federally qualified health centers, brella term, ”Advance Practice Registered tions currently pending approval. Mean- freestanding birth centers, and home Nurse.” while, this is a great time to practice health care settings. (West Virginia cur- We also suffered tough defeats along the midwifery in wild and wonderful West rently lacks CM regulation.) Many CNMs way. In fact, the hardest year was the 12 Virginia! employed in such health care settings may months before we got our bill passed. On a By Angelita Nixon, APRN, CNM, FACNM personal note, losing a previous legislative not experience noticeable changes in their [email protected] individual workplaces that are due to the fight affected me so much that I decided new law, and those who wish to remain to make preparations to close my practice altogether and relocate to a full-practice

Quickening Fall 2016 11 Georgetown Students Learn Advocacy Skills on Capitol Hill n August 25, Georgetown ing. They also connected University students met with staff students with their ACNM members of their US Senators state legislative chair to Oand Representatives to discuss national share their experiences health care and education policy initiatives locally. Students further important to the midwifery profession prepared by review- and to the women and families we serve. ing and printing ACNM Designed to coincide with other Midwifery State Fact sheets (www. Advocacy Month efforts, this event was the midwife.org/State-Fact- Georgetown Nurse-Midwifery Program’s Sheets) to leave with their second Advocacy Skills on Capitol Hill legislators. Students also Day. The inaugural event occurred on prepped themselves to May 5, auspiciously the International discuss issues influencing Day of the Midwife. On that day, students the health of women in presented their experiences during a their home state. Heather Bradford, CNM, Georgetown faculty (WA); Karla Hill, SNM Virtual Day of the Midwife Student Cafe, (CA); Sara Johnson, SNM (IA); Sarah Raider, SNM, (MD); Mary Kilianski, now available on the ACNM Grassroots Sharing SNM (MD); Jodi Westrum, SNM (MD); Francesca Samuelson, SNM (CA); Advocacy page (www.midwife.org/ Powerful Stories Kimberly Ladage, SNM (CA); and Jeanne Jacobwitz, CNM, Georgetown Grassroots-Advocacy). On the day of the visits, faculty (NY) pause after successful Congressional appointments. faculty, students, and Advocating as Voters ACNM volunteers and staff gathered at the compelling importance of this issue— Georgetown with its Washington, office of Patrick Cooney, ACNM’s lobby- and opened the eyes of a few aides. DC, location and its history of proactive ist, to review talking points. A briefing by Another appointment could not have engagement in federal relations, is ideally Jennifer Jagger, CNM, MSN, WHNP, chair of gone better if it had been scripted: The situated to provide its midwifery students the Midwives-PAC, assured the students students were asked if they were aware of with powerful experiential learning. their job was to share stories of what mid- the growing population of female veterans During May, students in their Integration wifery means to them and what it can do in need of health care and the dearth of Term schedule appointments with their for the women and families of their states. women’s health care providers. It was a home state legislators. The goal is to learn At least 1 faculty member or ACNM staff perfect segue into a discussion of HR1209: advocacy skills by describing the profes- or volunteer accompanied each student Improving Access to Maternity Care Act sion of midwifery and the federal legisla- delegation. Highlights of the day included: and the need for identifying maternity tion that ACNM currently supports to leg- ■■ At 1 appointment, a student shared shortage areas. A new co-sponsor for this islators and their staffs. Students schedule her inspiration to become a midwife. bill may result from this visit. the appointments as constituents, which In summary, she said she wanted “to To further their impact, students sent catches the attention of legislators in a be part of the most amazing profession thank you letters and filled out Legislator powerful way—these students are voters! the world.” Her story brought the whole Meeting Reporting Forms (http:// To date, 40 Georgetown students have room, including the aide, to tears. bit.ly/2ctwAVK) so ACNM staff and visited the offices of 58 legislators from 20 ■■ A Congressional Representative told a volunteers could follow up as appropriate. states and the District of Columbia. student advocate that he would appreci- Georgetown midwifery students and This innovative learning activity is a ate being invited to her place of practice other young advocates deserve congratula- collaborative effort among Georgetown’s for a tour. This student will be working tions for their efforts and involvement. midwifery faculty, ACNM Department with her preceptors to host this repre- Together, they are the future of health of Advocacy and Government Affairs, sentative at home in Iowa! policy and political advocacy for the Government Affairs Committee (GAC), ■■ A breastfeeding student with a 4-month- midwifery profession and the women and and Midwives-PAC. Affiliated individuals old baby found herself in need of a place families we serve. assisted students in making appointments for breast-pumping. Her request at each and preparing for their visits through web- office to be shown to the breast-feeding By Jennifer G. Jagger, MSN, WHNP, CNM; Jodi casts, discussions, and preparatory read- room underscored the personal and Westrum, BSN, RN, SNM; and Cindy L. Farley, CNM, PhD, FACNM

12 American College of Nurse-Midwives MIDWIVES PAC ACNM Unveils New PAC Rally Raises Record- Position Statements ver the past 12 months, I have Breaking Donation Dollars been privileged to be the chair of the Clinical Practice & Documents Gearing up for final push to meet annual goal OSection of the Division of Standards and hank you to the Practice (DOSP). A large portion of our midwives and affili- work encompasses ACNM documents, in- ates who supported cluding position statements. Each of these Tthe Midwives-Political concise documents articulates a position Action Committee (PAC) that ACNM has taken on an issue and offers at the Annual Meeting & the supporting evidence. Midwives can use Exhibition in Albuquerque. our position statements to advocate for Between the PAC-Rally and evidence-based practice congruent with member donations, we the midwifery philosophy of care. raised a record-breaking Our section reviews existing position $49,000 (and had a blast statements at least every 5 years and de- in the process). Way to go velops new position statements as needed. midwives! Any ACNM member can submit a request Each year, the Midwives- for the revision of an existing position PAC aims to raise $75,000. ACNM members enjoy themselves perusing the silent auction statement or the development of a new Although the bulk of these items at this year’s Annual Meeting & Exhibition in Albuquerque. one. Recently, we have issued 3 new posi- contributions come during tion statements: the annual meeting, the fall is when we is a great opportunity to rally affiliate 1. Prevention of Gun Violence. This was make our final push to meet the goal. So members around the importance of developed as a response to the issue we are once again gearing up for our 2 midwifery advocacy in Washington. If your of gun violence in the United States main fall fundraising activities: the Student affiliate is able, please consider making (http://bit.ly/2dhQBQJ). PAC-athon and the Fall Affiliate Challenge. a fall contribution to the Midwives-PAC 2. Conscientious Refusal and the Profession and challenge the membership to make of Midwifery. This statement addresses Students Step Up individual donations. Email pac@acnm. the issues that can occur when there is During the PAC-athon, students org if you have questions or would like conflict between patient choice and pro- across the country take time out of their support soliciting donations from your vider ethics (http://bit.ly/2cI4hVU). schedules to call ACNM members who affiliate or affiliate membership. 3. Legislation and Regulation that Affect haven’t made a donation yet this year. Midwifery Professionals Not Certified If you hear from one of these amazing Where the Money Goes by the American Midwifery Certification students, please take a few minutes to Curious about how the money raised by Board. This document supports connect with this next generation of the Midwives-PAC is spent? The vast International Confederation of Midwives midwives. Demonstrate your support for majority of funds raised become contribu- core competencies and standards of federal midwifery advocacy efforts by tions to the reelection campaigns of practice as the basis for legislation and responding affirmatively to their request federal representatives and senators who regulation (http://bit.ly/2d51oBd). for a donation. Or save them a call! If you have the ability to influence and support donate online or by mail (www.midwife. legislation related to midwifery and Our section also has updated several org/Donate) prior to the PAC-athon, they women’s health. The remainder funds the position statements, including on topics will skip your call. Let them use that time operations of the Midwives-PAC. We are such as elective primary cesarean birth, for studying! small compared with other health care induction of labor, and principles for For the Fall Affiliate Challenge, we ask PACs, but we like to think of ourselves as equitable compensation agreements. We affiliates to designate a portion of their getting our members a lot of bang for their encourage members to view the state- budget to the Midwives-PAC. Additionally, buck! Learn more about the Midwives-PAC ments on our site: www.midwife.org/ some states challenge their membership at www.midwife.org/Midwives-PAC. ACNM-Library. with a matching contribution. For example, By Jennifer Gwen Jagger, MSN, CNM, By Ruth E. Zielinski PhD, CNM, FACNM an affiliate may agree to donate a matching WHNP, Chair, ACNM Midwives-PAC Clinical Associate Professor, Midwifery $1,000 if individual members collectively [email protected] Program Lead, University of Michigan donate $1,000. The Fall Affiliate Challenge School of Nursing

Quickening Fall 2016 13 Changes in Advocacy and Government Affairs Department, Thank You to Jesse Bushman CNM’s Board of Directors, has and the health of mothers and babies. outcomes that we see in public and private Areviewed our advocacy and policy pri- Jesse has been a stalwart advocate for mid- insurance programs will, over time, result orities and current organizational capacity wifery, and we have been truly grateful.” in greater prominence for the profession. in the area of advocacy and government Jesse also wants to share his message It is a matter of getting that story in front affairs. We identified a greater need for with ACNM members. “I would like to of the right audiences.Frank Purcell, Cara support at the state level to give our affili- wish a sincere thank you to ACNM for Kinzelman, and Patrick Cooney are well ates the resources they need for advocacy the opportunity to work to help advance able to accomplish that work for ACNM, work. To support this need, we have re- the midwifery profession. If anything, and I wish them great success.” structured our Advocacy and Government the opportunity to immerse myself in the The ACNM Board thanks Jesse for his Affairs Department. Cara Kinzelman data surrounding midwifery outcomes many contributions, in particular his has moved to the position of Director of has cemented in my mind the value of the development of the Midwifery Value Advocacy and Government Affairs and will work you do, building on the personal Proposition, which will continue to be a address the department’s growth in this connection I already had as a result of the resource to promote midwifery care. We area. Patrick Cooney continues to coordi- home births of our 3 children. I strongly wish him well in the next phase of his nate our federal legislative work and lobby believe the heightened focus on value and career. efforts. Frank Purcell, our new CEO, who starts at ACNM on October 17, will also provide Comprehensive Addiction and Recovery Act of 2016 leadership to further enhance our advo- cacy work at both the federal and state Implications for Midwifery Practice levels. Frank brings extensive expertise n July, the U.S. Congress passed the Comprehensive Addiction and Recovery Act of and leadership in this area from his 16 2016 (CARA). This landmark legislation received bipartisan support to address issues years with the American Association of of access to substance use treatment, prevention, and education, with a special focus Nurse Anesthetists and prior work in Ion America’s opioid epidemic. The bill authorizes a broad program of activities that span Congressional offices. residential treatment for pregnant and parenting women and increased access to office- Jesse Bushman served ACNM very based treatment with buprenorphine. (Specific appropriations have yet to be approved.) well over the past 3 years in the role of CARA includes 3 key provisions that impact midwives and women of childbearing age and Director of Government Affairs prior to their families. his departure September 15 due to the department’s restructuring. Jesse made Key Provisions Under Title X, CARA requires the Center for Substance Abuse Treatment, a division of many contributions in promoting the role SAMHSA, to implement a pilot program of grant funding to state substance abuse agencies of midwives, including the development of to enable them to provide services to pregnant and postpartum women. the “Midwifery Value Proposition.” Jesse Title VII amends the language of the Child Abuse Prevention and Treatment Act brought together multiple data sources to (CAPTA), which applies to the care of infants affected by maternal substance use during provide a clear and directed proposal for pregnancy, including withdrawal or fetal alcohol syndrome. This update requires informa- “flipping the model” of maternity care with tion about best practices in the care of affected infants to be disseminated, and states to midwives as the mainstream provider, ar- provide data about the number of affected infants and the follow up they received in order guing that improved health outcomes and to continue to receive federal child-protection funding. Specifically, the law strengthens cost savings will result. Jesse demonstrat- language requiring the development of a Plan of Safe Care for all infants identified as af- ed his commitment to removing barriers fected by prenatal substance use so that it now includes providing treatment services as to midwifery care through presentations needed and monitoring the use of those services. to payers, policy makers, and essentially To improve access to treatment, Title XVII of CARA expands prescribing authority for anyone who would listen to him articulate medications for opioid use disorders to include specially trained and licensed nurse practi- the value midwives offer. tioners and physician assistants, in collaboration with or under the supervision of a quali- Kate Green, CNM, chair of ACNM’s fying physician as required by state law. Additional training will be necessary to qualify for Government Affairs Committee, noted the prescribing authority, but details about what this will entail have not been determined yet. importance of Jesse’s work. “We’ve been A full text of the CARA legislation can be found at: http://bit.ly/2cDH2dD. impressed by the outreach Jesse has done with the many other health care groups By Daisy Goodman, CNM, DNP, MPH that have an interest in women’s health [email protected] 14 American College of Nurse-Midwives DEPARTMENT OF HEALTH SCIENCE ONLINE PROGRAMS

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Nova Southeastern University is accredited by the Southern Association of Colleges and Schools Commission on Colleges to award associate’s, baccalaureate, master’s, educational specialist, doctorate, and professional degrees. Contact the Commission on Colleges at 1866 Southern Lane, Decatur, Georgia 30033-4097 or call 404-679-4500 for questions about the accreditation of Nova Southeastern University. • Nova Southeastern University admits students of any race, color, sex, age, nondisqualifying disability, religion or creed, sexual orientation, or national or ethnic origin. ACNM ELECTIONS 2016

