CALM works closely with midwives, consumers, policy makers and the state legislature to ensure access to the safe, patient-centered care with licensed midwives.
Our current legislative and policy agenda includes:
End the Medical Board’s regulatory oversight of licensed midwives, which creates an inherent conflict of interest that has led to a regulatory stalemate, putting VBAC clients at risk and preventing LMs from providing Comprehensive Perinatal Services to clients who qualify.
Transfer regulatory oversight for licensed midwives to an independent, LM-majority Midwifery Board with the authority to develop an evidence-based practice guidelines that meet the needs of midwives and especially the safety of midwife clients.
Remove the regulatory barriers that prevent licensed midwives from providing Alternative Birth Center specialty clinic services to clients seeking birth center care.
Recent legislative victories:
- Passed legislation to protect peer review and establish the ability to form professional corporations
- Organized district visits to build the relationships with legislators midwives need to ensure the best possible legislation
- Tracked California state legislation to monitor for bills and amendments that restrict practice
- Developed a proactive legislative strategy designed to increase access to licensed midwife care
- Continued fighting against VBAC restrictions
- Hands-on support and policy-level advocacy for midwives navigating Medi-Cal enrollment and Medi-Cal reimbursement process
- Worked alongside certified nurse midwives to avoid practice restrictions that could impact licensed midwives
Recent research on planned homebirth and birth center births with midwife-led care
Poor coordination of care across providers and birth settings has been associated with adverse maternal-newborn outcomes.
Research suggests that integration of midwives into regional health systems is a key determinant of optimal maternal-newborn, outcomes, yet, to date, the characteristics of an integrated system have not been described, nor linked to health disparities.
Citation: Vedam S, Stoll K, MacDorman M, Declercq E, Cramer R, Cheyney M, et al. (2018) Mapping integration of midwives across the United States: Impact on access, equity, and outcomes. PLoS ONE 13(2): e0192523. https://doi.org/10.1371/journal.pone.0192523
For this large cohort of women who planned midwife-led home births in the United States, outcomes are congruent with the best
available data from population-based, observational studies that evaluated outcomes by intended place of birth and perinatal risk factors. Low-risk
women in this cohort experienced high rates of physiologic birth and low rates of intervention without an increase in adverse outcomes.
J Midwifery Womens Health 2014;59:17–27 c 2014 by the American College of Nurse-Midwives.
Rates of adverse outcomes for this cohort in a U.S. state with well-established and integrated community midwifery were low overall. Birth outcomes were similar for births planned at home or at a state-licensed, freestanding birth center.
(Obstet Gynecol 2021;138:693–702) DOI: 10.1097/AOG.0000000000004578
CALM Legislative Advocacy Team
Pearl Yu, LM, CPM - Policy Co-Chair
Rosanna Davis, LM - Policy Chair
Kiki Jordan, LM, CPM
Michelle Welborn, LM, CPM
Tania McCracken, LM, CPM
Madeleine Wisner, LM, CPM