Elections Continued from page 1 of other health care providers and the interprofessional education models. The favor care that promotes physiologic birth public regarding the midwifery profes- future of midwifery is dependent on and the primary care of women. Further, sion, and the lack of a sufficient number of building partnerships that can benefit all midwives who commit to the future of well-educated midwives to integrate the stakeholders. midwifery by accepting students into their midwifery model of care into the US health practice should be rewarded in a mean- CANDIDATE FOR VICE PRESIDENT system are the most significant challenges Carol Howe, ingful way. As a former program director, to midwifery practice. CNM, DNSc, I believe that the most fair and viable Regulatory issues that limit midwives’ mechanism would likely be some kind of ability to practice continue to plague the FACNM, DPNAP tax credit for a demonstrated commitment As a long-term profession. We are making progress state to student clinical learning. I am open to midwifery educator, by state and our professional organization other mechanisms, but realize that direct the challenges I have needs to continue to support midwives’ reimbursement is not possible for all pro- experienced included efforts as they engage in these battles. grams. Therefore, broader solutions must responsibility for maintaining a fiscally vi- There is a lack of understanding about be identified. If elected, I will work with able faculty practice in a tertiary academic the education and scope of practice of mid- the BOD to support these goals as well as setting that was large enough to support wives. This lack of knowledge leads to re- other ACNM initiatives. student learning while ensuring that in luctance of some health care providers to that environment faculty and students CANDIDATE FOR VICE partner with us and reluctance of women PRESIDENT could truly be “with woman.” Although to use our services. We must educate the Michael there were unique aspects to functioning health care system and the public about in an academic environment, the challeng- McCann, CNM, the value of a midwife, our evidence-based es do not differ that markedly from any MS, FACNM practice, and our outcomes. midwifery practice trying to survive in a Answering this In order for midwives to be a solution health care world of uncertain reform, less question is a rather to the impending shortage of obstetrical than adequate reimbursement (particu- daunting challenge to complete in 260 providers, the profession must produce a larly for those serving vulnerable women), words, as I have both a regional and na- sufficient number of well-educated mid- and productivity expectations that make tional perspective. Having just completed wives. We need a strategy for dramatically the incorporation of students difficult. I 6 years on our ACNM Board of Directors, I increasing the midwifery workforce that have particular interest in ensuring that see vast challenges at both of these levels addresses such challenges as increased midwifery care is recognized at the highest for midwifery practice. That being said, we number of educational programs, clinical levels as being essential to the health of have the most nurturing national environ- site and preceptor issues, and partner- women, and that reimbursement models ment for addressing some of these con- ships with other disciplines to establish cerns with the passage of the Affordable Care Act, and with the increased use of advanced practitioners, including mid- Voting Instructions and Timeline wives, having opened many opportunities. Combined with the improved relationship oting members with an email address on file will receive an email from with our OB colleagues (ACOG) and sister our elections provider in January, which will include a link to the elections V midwives with our US MERA discussions, page. All other voting members will be mailed a paper ballot that offers online the possibilities for growing our profes- voting instructions. Visit to cast your vote. www.directvote/acnm sion have never been better. THURSDAY, DECEMBER 1, 2016: Make sure your ACNM membership is up to date, The major role of the vice president is to renewed, and accurate, so you’ll be eligible to vote in the 2016 election. serve at the will of the president and then assist in ensuring that all the parts of our FRIDAY, JANUARY 20, 2017: The election opens! Paper ballots will be mailed, and volunteer organizational structure remain online voting will begin. You may only vote for Region Representative if you are a operational. Some key areas that will need member of that Region. Electronic ballots will be sent from ACNM Election Coordinator continued efforts include: from [email protected]. We recommend that you white-list this email address to 1. Finding a way to educate a midwife for ensure that the email does not get lost in your email spam filter. every women and family. This is a big MONDAY, FEBRUARY 20, 2017: Election closes. Vote online by 11:59 Eastern time. one as it includes recruitment, educa- If you are voting via paper ballot, make sure it is postmarked by this date. tion, and financial aid to grow our pm profession. MARCH, 2017: We’ll announce the winners.

16 American College of Nurse-Midwives ACNM ELECTIONS 2016

2. We need a robust utilization of our We need to continue to work towards CANDIDATE FOR REGION VI REPRESENTATIVE social media and public relations tools practicing to the full extent of our educa- Jessica to educate consumers about our profes- tion, and as we strive towards that goal, Anderson, MSN, sion and gather data about our safety, we can optimize and strategize with more CNM, WHNP-BC quality, and consumer satisfaction. hands and minds. I have witnessed mid- 3. We need to chip away at practice barri- CANDIDATE FOR REGION IV REPRESENTATIVE wives unable to prac- ers in each state and secure reimburse- Barbara tice to our educational ment from private and public payers. Winningham, level, others unable In my 35 years of experience, I have DNP, CNM, to obtain hospital admitting privileges, served in many capacities as an ACNM WHNP-BC, restrictions on our scope of practice, and midwifery services closed due to sys- member. These efforts and many more are FACNM all part of what I have called the “never tem constraints. We need to continue on Our region consists ending story” for midwifery, with many our mission for midwives to obtain full of predominantly more tales to complete. practice authority, hospital privileges, hospital births, and I have seen some of my medical staff positions equal to other CANDIDATE FOR REGION IV REPRESENTATIVE colleagues struggle with setting up birth providers, and increased independence center and home birth practices. It is im- Kathleen through midwifery-led care services in our perative that we have access to midwifery Moriarty, CNM, communities. We can support midwives care for all women regardless of whether PhD, RN, CAFCI, at all levels through our affiliates’ and they are insured, uninsured, or under- FACNM national office’s development of tool kits insured. I support the right of women to There are similar to achieve these changes. In addition, the choose where and how to birth and would needs across Region midwifery voice must be present at every like to facilitate better access to options IV, yet, these chal- opportunity within our local communi- for women. Each state is unique with its lenges are contrasted with each member’s ties, our regions, and the nation as leaders own codes and laws; I would like to be a or each state affiliate’s circumstances. I of high quality, evidence-based care. We conduit between ACNM’s Department of have been honored to listen to individual need a midwife on every committee, task Advocacy and Government Affairs and CNMs/CMs, students, service directors, force, and stakeholder work group related the affiliates to advocate for change that educators, and affiliate leaders. I find that to women’s health and maternity care, a particular state identifies and support we are all looking for professional support particularly at the federal level. the affiliate as it introduces legislation and, at times, guidance. I would like to Another challenge I have witnessed is that will strengthen access to care and continue to support the affiliate members lack of understanding of our profession. midwifery practice. by making sure people know the available It is challenging for us to increase vis- One solution to enable us to have a ACNM benefits along with ACNM resourc- ibility if the public does not understand stronger voice is to encourage affiliates to es. This will help to strengthen affiliates’ our work. We can tackle this challenge identify midwives who would be willing to growth and development. I will continue with the support of members, affiliates, serve on boards of nursing, to be “at the ta- to encourage ACNM membership. We consumers, and stakeholders through ble” when proposals are being introduced need each CNM/CM to be a member. We educational, public relations, and marking that affect midwifery practice. Another key need the diversity of thoughts, ideas, and initiatives. We must educate the public on factor is to increase our midwifery work- passions as we move towards the work exactly what we do, including our value force. Indiana is one of the states with the outlined in our strategic plan—it is truly in evidence-based cost-effective care, fewest number of midwives per capita. a fabulous roadmap. It is essential that all our philosophy of care, and our scope of All states in Region IV could benefit from potential and actual ACNM members feel practice. This work can be done through more midwives to aid in access to care their value and also feel a strong sense of a variety of avenues including marketing, and in areas of provider shortage. Helping community. If they want to be an active social media, stakeholder relationships, with a campaign to encourage prospective and involved member, this should be midwifery involvement on local, state, and midwifery students to enroll in a program fostered, and I would like to assist them national platforms, and through the voices would be crucial for this. Recent research with actualizing their goals. We need to of families who receive our care. As mid- emphasizes that midwives are the answer continue to develop our next stream of wives, we all can initiate change! For some to the OB/GYN shortage; the time is now leaders! We can evoke more change with a this is in advocacy and health care policy, for us to forge onward with the goal of “a critical mass of engaged ACNM members. for others it is research and knowledge midwife for every woman.” development, and for still others it is as clinicians providing family-centered health

Quickening Fall 2016 17 ACNM ELECTIONS 2016 care based on evidence. Together, we can CANDIDATE FOR REGION VII REPRESENTATIVE it will increase significantly more in cer- make a difference for women and their Barbara tain Region VII states, including California families and ensure access to midwifery Anderson, CNM, (22.61%) and Nevada (64.8%). Of the 179 care for every woman! DrPH, FACNM, counties in Alaska, California, Nevada, Oregon, and Washington, 66 counties do CANDIDATE FOR REGION VI REPRESENTATIVE FAAN Kim J. Cox, The greatest challenge not have any OB-GYN providers. We need CNM, PhD, to midwifery practice more midwives, a fact that our collaborat- across the nation and, ing organization, ACOG agrees with. FACNM: On the other hand, the task of “birth- One of the most definitely, within my region, Region VII, is ing” more midwives is complex in that as significant challenges the freedom to practice within the scope the number of student midwives increase, to midwifery practice, of our education, as advocated by the 2010 so does the need for clinical experiences. both nationally and document, “The Future of Nursing.” We are Lack of preceptors and competition from regionally, is the ability of midwives to superbly educated in our midwifery pro- other education programs are often cited acquire hospital privileges as independent grams across the nation, in line with the as key issues, but site productivity con- providers. Even in states that authorize International Confederation of Midwives cerns may supersede even other (depositphoto.com) [email protected] independent practice for midwives, Global Standards for Midwifery Education. deterrents. hospitals generally require that a midwife However, unlike their experience in Another challenge is have a collaborative agreement with a staff other high-resource nations, in America, that our region still physician to obtain admitting privileges. midwives are restricted in practice and has one state, This situation diminishes our credibility autonomy in a number of states. This California, as providers and inhibits our ability to hampers our ability to fully implement the which provide the scope of care that midwives midwifery model of care and to engage requires are educated and licensed to provide. It independently in full-scope practice. It is physician also restricts women’s access to needed critical for ACNM to continue to support supervision and desired midwifery care. affiliates as they engage in legislative for certified The states and tribal nations of Region efforts to eliminate restraint of trade and nurse-midwives. VI have vast rural and frontier areas. foster an environment of holistic, mid- This archaic requirement restricts the Specialty care is concentrated in a few wifery care for mothers and families in our growth of midwifery businesses in large urban centers. When midwives lose nation. This national voice is a key solution California, thereby reducing access to or are denied hospital privileges in rural to the challenge, and input from affiliates women’s health care. areas, their clients may be forced to travel at the regional level is essential to finding So what are potential solutions? For a hundred miles or more when hospital solutions to this problem. California midwives, learning more about care is needed. Women of color and those CANDIDATE FOR REGION VII REPRESENTATIVE independent midwifery practice in other who are poor are disproportionately Ruth T. Mielke, regional states will be important as they affected. There is, however, a window of pursue further legislative efforts. To opportunity to change this situation. The CNM, PhD, increase the number of midwifery crisis brought on by the maternity care FACNM students, I will encourage efforts to secure provider shortage has motivated ACOG The women and state and federal funding to expand clinical and other policy makers to open dialogue families in Region VII placements. I look forward to discussions with ACNM and explore solutions. My need more midwives. on how interprofessional precepting experience on several ACNM committees This is both a simple occurs in our region in that many students in recent years has convinced me that and complex issue. On the one hand, it is need to learn about the midwifery model midwives are well-positioned to engage simple in that the excellent outcomes of of care. As the Region VII Representative, in these conversations and to facilitate midwifery care are receiving prominent I will be a conduit between state and needed change. If I am elected as Region attention via initiatives to prevent primary national levels and, in so doing, hope to VI Representative, I will work diligently to cesarean birth; e.g. ACNM’s Healthy Birth play a small role in increasing the number listen to your concerns, address these per- Initiative and California Maternal Quality of midwives in our region. sistent barriers, and ensure that the voice Care Coordination Collaborative. of the membership is heard. Thank you for By 2030, the female population in the considering me as a candidate for Region United States will increase by 17.76%, and VI Representative.

18 American College of Nurse-Midwives Meet the Nominating Committee Candidates Voting ACNM members will have the chance to select 2 members of the Pennsylvania, 2007 ■■ MS (Health Administration) Saint Joseph Nominating Committee. The committee helps to shape the future of ACNM University, Philadelphia, Pennsylvania, by selecting candidates for the ACNM Board of Directors office. The two 1988 winning candidates will each serve a 3-year term. Read more about the ACNM ACTIVITIES ■■ Member of the Midwives of Color candidates at www.Midwife.org/ACNM-elections-FAQ. Committee since 1997 ■■ Chair of Membership Committee, 2000 Judith A. Lazarus EDUCATION ■■ Member of Membership Committee, ■■ DNP, Frontier Nursing University, Hyden, 1998–2000 PRESENT POSITION Kentucky, 2016 ■■ Member of PA affiliate since 1985 Full-scope midwifery prac- ■■ MSN Frontier School of Midwifery tice with the same group in and Family Nursing Midwifery, Hyden, Venay Uecke, CNM Seattle for over 28 years. We Kentucky, 2009 PRESENT POSITION practice in a FQHC setting serving a richly ■■ BSN University of Texas Health Science Full-scope practicing mid- diverse group of women and families Center, San Antonio, Texas, 2000 wife for Native American and deliver in a large tertiary care center. Women in Gallup, New Also serves as faculty in the University of ACNM ACTIVITIES Mexico, including office and hospital care Washington Nurse-Midwifery Education ■■ President, Texas ACNM Affiliate, for women of reproductive age. Program. 2015-present ■■ ACNM Outstanding Preceptor Award co- EDUCATION EDUCATION recipient, 2014 ■■ MSN, Marquette University, Milwaukee, ■■ DNP, Washington State University, Wisconsin, 2003 Vancouver, Washington, 2016 Charlotte E. Morris, ■■ RN, BSN, Marquette University, ■■ MSN, University of California, San CNM, DNP Milwaukee, Wisconsin, 2001 Francisco, California, 1988 ■■ BS, (Science) Portland State University, ■■ CNM, University of California, San Diego, PRESENT POSITION: Portland, Oregon California, 1988 Working in OB triage ■■ BSN, University of Washington, Seattle, at Temple Hospital in ACNM ACTIVITIES Washington, 1983 Philadelphia; many years of experience in ■■ American College of Nurse-Midwives full-scope midwifery practice, working in Marketing Committee Member, ACNM ACTIVITIES underserved communities serving African 2015-current ■■ Co-founder of new section, Midwifery American and Latina women. Additionally, ■■ FOMOCC Secretary, 2014-current Educators, Division of Education, 2016 serving as adjunct faculty in the School of ■■ Business Section Committee Member, ■■ Co-chair, Midwives Teaching Midwives Nursing at Drexel University. 2013-current Committee, Midwifery Educators, 2016 ■■ IHS ACNM Affiliate Member, 2014 ■■ Secretary, Washington State Affiliate, EDUCATION ■■ New Mexico ACNM Affiliate Member, 2015 ■■ DPN, Temple University, Philadelphia, 2014 ■■ Member, CE Committee, 2015 Pennsylvania, 2012 ■■ ■■ National Program Committee member, MSN, Temple University, Philadelphia, 2015 ■■ Co-chair, Midwives Teaching Midwives Caucus, 2014 ■■ Nominating Committee, Washington Are you State Affiliate, 2014 Niessa C. Meier, staying CNM, MSN, DNP in PRESENT POSITION touch Clinical faculty for Frontier Visit www.OurMomentOfTruth. Nursing University and com/OMOT-eNews to sign up for full-scope practice at Peterson Women’s with our monthly newsletter. Associates in Kerrville, Texas. OMOT? Quickening Fall 2016 19 ACNM ETHICS COMMITTEE Fostering Full Diversity in Midwifery rowing a profession of midwives tion program equally open to students or make cat calls or rude noises during that represents and reflects the who will not perform abortions and those discussion. Support of diversity does not families we serve is the goal of who want abortion skills taught to them? try to legislate or require others—stu- GACNM’s diversity efforts. What’s more, Are Orthodox Jewish, Amish, and Muslim dents or midwives—to practice in the way diversity is a long-standing priority students welcomed without restrictions we choose. Support of diversity means with ACNM. ACNM launched a multiyear Diversification and Inclusion Task Force in 2012 to develop strategies to expand our diversity. The Midwives of Color Committee has years of history as advo- Truly embracing diversity cates, mentors, and providers of scholar- ships for midwifery students of color. The means moving beyond Gender Bias Task Force has also raised our awareness and, we hope, our understand- ing of ways to reduce gender bias in our mere “tolerance” toward profession. As critical as these goals are, diversity goes beyond race, ethnicity, and gender. We are thinking too small, and our acceptance, mutual support, narrow look is compounding our lack of diversity. To reach our goal of a midwifery workforce that reflects those we serve and and strength. leaves no one out, we must think bigger and broader. Diversity in education, for example, begins with the institution providing the program. There is diversity among public and private institutions. Midwifery educa- tion is provided in secular or religious- based universities with very diverse affili- ations and missions. We educate students at all levels including terminal degrees in nursing, public health, and midwifery. But they are all midwives when they gradu- ©depositphotos.com/upiramos ate and become certified. We educate on their faith-based dress? Online versus encouraging midwives to practice and live in traditional brick-and-mortar institu- brick-and-mortar education is a reality, within the values that normally govern tions and community-based/online. After but do we accept the need for diverse sites their lives. Support of diversity means to decades of debate, ACNM supported the across a much wider geographical area? agree to disagree on many issues with elimination of the requirement of nurs- Opening the path to midwifery for the full continued respect and support for each ing as one criterion to enter midwifery range of diversity begins in our educa- other. Support of diversity celebrates our education. However, many programs still tional settings. differences, makes room in ACNM for mul- require a nursing background and many How does support and encouragement tiple viewpoints, and resists the impulse to preceptors mandate labor and delivery of diversity look? Our communication say “all midwives must do x….” We serve a experience before they accept a student. precedes our action. Support of diversity diverse world of women who deserve care The debate about the value of the criteria means discussing our differences with providers who understand, support, and continues. Diversity in student selec- respect and the goal of understand- reflect their lives. We can only accomplish tion is certainly open to diversity in race, ing other views and sharing one’s own. this by widening our view of diversity, ethnicity, and gender. But, is a student Viewpoints may not change as a result listening more than talking, and celebrat- with a background in public health or the of honest discussion; however the best ing the differences that make each of us arts as welcome as the student who is a outcome is mutual respect and the agree- unique. labor and delivery nurse? Is the educa- ment to disagree. Support of diversity Diversity encompasses thought and does not belittle or demean other views, belief. We represent a wide variety of 20 American College of Nurse-Midwives philosophies, religious traditions, and beliefs. Accommodating the practice of religion in our settings and meetings supports diversity. Midwifery events where Muslim midwives have to retreat to a public restroom to pray or when Friday Jewish service or Christian Sunday services are not available is not supportive of diversity. We can agree that gun violence needs to stop, but we will disagree on how to accomplish that goal. Some will endorse strict gun control and others will support wider gun ownership. We can agree that every pregnancy should be planned and wanted, but we disagree about what is acceptable when an unwanted pregnancy occurs. Some will support a woman’s choice to terminate the From left: Heather Clarke, CNM, DNP, FACNM, Maria Avellino, CNM, Maria Valentic-Welch, CNM, pregnancy and provide that service. Other MPH, FACNM, and two other guests enjoy camaraderie in the Unity Tent. midwives cannot support that option and will not provide termination services. Some midwives will encourage wider use First ACNM Unity Tent Inspires Connections of contraception and others will decline to his year at the ACNM Annual Meeting, we hosted our first Unity Tent. participate in “morning after” contracep- TParticipants joined together to share cups of tea, laugh, and talk about popular tion. The ethical goal requires that all issues that concern all midwives. A little white box in the center of the tent contained views are reasoned and reflect the deep slips of paper that provided suggestions for lively conversation. At other times, convictions of midwives and, in many participants enjoyed a mini foot massage. Most importantly, the Unity Tent brought cases, the population they serve. Examples together midwives from widely diverse backgrounds, who otherwise might not have of the many topics that highlight our spent time together, to learn that the bonds that unite us as women, mothers, and differences include universal health care, midwives are much stronger than those that tear us apart. Thanks to Heather Clarke , circumcision, unrestricted access to CNM, DNP, FACNM, and Mairi Rothman, CNM, MSN, FACNM, for organizing the Unity second trimester termination, artificial Tent, as well as to our student volunteers and, most importantly, to the wonderful insemination in LGBTQ families, and post local midwives who did an amazing job putting the tent together. birth repair or restoration of genital “cutting.“ Truly embracing and celebrating diversity moves beyond mere “tolerance” of our differences towards acceptance, mutual support, and strength. Graduation on Developed by the ACNM Ethics Committee and Advisory Panel: Ira Kantrowitz-Gordon, CNM, PhD, the horizon? FACNM (Chair); Barbara Anderson, CNM, FACNM, Start preparing for your FAAN; Cindi Anderson, CNM, MS, ARNP, RM; Mary Kaye Collins, CNM, JD, LLM, FACNM; Jessica Dillard- AMCB Certification Exam by Wright, MA, MSN, RN, CNM; Leah McCoy, CNM, DNP; Wendi Fairweather, DNP, CNM; Julie Louis, purchasing the Exam Prep RN, SNM; Michael McCann, CNM, FACNM; Kathy Powderly, CNM; Nancy Jo Reedy, RN,CNM, MPH, Workbook in the ShopACNM FACNM; Joyce B. Thompson, CNM, DrPH, FAAN, FACNM: Erin Wright, CNM, APHN-BC, DNP. bookstore! REFERENCE www.tinyurl.com/z5f9lvo Code of Ethics with explanatory statements, ACNM, 2013. http://bit.ly/2ddO5v8

Quickening Fall 2016 21 Read Quickening on Your Mobile Device Continued from page 1 your PC, tablet, or other mobile device; edition, which comes out in January in the mail. Members who do not send us ■■ Printing the PDF to read at your leisure. 2017, all members will be transitioned to a print request by December 1, 2016 will digital copies unless they have specifically be switched to the online format with the Enhancements requested to continue receiving printed January 2017 issue. Coming in January copies by mail. Those who request printed Accessing it is that easy right now, and copies will be charged for printing and Accessing Quickening Online in January, you will notice a few improve- mailing their issues of the newsletter. If you have not yet read Quickening ments. Quickening will be more inviting online on at www.midwife.org/ and engaging online because it will be What You Need to Know quickening-archive, please do. The produced in full color. It will be more inter- To request the continuation of printed content is identical to the printed copy active, so you can link directly to sources copies of Quickening by mail, please that now comes to your home. When a for more information, as well as visit ad- send an email by December 1, 2016 to new issue of Quickening is published, all vertisers websites through “clickable” ads. [email protected] or call 240-485- members receive an email that links them These enhancements will improve your 1800. The cost for printing and mailing 4 to the most recent edition. Simply click on online experiences and bring you closer to issues in 2017 is $35.00. Members who the link to view the latest great articles, professional resources. notify us that they want printed issues resources, and news about what ACNM We appreciate all of the support we have will receive an email this fall with a link and your colleagues has been doing for received as our newsletter becomes to make the $35.00 online payment before you and your profession! paperless and more cost effective. If you the end of the year. If we do not have an You can read Quickening by: have any questions about Quickening, email address for a member who wants a ■■ Opening the PDF and reading it online; please email us at quickbymail@acnm. printed copy, you will receive an invoice ■■ Downloading the PDF and saving it to org. Thank you!

22 American College of Nurse-Midwives PROFESSIONAL CONNECTION Midwives’ Role in Educating about Vaccination arents consider health care professionals one of the most shot during pregnancy, and to commit to keeping her baby up-to- trusted sources for answering questions and addressing date on childhood vaccinations. We have eliminated many diseases concerns about their child’s health. In fact, 82% of parents in the United States, but in recent years, reported cases of measles Pcited their child’s health care professional as one of their top 3 and pertussis have increased. It’s important to address the risks trusted sources of vaccine information, according to a recent sur- of the diseases that vaccines prevent. Similarly, it’s imperative to vey by the US Centers for Disease Control and Prevention (CDC). acknowledge the risks associated with vaccines, because we know However, a second CDC survey revealed that close to 90% of first-time expectant mothers had already decided whether to vaccinate their children. Pregnant women—especially if this is their first child—may not have access to a pediatrician yet. Therefore, you as a midwife may be their most trusted source of information about both maternal and childhood vaccines. When educating your clients about the importance of vac- cines, make a strong recommendation for maternal vaccines as well as childhood vaccines. Let them know that the vaccines they get during pregnancy will provide their developing babies with some disease protection that will last through the first months after birth. This early protection, timed correctly, is criti- cal for diseases such as the flu and whooping cough, because babies in the first several months of life have the greatest risk of Photo Credit: ©depositphotos.com/imagepointfr Credit: Photo severe illness from these diseases. Passing maternal antibodies on to newborns is the only way to help directly protect them at that parents are seeking balanced information. Never state that first, but soon, they’ll need their own vaccines for protection. vaccines are risk-free and always discuss the known side effects In addition, let your clients know that their babies won’t be caused by vaccines. You can learn about the risks and side effects the only ones who benefit from the disease protection vaccines of each vaccine by viewing Vaccine Information Statements (VIS) provide. Vaccines also protect moms-to-be against diseases. That at www.cdc.gov/vaccines/hcp/vis/index.html. And, you can protection will last after the baby is born, which is important, reassure women that the side effects associated with getting vac- because new babies make such a demand on their moms that new cines are almost always mild (such as redness and swelling where mothers can’t afford to get sick with the flu or whooping cough. the shot was given) and go away within a few days. If your patient Women may ask you for more information about recom- is worried about thimerosal, a vaccine preservative, let her know mended vaccines. ACNM has a variety of immunization re- that thimerosal-free flu shots are available for her and her baby. sources for midwives available on its website, especially on If a woman chooses not to get vaccinated during pregnancy, or Midwifery and Women’s Health via Our Moment of Truth™ (www. not to vaccinate her baby, keep the lines of communication open. ourmomentoftruth.com/The-Importance-of-Vaccines), also Take each visit as an opportunity to remind her that it is not too (www.midwife.org/Immunization-Resources-for-Midwives). late to get vaccinated. As a midwife, it is also important to consider Even if you are not a vaccine expert yourself, you can refer your own vaccinations. your patients to other credible sources of information. CDC has A midwife’s expertise, knowledge, and advice are vital in information about vaccines during pregnancy (www.midwife. creating a safe and trusted environment for discussing immuniza- org/Immunization-Resources-for-Midwives) and a newly tions. You can learn more about making a strong Tdap recommen- redesigned website for parents (www.cdc.gov/parents), contain- dation at www.cdc.gov/pertussis/pregnant/hcp/index.html ing childhood immunization schedules, vaccine safety informa- and find CDC resources to educate pregnant patients about the tion, tips for a successful shot visit, and facts about vaccines and importance of an annual flu shot at www.cdc.gov/pertussis/ vaccine-preventable diseases. Other reputable vaccine information pregnant/hcp/index.html. To help you communicate with websites include: parents about childhood immunizations, CDC, the American ■■ Immunization for Women from the American College Academy of Family Physicians (AAFP), and the American Academy of Obstetricians and Gynecologists (ACOG) at www. of Pediatrics (AAP) partnered to develop Provider Resources for immunizationforwomen.org Vaccine Conversations with Parents (www.cdc.gov/vaccines/ ■■ Healthy Children from the American Academy of Pediatrics at hcp/conversations). Please take a few minutes to review these www.healthychildren.org. maternal and childhood immunization resources. Your clients will thank you. A strong recommendation from you as a midwife can make a patient feel comfortable with her decision to get Tdap and the flu By Nancy Messonnier, MD, MPH, Director, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention Quickening Fall 2016 23 PROFESSIONAL CONNECTION Secrets in the Waiting Room: The Face of Domestic and Sexual Violence uring October, recognized nationally as Domestic Violence harmful or life-threatening and that has lasting adverse effects on Awareness month, we are reminded of the pervasiveness the individual’s functioning and mental, physical, social emotional, of Intimate Partner Violence (IPV). We know the troubling or spiritual well-being. Trauma-informed care incorporates the Dstatistics: 1 in 3 women will experience either IPV or sexual vio- three “R’s”: Realize the widespread impact of trauma and the lence (SV) during her lifetime (CDC, 2011). This prevalence among potential paths for recovery; Recognize the signs and symptoms of every segment of society has prompted ACNM, along with other trauma in clients, families, and staff; Respond by fully integrating major health care organizations, to recommend universal screen- knowledge about trauma into practice, policies, and procedures. ing of our patients for To this we might add: and Resist domestic and sexual re-traumatization. violence. Key principles of trauma- This starts with informed care include: safety, acknowledging the face trustworthiness and transparency, of that experience as peer support, collaboration and we see it in the women mutuality, empowerment in voice who sit in our waiting and choice, and consideration of cul- rooms. It also means tural, historical, and gender issues. understanding how Trauma-specific interventions rec- the care we provide for ognize the victim-survivor’s need to these women impacts be respected, connected, informed, their experience. and hopeful. They also recognize If 24 women enter the interrelationships between your waiting room trauma and presenting symptoms. ©depositphotos.com/wavebreakmedia today, among them A trauma-informed environment is might be Isabel, who, at age 42, is single, but who experienced do- a quiet, unhurried atmosphere that is supportive, affords privacy, mestic violence in a 12-year same-sex relationship, before leaving and encourages rather than diminishes self-efficacy. her partner 3 years ago; Malika, 27, here for a prenatal visit at 24 weeks, whose “concerned” husband accompanies her to every visit Organization-wide Support to prevent detection of escalating abuse; Ana, 36, here for her an- As midwives, we pride ourselves on delivering this type of care. nual after many “missed” appointments. Repercussions from her However, this approach encompasses not only the interactions history of sexual abuse from age 9 to 12 include extreme difficulty between the individual midwife and the woman seeking care, with pelvic exams. Sophie, 22, known to the appointment staff as but also each entire organization. Until the principles of trauma- a “frequent flier,” comes in for a “STD check” and reassurance that informed care become systemic and are incorporated into the or- “everything down there is OK.” Her college years include a his- ganizational culture at every level, we will not be able to meet the tory of sexual assault. Then there is Ana, 63, who has early onset goal of true trauma-informed care for our patients. So for Sophie dementia and lives in an assisted living facility. She arrives for a this would translate to the staff who make her seventh appoint- follow-up after a prior visit for post-menopausal bleeding revealed ment being as respectful and kind as they were with the first. sexual assault by a caregiver. Midwives have a long history of not only caring for women, but also being activists to ensure that women receive optimal care. In Extending Trauma-Informed Care this arena, that activism may mean partnering with local DV/SV As midwives, we are already experts in helping women feel safe agencies so referrals can be seamless or participating in DV/SV in situations that can include discomfort or pain, and in assist- community events to show that “midwives care.” It may mean ing and supporting them to achieve the best possible outcomes. working to assure that the climates in the institutions in which we Providing the “trauma-informed care” that women who have work become trauma-informed, so women will receive the kind of experience IPV or SV clearly need is therefore a natural extension care that they need and deserve, which is an essential part of their of the midwifery philosophy. health and healing. Both DV and SV fit the Substance Abuse and Mental Health By Linda Sloan Locke, CNM, MPH, LSW, FACNM Services Administration ( ) definition of trauma www.samhsa.gov [email protected] as “resulting from an event, series of events, or set of circumstanc- es that is experienced by an individual as physically or emotionally

24 American College of Nurse-Midwives ACNM BENCHMARKING PROJECT Enablers and Barriers to High Breastfeeding Rates in Your Practice he ACNM Benchmarking Project serves as a tool for members nationwide to collect and report data about their What Factors Do You Think Contribute to practices, enabling comparisons to improve midwifery Your Excellent Breastfeeding Rates?* Tcare. Although there are many data points that can be followed, participating requires tracking only a mere 6 items, half of which are basic practice demographics. If you are not currently active in this professional effort, this fall is the time to start. We all benefit from our colleagues’ dedication to this collaborative quality- improvement investment. What’s more, as a midwife, you are surely a breastfeeding advocate, so you’ll want to include this valued outcome in your benchmarking efforts. Benchmarking on Breastfeeding There are 3 survey items about breastfeeding and postpartum care included in the ACNM Benchmarking Project. They are: 18) Total number of women who initiated exclusive breastfeeding of their infant during the first 24-48 hours after birth; 19) Total num- What Barriers Do You Encounter in Maintaining ber of women who attended their 6-week postpartum visit; and a “Best Breastfeeding” Practice?* 20) Of the number of women who attended their 6-week postpar- tum visit, give the total number of women continuing to breastfeed (any breastmilk provided to infant at 6 weeks postpartum; may be supplementing or providing formula in addition to breastmilk). To improve the health of our neonates, the US Department of Health and Human Services’ Healthy People 2020 Initiative, from the Health Resources and Services Administration, includes as an objective, increasing the number of infants who ever breastfed and reducing the number of breastfed infants who receive formula supplementation during the first 2 days of life (HRSA Office of Disease Prevention and Health Promotion, 2016). Best Practices for High Breastfeeding *Respondents were allowed to check all answers that applied to them. Of the 329 practices that completed benchmarking surveys in Eleven practices recognized for their high breastfeeding rates share their insights. 2014, a proud 11 achieved recognition as a Best Practice in High Breastfeeding. ACNM surveyed these breastfeeding champions to ■■ Encourage support of community resources with partner solicit the wisdom behind their success to share with the ACNM participation; and community. (See their feedback in the chart on the top right on ■■ Share references for medication safety in breastfeeding. contributing factors). Knowing that selecting factors from a pre-determined list could Similarly, the project asked the champions to identify the bar- be limiting, the project also asked practices whether they would riers they encountered as they tried to maintain best practices. be willing to describe their facilitating factors. Their responses (See chart above.) Identifying barriers to a practice’s breastfeeding included the following breastfeeding practice pearls: success enables it to tailor a plan to overcome the deterrents and ■■ Cultivate breastfeeding as a norm in your culture; increase moms’ initiation and continuation rates. ■■ Introduce the topic of breastfeeding early in pregnancy; ■■ Assess the mother and baby to ensure adequate latch before How to Get Started leaving the homebirth setting; If you’re not currently participating in ACNM’s Benchmarking ■■ Make it a priority; Project or you’re participating, but not collecting data on breast- ■■ Have trained, committed RNs; feeding, start today. Check out www.midwife.org/ ■■ Involve full-time lactation consultants; Benchmarking. ■■ Provide ongoing support after discharge; By Noelle Jacobsen, CNM, MSN and Diana R. Jolles, CNM, PhD [email protected] Quickening Fall 2016 25 Prepared to Take the Sonography Exam? ltrasound is an extremely powerful tool. Medical Pegasus Lectures has pioneer Ian Donald first developed a comput­er- Uused it for obstetrical care in based exam simulation Glasgow at least 60 years ago. program that covers From those early days in 1956, such topics as gauging delivery dates, fetal ultrasound has advanced tre- blood flow through the mendously, providing important heart, and maternal information that can aid in a safe circulation. delivery for baby and mother. During the past few years, the number of midwives in the United States who are learning ultrasound or who want to improve their ultrasound skills has increased dramatically. Recognizing this movement, the potential benefit to patients, and the technology’s capacity to increase the scope of practice of midwifery, ACNM has worked with a variety of organizations to develop a method for acquiring and demonstrating these skills. Improving Knowledge The American Registry for Diagnostic Medical Sonography (ARDMS), which tests the basic ultra- know exactly what to expect when sitting and Third Trimester. For midwives who sound proficiency of midwives, recently for the exam. desire to learn more, Pegasus Lectures has announced a new certification exam. So additional modules on Fetal Ultrasound. the question many midwives may ask is, Modular eCourse For individuals who need dedicated “What is the path for me to improve my If you have not yet had adequate hands-on training, the eCourses can be ultrasound knowledge and to prepare for training in ultrasound, Pegasus Lectures coupled with this service as well. This the exam?” has also developed a comprehensive, training can be done either at your site or In partnership with the ACNM, Pegasus modular eCourse to teach ultrasound in Las Vegas at a training site, whichever Lectures, a professional medical educa- physics principles and OB/GYN best accommodates your schedules and tion company, has developed a comput- Ultrasound for the Midwife. This online finances. For more information, visit, er-based exam simulation program. It course provides dynamic instruction www.PegasusLectures.com/ includes 3 full-length practice exams, but by 2 of the most widely recognized acnmProducts.php, or call, goes significantly further. In addition, the instructors in the field, who emphasize 972-564-3056. program provides comprehensive, detailed conceptual understanding, so you can explanations of each question and answer, improve the quality of care you deliver Editor’s Note: You can hear Frank Miele, a patented score report that identifies to your patients. The course begins with president of Pegasus Lectures, speak about strengths and weaknesses, a strategy sec- 8 modules that review the underlying ultrasound or visit with him at the Pegasus tion to improve students’ test-taking abili- principles of ultrasound physics and booth at Midwifery Works! 2016, November ties, and CME that meet the exam require- ultrasound imaging. At these modules’ 3–6 in Myrtle Beach, South Carolina (www. ment condition for ultrasound CME. The completion, there are 3 sections consisting midwife.org/Midwifery-Works-2016). program also simulates the conditions of of a total of 18 modules, which cover the You can also hear him at the ACNM 62nd the actual certification exam, so students clinical aspects of ultrasound. They are: Annual Meeting and Exhibition May 21–25 Gynecology, First Trimester, and Second in Chicago.

26 American College of Nurse-Midwives Midwife Sonogram Certification: The Details You Need Now

n July, the American Registry for ■■ Watch for updates about the midwife For more information, including how to Diagnostic Medical Sonography sonography assessment program and prepare, apply for, and maintain the (ARDMS) announced the spring corresponding education resources in Midwife Sonography Certification, please I2017 launch of our midwife sonography Quick eNews and Quickening. visit www.ARDMS.org/MW. Be sure to assessment program. As promised, we ■■ Sign up for Pegasus education programs sign up to receive alerts about upcoming are now ready to share details regarding (www.pegasuslectures.com), ACNM’s application and administration dates. eligibility requirements, prerequisites, and ultrasound education partner. certification process. Over the past few months, a volunteer- led midwife task force has worked NOTICE OF ACCREDITATION ACTION diligently to evaluate the eligibility requirements reflective of the nurse- ccrediting agencies recognized by the US Department of Education (USDE) are midwife scope of practice. Arequired to notify regional accreditors, selected specialized accreditors, and state To earn the ARDMS Midwife Sonography licensing agencies responsible for post-secondary education of final accreditation Certification, applicants must success- decisions. In addition, the Accreditation Commission for Midwifery Education (ACME) fully meet or complete the following 3 also provides notice of its accreditation decisions to the public on its website (www. components: midwife.org/Accreditation). In accordance with 34 CFR §602.26(a), you are being provided with notice of these 1. ELIGIBILITY: Applicants must hold an actions no later than 30 days following the Commission decision. active CM or CNM certification offered Please be advised that ACME, the recognized accrediting agency for the accreditation by AMCB, and must submit proof and pre-accreditation of basic certificate, basic graduate nurse-midwifery, direct entry of Inteleos-approved OB and GYN- midwifery, and pre-certification nurse-midwifery education programs, including those ultrasound education (at minimum, programs that offer distance education, took the following actions at its Board of 12 CME, or more) earned within Review (BOR) meeting July 14, 2016. the preceding 5 calendar years of application submission. Applications for Continued Programmatic Accreditation (through July 2026) the Spring 2017 administration open on ■■ East Carolina University, College of Nursing, Nurse-Midwifery Program—Master of January 4, 2017. Science (MS) and Post-Graduate Certificate ■■ Emory University, Nell Hodgson Woodruff School of Nursing, Nurse-Midwifery 2. WRITTEN EXAMINATION: Eligible Program—Master of Science (MS) and Post-Graduate Certificate candidates must take and pass the ■■ University of Utah, College of Nursing, Nurse-Midwifery Program—Doctor of Nursing midwife sonography examination during Practice (DNP) and Post-Graduate Certificate select administration periods. The first administration period is from April 4, Substantive Change 2017 to May 4, 2017. ■■ Emory University, Nell Hodgson Woodruff School of Nursing, Nurse-Midwifery 3. PRACTICAL EXAM (SCANS & CME): Program—added a Doctor of Nursing Practice (DNP), accredited through July 2026. Upon successful completion of the writ- ■■ SUNY Stony Brook University, School of Nursing, Nurse-Midwifery Program—added ten examination, the CM or CNM will a Doctor of Nursing Practice (DNP), accredited through February 2018. have up to 2 calendar years to success- Withdrawal of Accreditation fully obtain requisite scans and further ■■ University of Puerto Rico Graduate School of Public Health, Nurse-Midwifery education. Program—voluntarily withdrew accreditation and closed program effective as of Test Prep Resources November 1, 2016 To prepare successfully for the examina- These actions and decisions have been posted on the ACME website at www. tion, take the following three steps: midwife.org/ACME-Accreditation-Action-Notices. For additional information about ■■ Visit . ACNM offers www.midwife.org nurse-midwifery and midwifery accreditation, contact the Accreditation Commission resources, including exam simulations, for Midwifery Education (ACME), 8403 Colesville Road, Suite 1550, Silver Spring, and information such as updates about Maryland 20910, Phone: (240) 485-1802, Fax: (240) 485-1818, Email: hmaurer@ workshops. acnm.org, website: www.midwife.org/acme.

Quickening Fall 2016 27 GLOBAL HEALTH Mentoring in Tanzania and Malawi uring the past 6 months, I have district. The program’s had a golden opportunity to work elements include: as a volunteer mentor with the ■■ Focusing on the DACNM Department of Global Outreach mother and her family (DGO) on two projects, one in Tanzania as the primary care- and the other in Malawi. takers of preterm/low In Tanzania, we focused on upgrad- birth rate infants, and ing the process for evaluating midwifery providing them with students’ clinical learning. This project the skills, information,

had two parts. First, we provided technical and confidence to http://bit.ly/2d6m0XW assistance that supported a revision of the care for their babies documentation of that learning. Second, both in the facility we instructed tutors as they learned effec- and at home; tive use of simulation for teaching birth ■■ Providing tools, such and aftercare of the mother and infant. as job aides and Improving midwifery educators’ skills guidelines, for the 2.0, UK DFID CC Make by Mums Matter Credit: Photo and knowledge is essential to achieving facilities’ health care midwifery competence so women receive workers to enhance the best and most evidenced-based care the care of preterm/ possible. low birth weight infants; Facilitating Care ■■ Strengthening the The Malawi project centered on the care clinical capacity of of preterm and low birth weight infants facility staff through through an approach called Kangaroo skills building and Mother Care (KMC), which the World quality improvement Health Organization endorses and strongly processes; and encourages. Malawi has one of the highest ■■ Supporting facility-to- global incidences of preterm/low birth TOP: New moms in Malawi, like this woman, can benefit from the community linkages. Kangaroo Mother Care program. weight infants. According to the Healthy BOTTOM: The author (top row, second from the right) collaborates to Newborn Network, approximately 120,000 Building create teaching tools for mothers and families. babies a year are born prematurely in Capacity Malawi. So it was a natural choice to What crystalized my experiences in in another culture and, as such, must listen be 1 of 4 demonstration countries for a Malawi was a week we spent with a mixed as much as speak. Although I have worked USAID project called Every Preemie SCALE group of midwives, health educators, for years internationally, I never fail to find (Scaling, Catalyzing, Advocating, Learning, and officials from the Ministry of Health, that working in other cultures is a two- and Evidence-Driven). Every Preemie working collaboratively to create essential way street, one in which I contribute to and its three partners, including ACNM, teaching tools for mothers and families. projects, but also learn from local families facilitate the implementation of learning I was happy to see the Malawian experts and experts on critical issues and ideas. about the evidence-based interventions, translate the materials into Chichewa, After so many years working in and care, and support of these infants in low- since this is the language the families teaching midwifery, participating in DGO resource settings. speak. I felt that we were building capac- projects is a gift through which I can share In Malawi, the project targets the Balaka ity, both within the Malawian profes- with midwifery colleagues in other district in the southern region of Malawi sional community and among the families countries the benefits of my own profes- because of the area’s high poverty, malnu- involved at the local hospital and 8 health sional life journey. We all benefit through trition, and maternal and newborn mortal- centers. this partnership. ity rates. Stakeholders, including Ministry Not surprisingly, capacity building is the of Health representatives at the national primary principle that underpins the work By Patricia Burkhardt, LM, CM, DrPH, FACNM and local level, designed a program en- of DGO and its related funding sources, [email protected] titled “Family Led Care” that will be among them USAID. Creating it effectively implemented within the KMC units in the means recognizing that we are strangers

28 American College of Nurse-Midwives CLINICAL NOTES Avoid the Nasal Spray maternal morbidity. Similarly, the CDC ter than using a short-acting method. This Flu Vaccine in 2016-2017 has outlined five public health strategies major study is published in the American For the 2016-2017 flu season, the to prevent preterm birth. Learn more: Journal of Obstetrics and Gynecology: CDC recommends use of the flu shot http://bit.ly/2dQ0hSu. http://bit.ly/2cGilNQ. (inactivated influenza vaccine, IIV) and the Major Study Supports Use Breast Density is Key to recombinant influenza vaccine (RIV). The of Long-Term Reversible Appropriate Screening nasal spray flu vaccine (live attenuated Contraception Intervals influenza vaccine or LAIV) should not New research provides strong scientific For women between ages 50 and 74, be used during 2016-2017. Read more: evidence that long-acting reversible con- those with dense breasts had fewer breast http://bit.ly/2dmX6V1. traception (LARC) benefits a wider popu- cancer deaths when they were screened New Guidance Addresses lation of potential users than previously yearly rather than every other year, a study Severe Maternal Morbidity thought. Women who tried LARC, despite in the Annals of Internal Medicine found. their preference for oral contraceptives Learn more: . The American College of Obstetricians http://bit.ly/2criIzT or injections, found these methods highly and Gynecologists (ACOG) and the Society Ovarian Cancer Screening satisfying. Their decision to try LARC for Maternal-Fetal Medicine (SMFM) have prevented unintended pregnancy far bet- Tests Not Reliable jointly issued guidance to address severe “Despite extensive research and published studies, there are currently no screening tests for ovarian cancer that BULLETIN BOARD are sensitive enough to reliably screen for Volunteer Opportunity with ACME ovarian cancer without a high number of The Accreditation Commission for Midwifery Education (ACME) seeks a member of inaccurate results,” the FDA has reported, the public to serve on its Board of Commissioners (BOC). The BOC develops, approves, warning the tests should not be used: implements, and evaluates the pre/accreditation criteria; establishes the policies http://bit.ly/2d33Wyp. and procedures for pre/accreditation of midwifery education programs; administers, reviews, and evaluates the accreditation process; and publishes and disseminates AAP: Safe Sleep and Skin-to- information regarding the accreditation process and accredited programs. The BOC Skin Care Clinical Report meets monthly by conference call, and as needed. The American Academy of Pediatrics The mission of the ACME is to advance excellence in midwifery education. Public has released a new clinical report titled member representation is necessary for effective operation of the BOC. A public mem- “Safe Sleep and Skin-to-Skin Care in ber is not a midwife, and one who shall not derive any income from midwifery-related the Neonatal Period for Healthy Term sources. For a full description of the position and application process, please visit Newborns” intended for birthing www.midwife.org/acme. centers and delivery hospitals caring for healthy newborns to assist them in the Hunting for New Annual Meeting Exhibitors establishing skin-to-skin care and safe We want to keep our exhibit hall interesting and dynamic for you, so please share sleep policies: http://bit.ly/2coPEUM. with us the names of any companies you would like to see at the ACNM Annual Meeting in Chicago. We welcome and will follow up on all new exhibitor leads. Think outside of Blood and Body Fluids of the box, and, for any company you wish to suggest, please find out the name of the con- Severely Ill Zika Patients May tact person for exhibitors, and his or her contact information, otherwise it can be very Be Infectious difficult us to get to the right person. Having exhibitors at the meeting gives you the op- A Utah health care worker contracted portunity to learn about new products. It is also a source of revenue for ACNM. Thank Zika virus after caring for a severely ill you for your help and creative ideas! For exhibitor leads contact: Eileen Ehudin Beard, Zika patient. A CDC investigation con- CNM, FNP, MS, FACNM, Senior Practice Advisor, 240-485-1842, [email protected]. cludes blood and body fluids of severely ill patients might be infectious. “Given Calling for Business Documents recognition of high levels of viremia during The Business Section of the ACNM Division of Standards and Practice is working illness, it is essential that health care diligently on several initiatives in preparation for Midwifery Works! 2016 meeting in workers continue to apply standard Myrtle Beach, South Carolina, November 3–6, 2016. Under the direction of new precautions while caring for all patients, Business Section Chair, Barbara Hughes, CNM, along with efforts of the newly formed including those who might have Zika virus Midwifery Business Network Caucus led by Barbara Wax, CNM, momentum is building disease,” a spokesperson said: http://bit. for the development of business resources for midwives. To this end, if you have a ly/2d7kGWu. document such as a business plan template, evaluation tool, or staff meeting template that you have found helpful, please submit it to [email protected].

Quickening Fall 2016 29 WISE MIDWIVES TALES And So the Adventure Begins fter 35 years of being a midwife, Midwives can also give back through consider your spiritual center or a shelter the decision to retire was one mentoring. It’s easy to reach out to a for the homeless. A woman’s homeless ini- of the most difficult of my life. I nearby certified midwifery program or to tiative in my area is thrilled to have caring Ahad loved being in clinical practice and connect directly with a novice or potential volunteers sign up to help cook a meal or teaching, first at Shiprock, New Mexico, midwife. Encouragement on the journey is simply be an attentive listener. and then at the University of Working a midwife’s unpredictable Colorado, and I spent the 10 schedule always provided a good excuse years leading up to my decision to say no. Now you could find yourself wondering whether I would more in demand know when to stop practicing “Retire to something rather than you want and what path I would follow to be. So make next. Fortunately for me, a con- than from something,” sure to dedicate vergence of life events showed someone once advised me. time to activities me clearly when the time to that you think retire had arrived. will be fun. A friend of mine is singing in a Retire to something rather choir. I have explored my individual family than from something, someone genealogy. My search led me to a colonial once advised me. Following this ancestor who was the first female phar- sage advice, I looked around macist in Massachusetts and another who and found many ways to use my was hung as a witch in Salem. I was proud talents in my community. As an of the legacy these brave women left me. “organizational junky”— (I loved Joining a book club is another enjoyable being active in ACNM)—I looked option, and any discussion can benefit first to ACNM for volunteer from a midwife’s point of view. I am a mys- options. I saw that virtually every tery fan, but had never heard of Josephine committee, caucus, division, Tey or Jacqueline Winspear until my book and task force could use help. club elected to read them. I focused on the policy front, Retirement also presents wide-open making a commitment to myself opportunities to travel. This summer was to call, write, or visit one of my the 100th anniversary of the National Park legislators either every month Service. This inspired my sister and me or when I received an alert. Laraine Guyette, PhD, CNM, FACNM, (right) toured national to take a 30-day, 6,000-mile road trip. Having worked with incarcerated parks with her sister, Mary Waller, and stopped in Maine. Departing from Colorado, we wound pregnant women, I had the our way to the Blue Hills Parkway in opportunity to testify in support of a bill always welcome. Midwifery students seek- North Carolina, up to Shenandoah and for safer and more humane restraint of ing a scholarship through the Midwifery Gettysburg, on to Maine, west to the Black these women during transport to clinic Legacy Project also need to find those who Hills, and home to Denver. We visited visits and during labor. The bill passed, are willing to tell their stories. Step up family and friends, returned to beloved and I felt proud of a former private client and volunteer. Conversely, interview other spots, and took in amazing new sights. who had taken this on as a personal cause senior midwives so their stories are saved. Our pace gave us time to enjoy each other and happy I could help her. The members of Midwifery History Caucus and the beautiful countryside along many Applying our midwifery knowledge in can offer guidance with this project. secondary roads. other settings is another way to use our Or tap your other talents. If you’re an So ask yourself, now that you have time skills. A colleague of mine taught emergen- accomplished knitter, ask yourself whether to accomplish a few unfulfilled goals and cy childbirth to local EMTs, while another you could knit blankets or bonnets for dreams, “What is on my bucket list?” Then gave infant CPR lessons to a parenting your local birthing facility. If you like to make it happen, enjoy every minute, and group. Why not collect birth supplies for create handicrafts, you could add them remember, life is good. Midwives for Haiti or consider volunteer- to care packages for our service men and By Laraine Guyette, PhD, CNM, FACNM ing on the local disaster preparedness women. Thoughtful handmade items are [email protected] committee? (Babies like to come at the especially welcome during the holidays. most inconvenient times.) If you’re looking for places to volunteer,

30 American College of Nurse-Midwives ACNM MIDWIFERY HISTORY CAUCUS The Changing Midwife: Cecilia Wachdorf, CNM, PhD ow diverse can your career be at me wide-eyed and said, ‘What kind of if you are a midwife? For Cecilia magic do you have?’” Wachdorf, CNM, PhD, it can range “They had all had thought that the baby Hfrom having a private birth center practice was stillborn. Their tradition was not to to teaching native Papua New Guinea stimulate or resuscitate babies, but accept nurses to become midwives to directing a midwifery practice in Minnesota that included 8 clinics, 3 hospitals, and 23 midwives. Now Cecilia works with the Minnesota Department of Health in the Maternal and Child Health Section. Her diverse positions illustrate how a midwife can parlay her career into satisfying alternatives as her interests and tolerance for being “on call” changes throughout her lifetime. “I realized there was complete “silence. What was wrong?”

Cecilia was recently interviewed for the History Caucus’s project. During the in- Cecilia Wachdorf, CNM, PhD terview, she described her first “observed” birth in Papua New Guinea. After the deliv- what nature had given. They were stunned ery, she wiped the baby’s face, rubbed his to watch the newborn go from unrespon- spine gently with her fingers, and he cried. sive to a vital, nursing infant. ‘This baby “With the completion of the birth, my has seen the ancestors; he will be raised as focus shifted from the mother to the a shaman,’ the nurse told me. From then on observers,” she said. “It was then that I I taught my students to stimulate babies to realized there was complete silence. What cry even before their feet were born.” was wrong?” She continued: Read her Cecilia’s full story about Papua “None of the observers would talk to me. New Guinea and more on the ACNM Finally, I cornered one of the nurses who Midwifery History Caucus Facebook page had previously been friendly. What is go- or at www.frontier.libguides.com/ ing on? Had I failed their test? She looked digitaldepot.

By Karen B. McGee, CNM The ACNM Midwifery History Caucus is collecting interviews of midwives who are Don’t hide 65 or older. Members of the caucus are writing their stories in a format developed from new clients! to stir the memory of what is was like to practice during the 20th century. The written Make sure your practice information is or video interviews are located on a special up to date in our Find a Midwife tool, and project page on the website of the Frontier Nursing University Library. To schedule an ensure prospective clients can locate you. interview, contact [email protected] or Visit www.midwife.org/find-a-midwife. [email protected]. For information about this ACNM Caucus, visit www.midwifery.org/

©depositphotos.com/Wavebreakmedia caucuses. Quickening Fall 2016 31 COMMUNICATIONS Midwifery Works! 2016 Get Moving to Promote Midwifery Continued from page 1 or the past couple of months, ACNM NOVEMBER is American Diabetes management, and expand your leadership has been sharing new ideas about Month, a time to raise awareness of this knowledge to make sure you stay on top of ways to promote midwifery and widespread disease and its effects on what it takes to be successful. Midwifery Fwomen’s health to women and families. women. Topics include how to prevent Works! will deliver best practices in com- August was both National Breastfeeding type 2 diabetes and how to prepare preg- fortable, intimate settings, while ensuring Awareness Month and National nant women who have diabetes with a sufficient downtime for networking and Immunization Awareness Month, so we diabetes education program. meeting with friends and ACNM staff. You shared resources to empower women DECEMBER is AIDS Awareness Month. can register for the meeting and reserve to commit to breastfeeding and getting It kicks off with World AIDS Day on your hotel room at www.midiwife.org/ themselves and their families vaccinated. December 1, when we raise awareness of Midwifery-Works-2016. In September, we pushed out healthy liv- the AIDS pandemic and educate women Here’s an overview of what you can ing messages and activities, and because about the prevention and control of the expect at Midwifery Works! 2016: it was also Fetal Alcohol Syndrome disease. This month also encourages us to ■■ Two types of billing and coding work- Awareness Month, we provided resources reinforce the importance of vaccination. shops with Joani Slager, CNM, DNP, CPC, for pregnant women to guard themselves During National Influenza Vaccination FACNM, ACNM Treasurer and their babies against fetal alcohol Week, the first full week of December, ■■ New midwifery practices with Connie syndrome. Check out these resources the US Centers for Disease Control (CDC), Dewees, CNM, DrPH, FACNM at Discovery Midwifery Care at Our ACNM’s immunization partner, will ■■ Positive thoughts yielding powerful Moment of Truth™ at www.midwife.org/ provide information about the week’s im- results with Barbara Hughes, CNM, MS, OMOT-Toolkit. portance, which we will share across our MBA, FACNM, NE-BC channels. Ways to stay healthy over the ■■ Ultrasound prep program with Frank What’s Ahead this Fall holidays is another December topic that Miele of Pegasus Lectures OCTOBER is our favorite month because clients appreciate. So we’ll be develop- ■■ HIPPA, billing, and finance with it brings National Midwifery Week. If you ing resources to help them stay on track Nicole Wocelka, Certified Professional celebrated your profession during October by eating healthy throughout the season Compliance Officer, and Christine 2–8, we would love to hear about what you and finding ways to keep moving, even Romney, President, CEO Larsen did! Please send us an email at clynam@ indoors. We’ll also be providing resources ■■ Quality improvement with Lisa Kane acnm.org. If you that you can share with your clients about Low, CNM, PhD, FACNM, and ACNM are just getting managing winter pregnancies. President, and Leslie Cragin, CNM, PhD, around to honor- FACNM ing midwives and e-Newsletter and More ■■ Benchmarking with Karen Peridion, the terrific care Have you looked at our consumer-fo- CNM cused eNews- you collectively Midwifery & Women’s Health ■■ Contracts with Nancy Jo Reedy, CNM, provide, we have letter lately? If not, sign up for it today and MPH, FACNM encourage your clients to do the same at a 5-day plan ready ■■ Establishing birth centers with Maureen for you to implement at your leisure. www.ourmomentoftruth.com/OMOT- Darcy, CNM . You can also join our Please check it out at www.midwife.org/ eNews Our Moment ■■ State legislative support with Cara National-Midwifery-Week. of Truth™ members-only listserv at www. Kinzelman, PhD, Director of ACNM This year’s theme, Get Moving, empha- midwife.org/OMOT-Listserv. Advocacy and Government Affairs ACNM as an organization can’t tell—or sizes physical movement so our bodies ■■ Water birth with Jenna Shaw Bautista and minds stay healthy and active. It also sell—the midwifery success story by itself. CNM, PhD So we need every member to step up and focuses on “movement” at the local level ■■ Advertising and grassroots support with through community engagement—using do his or her part to attract the attention Sheri Mateo, CNM our tools, expertise, and relationships to of women and families. Please think of one promote midwifery where midwives live thing you can do today to promote You can view a full copy of the schedule and work. By joining together, we can midwifery and Get Moving! at www.midwife.org/MW16-Complete- Schedule, and learn more about our spon- shine a bright light on midwifery and the By Clare Lynam, Director of sors and exhibitors at myriad services we provide to women, Communications, ACNM www.midwife.org/ from puberty through menopause and [email protected] MW2016-Sponsors-And-Exhbitors. newborn care. Let’s raise awareness in our We hope to see you in November in communities and get more women and sunny Myrtle Beach! families talking about midwives!

32 American College of Nurse-Midwives JOURNAL OF MIDWIFERY & WOMEN’S HEALTH New ACNM Resources in the Journal of Midwifery & Women’s Health ew ACNM resources, partnership describes classifications of abnormal uter- women at low risk for gastric aspiration. documents, and updates from ine bleeding, reviews updated terminol- The September/October issue includes the 2016 Annual Meeting are ogy, and identifies methods of assessment an article, “National Partnership for Nfeatured prominently in the July/August and treatment using a woman-centered Maternal Safety: Consensus Bundle on and September/October issues of the approach. “Providing Oral Nutrition to Venous Thromboembolism,” which is be- Journal of Midwifery & Women’s Health Women in Labor” (originally published in ing published concurrently in Obstetrics (JMWH). Have you taken a look? The July/ 2008) reviews the evidence related to this & Gynecology, Anesthesia & Analgesia, and August issue includes 2 revised Clinical practice and provides recommendations to the Journal of Obstetric, Gynecologic, & Bulletins. “Abnormal Uterine Bleeding” promote informed, shared decision mak- Neonatal Nursing. This article outlines the (originally published in 2002) defines and ing regarding oral intake during labor with clinical implementation of a safety bundle devised to provide routine risk-based as- MEMBERSHIP sessment and appropriate prophylaxis that may reduce the risk of obstetric throm- How Affiliates Can Help boembolism. Another such partnership document appeared in 20151: “National Engage and Retain Members Partnership for Maternal Safety Consensus Bundle on Obstetric Hemorrhage.” Read ffiliate leaders often ask me for advice to help them engage and retain members. both now: ACNM members have free I love this question not only because it demonstrates how much they care about access to all JMWH content by accessing their members, but also because I love collaboration. Focusing on the needs of JMWH issues through the Professional AACNM members provides a great opportunity for us to work together. Resources section of the ACNM website. I like to start these conversations by asking what they currently do when a new member Also in the September/October issue of joins. My reason is simple: This is when their renewal cycle officially starts. While some JMWH, catch up on the research presented affiliate leaders know this, it’s a revelation to others. And that’s OK. Membership in ACNM and the midwives honored at the 2016 and their affiliate is a personal experience for each individual, and retention often can be ACNM Annual Meeting in Albuquerque. tied to how successfully we deliver that experience. At the end of the day, what we don’t Read the abstracts presented at the 2016 want to hear is “I joined last year, but the next time I heard from someone was when it was Research Forum podium presentation, time for me to renew.” which the ACNM Division of Research and So how best to fill the time between joining and renewing? Many affiliates have devel- Division of Global Health selected at oped their own tactics for addressing this question. Essentially, though, it involves taking http://bit.ly/2d8Fxa8. These abstracts their roster of new members, contacting and welcoming them to the affiliate, and inviting demonstrate the breadth and quality of them to their next function. Successful affiliates also assign at least one person at every research being conducted about midwifery function to greet new members, talk to them about the affiliate, discover their interests, and women’s health by midwifery and introduce them to the leaders and other members, especially those who have match- researchers and our colleagues. In ing interests. Extroverts love this job! addition, the issue includes the biogra- Members often want to give back and contribute to their organization. So next you will phies of the newest class of ACNM Fellows, want to guide all members, but especially your newer ones, to where they can find oppor- and this year’s winner of the Hattie tunities to volunteer and get involved. Then most importantly, when they do volunteer, be Hemschemeyer Award, as a testament to sure to find fun ways to recognize them for their work. the contributions these individuals have Additionally, look for avenues to help student and younger members grow, for instance, made to the profession of midwifery, the by involving them in committee and leadership roles. This can be a powerful way to men- health of women, and the impact of tor the next generation of ACNM leaders! ACNM. These are only the first steps to engaging and involving new members, but they are steps most affiliates can do now. This being said, if you are an ACNM member who wants By Brittany Swett, Managing Editor to become more active in your affiliate, I encourage you to reach out to your leadership. Journal of Midwifery & Women’s Health (For a listing of your officers, go to www.midwife.org/ACNM-Affiliate-Map.) [email protected] REFERENCES By Salvador Chairez, CAE, ACNM Director of Membership and Marketing 1. J Midwifery Womens Health. [email protected] 2015;60[4]:458-464

Quickening Fall 2016 33 THE A.C.N.M. FOUNDATION Breckinridge Level New Texas Midwifery Gifts to the A.C.N.M. Foundation March 1 to August 31, 2016 Donation “Mary” Pin: Creation Scholarship UNRESTRICTED GIFTS— Don’t Miss Out! INDIVIDUALS n just a few short months, the Texas Affiliate of Mary Breckinridge Club special premium gift was designed for this years’ ($1000 or more) ACNM—the Consortium for Texas Certified Nurse- donors of $1,000 or more at the Mary Breckinridge Anonymous, in memory of Midwives (CTCNM)—established and raised more A my late husband, “the wind Club level. Donors who would like to receive the 2016 beneath my wings” Ithan $20,000 for a new scholarship designed to increase “Mary” Pin may do so by making a donation or a monthly Royda Ballard, in honor the number of practicing CNMs/CMs in Texas. Eligible of the Midwifery Legacies pledge. Contact our business office or visit our online Project applicants will be a student member of ACNM, enrolled donation page (see below). Rebeca Barroso as a student in good standing at an ACME-accredited or Ginger Breedlove pre-accredited basic midwifery education program, with Mary Kaye Collins Leslie Cragin, in honor or a stated intention to practice midwifery in Texas after Did You Know? Afaf Meleis Susan DeJoy, in memory of CNM membership is required for nearly all Christine N. Nuger Foundation scholarships and awards. Yes, it’s Nivia Nieves Fisch A Judith Fullerton, in memory another member benefit! of my parents and siblings Carolyn Gegor November 1, 2016 Application Deadlines Laraine Guyette, in memory for the following: of Jennifer Hensley Lisa Hanson, in honor of the Doctoral Scholarship for Midwives of Color DOR Board of Governors This $5,000 scholarship is given to a midwife of Kathryn “Kate” Shisler Harrod color (CNM/CM) who is actively enrolled in doctoral Denise Henning or post-doctoral education. Funding comes from the Bridget Howard Barbara Hughes/Wilson Foundation’s Midwives of Color Scholarship Fund. Hughes Consulting LLC, in honor of Roberta Poirer Jeanne Raisler International Award for Midwifery Marsha Jackson This award honors the memory of Jeanne Raisler, CNM, Cecilia Jevitt DrPH, FACNM, and supports midwives interested in be- Peter & Tina Johnson, in memory of Maria M. coming involved in global midwifery. It enables awardees Mancusi to gain experience in international midwifery through Holly Powell Kennedy participation in a project designed to improve the health Julia Lange Kessler Tekoa King, in honor of the of women in a developing country. JMWH Editorial Board Susan Agard Krause, in Thacher Community Grants memory of Christine N. These $500 grants support small, yet high-impact Nuger This year a newly created scholarship will honor Sr. Angela Jan M. Kriebs community-based projects. Preference is given Murdaugh, CNM, FACNM, and the late Nivia Nieves Fisch, CNM, Cara Krulewitch to community projects that address leadership Dorothea Lang, in memory FACNM. Read ACNM’s tribute to Nivia Nieves Fisch on page 37. of John Sparacio development at the community level, care for women Mary Jane Lewitt graduation. Priority will be given to applicants with with physical or mental illness or disability, or care Frances E. Likis Texas roots by virtue of residence, family, education, or of underserved populations, especially those in low- Lisa Kane Low Vivian Lowenstein, in prior clinical work in Texas. Each $500 scholarship will resource settings. memory of Netty Lowenstein Ellen Martin be given in honor of individuals who have contributed to All applications are available at: www.midwife.org/ midwifery in Texas through clinical practice, education, Michael McCann Foundation-Scholarships-and-Awards. Karen McGee, in honor of or advocacy. The first scholarship will be given in honor Midwifery Legacies Project and memory of late Texas midwife Nivia Nieves Fisch, QUESTIONS ABOUT DONATIONS OR AWARDS? Denise McLaughlin Elaine Moore CNM, FACNM. The second will be given to another CONTACT THE FOUNDATION BUSINESS OFFICE: Tonia L. Moore-Davis renowned Texas midwife—Sr. Angela Murdaugh, CNM, The A.C.N.M. Foundation, Inc. Lonnie C. Morris FACNM. The amazing work of the philanthropic midwives Patricia Aikins Murphy Linda Nanni of CTCNM, led by Patricia Olenick, CNM, PhD, have PO Box 380272 | Cambridge, MA 02238-0272 Kathryn Osborne, in honor created a fantastic prototype for other affiliates who [email protected] of my mother, Carolyn 240-485-1850 phone | 617-876-5822 fax Karen Perdion might wish to establish a scholarship and award within To make a tax-deductible donation in support of the Pamela Reis the Foundation. Winners of the first award(s) will be Nancy Jo Reedy Foundation mission, go to: announced in the next issue of Quickening! www.midwife.org/ Sharon Shindler Rising Charitable-Contributions. Kerri Schuiling

34 American College of Nurse-Midwives Gifts to the A.C.N.M. Foundation March 1 to August 31, 2016

Mavis Schorn Mark DeFrancesco Lily Fountain Essence Williams Susan E. Hetherington Christine Stuart, in honor of VARNEY PARTICIPANT Mary E. Sheridan Jennifer M. Demma Cassandra Garcia Kendra Wyatt Janice Keller Kvale Sr. Angela AWARD FUND Joan Slager, in honor of Kathleen Dermady Carolyn Gegor Margaret Zuccarini Lois M. Lehman Patricia Olenick, in honor of Francie Likis, in honor of Ali Nivia Nieves Fisch Teresa Marsico, CNM Elaine K. Diegmann Anne Gibeau Lisa Kane Low Cocco, CNM, MSN, MDiv’s RESTRICTED GIFTS— Kellie Thiessen graduation & certification Suzanne M. Smith Cathy & Bill Emeis Katherine Green, in Jeanne Meurer INDIVIDUALS as a CNM Letitia Sullivan Jenifer Fahey, in honor of memory of Christine Nuger, Madge Mulkey, CNM Midwives of Color— CNM & Susan Liddell, CNM Susan Stone Jan Kriebs Dianne S. Moore Sister Angela Murdaugh, Watson Scholarship Bonnie Westenberg Tanya Tanner Kate Fouquier Karin Gustafson Midwifery Research in honor of Nivia Fisch Fund Pedersen International Scholarship Fund Midwife Award Fund Frances T. Thacher Carolyn Gegor, in kind Laraine H. Guyette Betty Schlatter Michella Habeck $500-$999 Deborah A. Armbruster Thomas D. “Toby” Thacher Ann Geisler $25,000 Margaret A. Taylor, CNM, Patricia Loftman, in kind Melissa Hasler, in honor of APRN Joyce E. Thompson, in Alvin Goldansky, MD, in Ryan Gonzalez, in memory FOUNDATIONS AND Rebeca Barroso memory of Glen & Ida Beebe memory of my cousin Shirley of Dianne S. Moore, CNM, Eileen Thrower $100-$499 CORPORATIONS Maria Valentin Welch, Okrent, CNM Lisa Hobbs MPH, PhD Ginger K. Breedlove $1-99 (RESTRICTED AND in memory of my pet & Laraine H. Guyette Sharon Holley Sean Gonzalez, in memory Andrea Christianson UNRESTRICTED): Barbara J. Reale companion, Raven, with Lisa Hanson Melissa R. House of Dianne S. Moore, CNM, Mary Kaye Collins thanks for years of love, Patricia Urbanus, in Dorothea Lang Kathy Higgins Jane Houston MPH, PhD Candace Curlee laughter & joy memory of Elizabeth S. Pioneer Award Lynne Himmelreich BreAnne Huss Eleanor Fisher Deborah Walker, in memory Teresa Marsico Memorial Sharp The Sparacio Foundation, of Anna & Wilbur Walker Jerrilyn (Jerri) Hobdy Karen Jefferson Fund (in response to the Laraine H. Guyette Inc. Carol L. Howe, in memory of Ira Kantrowitz-Gordon “Kitty Appeal”) CTCNM Texas Midwifery Amy Levi Clare Westdahl, in memory Creation Scholarship Elizabeth S. Sharp Shannon Keller General Fund of Robert L Westdahl, my $1000-4999 Lisa Kane Low husband for 40 years Annemarie Krim, in honor Mary J. Kempf, in honor of John Wiley & Sons, Inc Melissa Avery, in memory of $5,000-10,000 Michael M. McCann of Connor Sweeny Rebeca Barroso Angela Wilson-Liverman Robert Frederick Avery Consortium of Texas Yolanda Meza, in honor of Grants for Projects Cara Krulewitch Hillary Kieser, CNM CNMs, in honor of Nivia Nivia Fisch $500-999 Rebeca Barroso Carried Out by ACNM Kathryn Landau, in memory Mary Kilianski Nieves Fisch & Sister Angela Michelle Pino Anonymous of Christine N. Nuger Patricia Boone Transforming Birth Fund, Lori Knoth Murdaugh Helen Burst, in memory of Pamela Reis a donor-advised fund of the Rebeca Barroso, in memory Dorothea M. Lang, in Patricia Olenick, in honor of Gwen Latendresse Teresa Marsico Maria Valentin-Welch New Hampshire Charitable of Elizabeth S. Sharp memory of Shirley Okrent Nivia Nieves Fisch Rita Ledbetter Maria Valentin-Welch, in Foundation to support Joyce King Julia Lange Kessler Katherine Camacho Carr the “Re-Envisioning US Theresa Lirette $1,000-4,999 kind, in honor of new MOCC Lisa S. Lederer Lisa S. Lederer Carmela Cavero Maternity Care” Meeting Emily Levingston Luna Chairperson, Pat Loftman Betty Jane Chiota, Teri Teresa W. Marchese Candace Curlee Dorothea Lang, in honor of in Albuquerque, NM, May Kitty F. MacFarlane, in Nivia Fisch and Sr. Angela 22, 2016 Delafleur, and Bonnie Ellen Martin, in memory of Kitty Ernst $1-$99 memory of Elizabeth S. Burchell Elizabeth S. Sharp Jennifer Foster, in memory Franciscan Sisters of Mary, Lauren Abrams Sharp FEDERATED Donna Chuzi, Vicki Ruth, of Alexander Whitman in honor of Sister Angela Michael McManus Donica Anderson CAMPAIGNS Susan Hoffman,in memory Esther Mast Murdaugh Gretchen G. Mettler Joyce Foster, in memory of Cara Busenhart (UNRESTRICTED) of Hugh Logsdon, husband Mary Milkey, CNM Ernestine Weidenbach Nora McDermott Lewis, in Elaine M. Moore, in memory Melissa Cardeña United Way of Frederick of Virginia Crandall, CNM Ida K. Miller, in memory of honor of Nivia Fisch of Elizabeth S. Sharp Mary Gillmor-Kahn County, Maryland Holly Powell Kennedy Elizabeth S. Sharp Katherine Camacho Carr, Tonia L. Moore-Davis Dorothea Lang, in honor $500-$999 in kind Sharan Love, Claudia Ravin, Mary Kay Miller of Teresa Marsico – Past Lonnie Morris Dr. Shevaun Beck, in honor Kathryn Kravetz Carr, in *Additional unrestricted and Chee Lee Mao Leong Brigit Mulloy President of ACNM who Sister Angela Murdaugh, in of Nivia Nieves Fisch & Sr. honor of Midwives of Color donations made at the Linda Hewes, Vivian Ford, Elizabeth C. Nelson included in her vision a honor of Nivia Nieves Fisch Angela Murdaugh Kathryn Kravetz Carr, in Foundation’s Annual and Terri O’Neal Berthier Kathleen Pool “name change” for ACNM Meeting Fundraiser in May Claire Nelson Rebecca H. Burpo, CNM, in honor or Students of Color Kathleen Hogan, Mary Lori Powers Ruth Lubic, in honor of Kitty honor of Nivia Nieves Fisch 2016 will appear in the Ellen Bouchard, and Bryn Susan Papera, CNM Ernst, Past President Jillian Cauley next issue of Quickening. Noura Quayson Barbara Larsen, Founding Burke Nancy Jo Reedy Anne Richter Candace Curlee Ebony Roebuck Donor Judy Rohner Newman and Heather Reynolds Joyce Roberts Mari-Carmen Farmer Connie G. Murray Elizabeth Roeske Nancy Selix Laverne Puetz, in memory $100-499 Nandi’ Andrea Hill Shari Long Romero Lesley Rathbun Carol Snapp, in honor of of Elizabeth S. Sharp Erin Biscone Mary Rose Korduner Patrice White Bob Harris Mairi Breen Rothman Jo Ellen Reynolds, in Elaine Brightwater in honor Amy Levi Letitia Sullivan Sarah Ryan memory of Josephine of Nivia Nieves Fisch & Sr. Sharon McDowall $100-499 Angela Murdaugh Heather Swanson Irene Sandvold, in memory D’Aratro Ingraffia & Mary Lisa Kane Low Melissa D. Avery of Elizabeth S. Sharp Carmel Hager Beach Kristy A. Culp-Leonard, in Tanya Tanner Shay Recalde Manuela Barcelos, in honor Paulette Schalck Barbara Sellars, in memory honor of Nivia Fisch of Judith Mercer, CNM, PhD Margaret A. Taylor Michelle Grandy Jacqueline J. Scott of my mother, Betty Sellars Amy D. Gillespie, in honor Mary Barger Sarah Toler of Nivia Nieves Fisch Deborah Kaiser Melissa Scott Jean Tease Charles Bear, Charles Bear Mary V. Widhalm Mary K. Loftin Teresa W. Marchese Stacey Shearin Joyce Thompson, in Photography, in kind memory of Glen & Ida Sister Angela Murdaugh, in Monica McLemore $1-99 Lori Sherman Elizabeth M. Bear, in Beebe honor of Nivia Nieves Fisch Patricia Olenick Thorhildur Agustsdottir Susan Skinner memory of Elizabeth S. Heather Swanson Felina Ortiz, In kind Susan Altman Dr. Brenda Leigh Yolles $500-999 Sharp Madeline Pacheco Elizabeth Amaya Smith, in memory of Mary Kaye Collins, in $1-$99 Sharon M. Bond, in honor Michelle Pino of my dear friend, Leigh Kelly Aten Elizabeth S. Sharp memory of Elizabeth S. Elizabeth (Berry) Fairman Sharp Kizzie Ricks Wood, CNM Cecelia Bacom Mandesa Smith Hoffman Barbara L. McFarlin Brittany Simplicio Mary Ellen Bouchard, in Linda Bergstrom, in honor Virginia Sullivan Susan Stone, memory of Lawrence Hewes Connie Swentek Stephanie Tillman of Sean Johnson, beloved $100-499 Lauren Knorr, in honor of & Ed Leong son of Peter & Tina Johnson Eileen Thrower Nivia Nieves Fisch Maria Valentin-Welch Anonymous Heather Bradford Jesse Bushman Lori Trego Sister Kay Kramer, in honor Monica Viera Anonymous Katherine Camacho Carr Betty Chern Hughes, in Maria Valentin-Welch of Sr. Angela & Nivia Fisch Midwifery Legacies Project Dawn Durain Fund Elizabeth Cooper, in memory of Julie Hallerdin, Clarice Wardlaw Anna L. White, in honor of memory of Elizabeth S. CNM Dorothy M. Gallagher- Nivia Fisch Maria Fischer, in honor of Susan Way Sharp Mary Kaye Collins Garcia Tori Agustdoltin, in honor Maureen Rayson, CNM Metta Weaver Julia Cross, in honor of Shannon DaSilva Elaine Germano of Nivia Nieves Fisch Karen McGee Mary Rossi Katy M. Wehrmann Tracy Donegan Caryn Schloss Hanrahan Amy Moore

Quickening Fall 2016 35 CONGRATULATIONS NEW MIDWIVES

Congratulations to the following midwives Dear Members, for passing the AMCB Midwifery Certification ’d like to introduce myself as the new Ieditor of Quickening. I’m delighted to Exam, February—July 2016 be part of Quickening’s Marian Elliot Acquistapace, CNM Rachel Heisman, CNM Cindy Pohner, CNM rich tradition of provid- Jane Elizabeth Adkins, CNM Meghan Hayes Henry, CNM Amanda Poorman, CNM ing news, research, and Janelle Brubaker Alier, CNM Adriana Maria Hernandez, CNM Abigail Elizabeth Pope, CNM information to midwives Corinne Almquist, CNM Serina Hernandez, CNM Karen Grace Pope, CNM Jillian Artis, CNM Bree Herndon, CNM Michelle Radloff, CNM throughout the country. Jessica Jane Bartlett, CNM Amy Hill, CNM Nuranisa Fatima Rae, CNM My goal is to continue to Angela Beals, CNM Chasity Hill, CNM Julie Rael, CNM bring you high quality Brittany Bove, CNM Michelle Therese Hoffman, CNM Brooke Raidmae, CNM Maura Christopher Allison Renee Bower, CNM Deirdre Horvath, CNM Christa Ramsey, CNM content, and I welcome Julie Ann Brasel, CNM Laurie Horvath, CNM Jessica Reichert, CNM your ideas for articles. Megan Brister, CNM Mary Humbert, CNM Hannah Marie Reinker, CNM Please send them to Lindsay Bustle, CNM Chelsea Lynn Iversen, CNM Rachel Ritter, CM Ayisha Byrd, CNM Emily Jackson, CNM Sherlene Vonnette Roberts, CNM me at mchristopher@ Nicole Jane Camp, CNM Jillian Leigh Jernigan, CNM Eileen Robinson, CNM acnm.org. Thank you! Celeste Ann Chavez, CNM Tyler Johnson, CNM Laurie Anne Rodenberg, CNM ACNM communica- Erin J. Cole, CNM Katherine Edna Johnson, CNM Catherine Ann Ruell, CNM Kristina, Colwell, CNM Natasha Jones, CNM Alexis Rylee, CNM tions is also delighted to Joy, Cosenza, CNM Kathryn Jones-Stadler, CNM Allison Elaine Saran, CNM welcome Ashley West, Kim Margaret Craig, CNM Megan Michelle Keeney, CNM Christine Schlaerth, CNM our new communications Ashley West Brandi, Craig, CNM Lindsay Kennedy, CNM Jody Leigh Schmit, CNM Megan Adelle Crane, CNM Heather Kent, CNM Leah Marie Schroeder, CNM and marketing specialist. Ashley brings a Susan Marie Czelusta, CNM Megan Heather Sue Kimberly, CNM Sarah Ann Schubert, CNM master’s degree in marketing and experi- Catherine Daily, CNM Kassie ShaLane King, CNM Brittany Kaye Schultz, CNM ence in marketing, IT, and editorial. She is Amy Daily, CNM Kimberly Kirby, CNM Katie Elizabeth Schulz, CNM Sandra Darko-Williams, CNM Benjamin E. Kitchin, CNM Sarah Cummings Sears, CNM an indispensable member of the team. Justine Elise Della Fave, CNM Sarah Koenigseker, CNM Nicole Mari Sekulich, CNM Sincerely, Tara Jane Dethmers, CNM Briana Elise Kramer, CNM Julie Anne Shiprack, CNM Maura Christopher Elizabeth Detroyer, CM Natalie M. Kukucka, CNM Stephanie Nicole Shivers, CNM Angie Renae Detwiler, CNM Laura Jill Langberg, CNM Meredith Causey Sigmon, CNM Kristen Dib, CNM Belinda K. Lashea, CNM Kiki Smith, CNM Angela Dickson-McDowell, CNM Sara Michelle Lebovic, CNM Rebecca Mary Smith, CNM Amy Ellis Dixon, CNM Tashein Lecky, CNM Amanda Eileen Smits, CNM Zika Corner Olivia Dixon, CNM Alanda Lemings, CNM Adeyinka Sokunbi, CNM Lydia Marie Dominic, CNM Rachel Mackenzie Lemos, CNM Darrah Jean-Steingraber Solitario, CNM For up-to-date information, Sara Kathryn Dowd, CNM Maria Lengele, CNM Karen Sonnenburg, CNM Ashley Nicole Draper, CNM Laura M. Letts, CNM MacKinsey Davis Stanley, CNM subscribe to CDC updates at Danielle Elswick, CNM Catherine Lukes, CNM Tahiti Starship, CM Aubrey Adamthwaite Engert, CNM Dawn Marie Maberry, CNM Daniel Terry Stec, CNM www.cdc.gov/zika. Robin Lee Etter, CNM Lauren Wilson Mace, CNM Courtney Ellen Stroud, CNM Erin Nicole Everett, CNM Rachel Malota, CNM Kathleen Sugrue, CNM The Primary Care Emergency Amanda Leigh-Reynders Ezekiel, CNM Erin Christine Marten, CNM Lori L. Swain, CNM Shaina Federman, CNM Grace Julia Olds McBride, CNM Samantha Cohen Tamulis, CNM Preparedness Network Sabrina Fernandez, CNM Leah Ursula McCoy, CNM Hannah Marie Thomas-Gentz, CNM Kortney Elizabeth Fisher, CNM Adrian Michael Medina, CNM Ciara Thomson-Barnett, CNM has collected the CDC’s Merry Fontenot, CNM Maggie Louise Miller, CNM Kimberly Jo Tibai, CNM resources for clinicians at Heather Joleen Foresman, CNM Grace Ogle Mishkin, CNM Sabrina Jo Tucker, CNM Lauren Orengo Fountain, CNM Shannon Mojica, CNM Connie Van Baah, CNM http://bit.ly/2d7tZpLt. Shara J Frederick, CM Tiffany Tomoko Nakajima, CNM Heather Ewing Veitch, CNM Julia Fries, CNM Lauren Taylor Narbey, CNM Rosina Victor, CNM Erica Garrett, CNM Carly Nathan, CNM Casey Vizenor, CNM See ACNM resources on Constance Ger, CNM Danielle Nichole Nazarenko, CNM Rebecca Jo Wagschal, CNM Mollie Rose Gilbert Brody, CNM Trisha Lynn Nelson, CNM Caitlin Elizabeth Warren, CNM Zika at www.midwife.org/ Laura Michele Giles, CNM Lisa Renee Neumann, CNM Cassandra Emily Welch, CNM Resources-for-Zika-virus. Kristen Elizabeth Green, CNM Amanda Lynn O’Briant, CNM Linda Wenger, CNM Elizabeth Finan Guiney, CM Jenny Olson, CNM Anna Louise White, CNM Kristen Noelle Hall, CNM Signey Mollinger Olson, CNM Kaitlyn Jessica White Bathold, CNM Clare Marie Hall, CNM Shauna O’Neal, CNM Alneader Kenner Woodard, CNM Taya Hamilton, CNM Renee Elizabeth O’Neill, CNM Jocelyn Susan Yale, CNM Stacey Marie Hamlett, CNM Madeline Pacheco, CNM Kirsten Zimbelman, CNM Beth Harpenau, CNM Madeleine Pascale, CNM Amanda Zimmerman, CNM Cheryl Kailyn Harrington, CNM Simone Andrea Payan, CNM Emily Hazan, CNM Heidi Michelle Pham, CNM ©Depositphotos.com/beholdereye

36 American College of Nurse-Midwives KEEPING IN TOUCH Birth Announcements Shannon Keller, former student rep to the Remembering Nivia Nieves Fisch ACNM Board of Directors, is thrilled to an- fter a hard-fought battle with cancer, Nivia nounce the arrival of Jude Thomas Keller, ANieves Fisch, CNM, FACNM, 68, passed peaceful- September 19, 2016 at 9:18 . 7lbs 5oz. of ly in Harlingen, Texas on September 15. Nivia, born absolute perfection. “Lucky to have my col- in Puerto Rico and raised in the Bronx, New York, pm leagues right by my side and @akeller14 grew up in a loving home. She was a bright student for my labor coach!” Shannon said. More and after attending a vocational high school and photos to come from @morganvuznytsya. Bronx Community College, she became a nurse. She married, and in 1973, moved with her hus- Honors and Awards band, Stan, to Harlingen, Texas, on assignment with American Academy of Nursing has named the US Public Health Service. Both found them- Colleen Conway-Welch, PhD, CNM, RN, FAAN, selves deeply committed to the Rio Grande Valley FACNM as a “Living Legend” honoree, its community and to providing health care to the highest honor. She will receive recognition area. In 1976, after continuing her training, Nivia at a special ceremony in Washington, DC began her service as a nurse-midwife. Alongside on October 20. her mentor, role model, and dear friend, Sister Angela Murdaugh, she established a birth center within Su Clinica Familiar in Harlingen and saw it grow into a major pro- Congratulations to Mary Ellen Doherty, vider of maternity care. PhD, CNM and her twin sister Elizabeth In 1994, Nivia became the first nurse-midwife in the Valley to be credentialed to Scannell-Desch, PhD, RN on the release work in a hospital. At Valley Baptist Medical Center, and later at Harlingen Medical of their second book, Nurses after War: Center, Nivia extended her model of collaborative midwifery practice in a hospital set- The Reintegration Experience of Nurses ting. Over the years, she was deeply honored to take part in the delivery of more than Returning from Iraq and Afghanistan. This 7,000 babies. book was born from a research study that Nivia served on the faculty of the University of Texas Health Science Center at San captured the experiences of 35 nurses Antonio as part of their Regional Academic Health Center campus, introducing medi- from the Army, Navy, and Air Force. The cal students to gentle, non-interventive childbirth. She was also an active member authors presented this research at the of ACNM and a founder of the Midwives of Color Committee. “The struggle waged to 2016 ACNM Meeting & Exhibition in transform MOCC from an ad hoc committee to a standing committee in ACNM was Albuquerque, New Mexico. successful largely due to a group of women of color that included Nivia,” Patricia O. Loftman, CNM, LM, MS, FACNM noted recently. “She will be remembered as a steadfast Mimi Niles, LM, CNM, MPH, from New champion for providing care to low-income women and women, children, and families York has been awarded the 2016–2017 of color.” Johnson & Johnson-American Association ACNM honored Nivia in 2015 by naming her a Fellow of the College and giving her of Colleges of Nursing-Minority Nurse the National Distinguished Service Award. She was a true light to her family, friends Faculty Scholarship. The award supports and ACNM. “Nivia impacted the spirit of all who had the pleasure of knowing her,” graduate nursing students from minority Shirley White-Walker, CNM, Ed.M, FACNM, said. “Her warmth, infectious laugh, and car- backgrounds to become leaders in nursing ing attitude always shown through.” education. Niles is a third-year full-time Gifts in Nivia’s memory can be directed to: www.midwife.org/Charitable- PhD student and adjunct clinical faculty Contributions. You may donate online or you can download forms that can be faxed or in the nursing and midwifery programs at mailed in with the donation form. Two foundation-endowed funds might be of interest New York University Rory Meyers College to donors who wish to make a donation in Nivia’s memory. The Midwives of Color of Nursing. Scholarship Fund, which supports the Carrington-Hsia-Nieves Doctoral Scholarship for Michele Pino, CNM, has received the 2016 Midwives of Color. This scholarship is awarded to a CNM/CM of color who is actively Indian Health Service Albuquerque-Area enrolled in doctoral or post-doctoral education. This award is named in honor of Nivia Provider of the Year Award from the and two of ACNM’s most distinguished midwives of color: Betty Watts Carrington, CNM, Indian Health Service. PhD, FACNM and Lily Hsia, CNM, PNP, MSN, FACNM. The other fund is the CTCNM Texas Creation Scholarship Fund. The first award from this fund will be given in November Mayri Sagady Leslie, EdD, MSN, CNM, 2016 in Nivia’s honor. received the Nursing for Women’s Health’s 2016 Excellence in Writing Award for her article entitled, “Perspectives on CORRECTION: A listing of ACNM awards on page 18 of the Summer 2016 issue of Implementing Delayed Cord Clamping.” Quickening misidentified Jan M. Kriebs, CNM, MSN, FACNM, who received a 2016 Distinguished Service Award. Quickening regrets the error. Quickening Fall 2016 37 CLASSIFIEDS LEARN SPANISH FOR CHILDBIRTH AND WOMEN’S HEALTH. Wondrous Woman is an elegant gift-boxed Spanish/English phrase book and audio program written by the nationally-acclaimed speaker and author Susan Nadathur. Susan is available for conference presentations and language training workshops. The gift-boxed program may be purchased online at www.susannadathur.com or by calling 888-251-4562.

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ACNM BOARD OF DIRECTORS & STAFF BOARD OF DIRECTORS Journal of Midwifery & Communications & Marketing Specialist President Women’s Health Ashley West Lisa Kane-Low, CNM, PhD, FACNM, Editor-in-chief FAAN Francie Likis, CNM, NP, DrPH, FACNM Department of Professional Practice Vice President Deputy Editors & Health Policy Cathy Collins-Fulea, CNM, MSN, Tekoa King, CNM, MPH, FACNM Director FACNM Patty Aikins Murphy, CNM, DrPH, Tina Johnson, CNM, MS, FACNM Secretary FACNM Senior Practice Advisor Stephanie Tillman, CNM, MS Managing Editor Eileen Ehudin Beard, CNM, Treasurer Brittany Swett FNP, MS, FACNM Joan Slager, CNM, DNP, CPC, FACNM Senior Education Policy Advisor Region I Representative Department of Elaine Germano, CNM, DrPH, FACNM Kathryn Kravetz Carr, CNM, MSN, Finance & Administration FACNM Director Department of Advocacy & Government Affairs Region II Representative Alison Brooks Máiri Breen Rothman, CNM, MSN, Senior Accountant Director FACNM Chandru Krishna Cara Kinzelman, PhD Region III Representative Accountant Federal Lobbyist Jenny Foster, CNM, MPH, PhD, Sujata Chavan Patrick Cooney FACNM Accreditation Commission Region IV Representative Department of Global Outreach for Midwifery Education Katie Moriarty, CNM, PhD, RN, CAFC, Vice President FACNM Suzanne Stalls, CNM, MA, FACNM Executive Director Heather Maurer Region V Representative Senior Technical Advisor Lynne Himmelreich, CNM, MPH, Kate McHugh, CNM, MSN, FACNM Administrative Assistant Julie Levin FACNM Senior Technical Advisor Region VI Representative Patrice White, CNM, DrPH The A.C.N.M. Foundation, Inc. Jane Dyer, CNM, PhD, MBA, FACNM Program Manager President Region VII Representative Kiev Martin Barbara Anderson, CNM, DrPH, Elaine Moore, CNM, FACNM FACNM, FAAN Department of Membership Executive Director Lisa L. Paine, CNM, DrPH, FACNM Student Representative Director Andrew Youmans, SNM Salvador Chairez, CAE Membership & Marketing Manager NATIONAL OFFICE STAFF Andre Owens Executive Office Membership Marketing Coordinator Acting CEO Anisa Yusuf Wendy Scott, CAE Executive Assistant Department of Communications Tamika Caldwell Director Information Technology Manager Clare Lynam Fausto Miranda Senior Editor & Writer Member Services Associate Maura Christopher Megan Bassett Graphic Designer Rebecca Feldbush

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Join us in Chicago in 2017! ACNM 62nd Annual Meeting & Exhibition CHICAGO, ILLINOIS | HILTON CHICAGO | MAY 21–25, 2017