History of Midwifery in the United States

Helen Varney Burst, MSN, CNM, DHL (Hon.), FACNM, is Professor Emeritus at the Yale University School of Nursing.Joyce Beebe Thompson, DrPH, CNM, FAAN, FACNM, is Professor Emeritus at the University of Pennsylvania and Western Michigan University, and an international consultant in midwifery education, women’s health, and human rights.

• ContentsPrefaceAcknowledgmentsAbbreviationsIntroductionDefinitions, Titles, and CredentialsNurse-MidwivesLay, Empirical, Community, and Direct-Entry MidwivesMidwifery and Midwives Through the CenturiesMidwifery Models of CareThe ACNM Midwifery Model of CareMANA: “The Midwives’ Model of Care™”Summary of Midwifery Models of CareSECTION I: EARLY HISTORY OF MIDWIFERY IN THE UNITED STATES (1600s–1940s)1. The Early Voices of MidwivesThe Voices of Predecessor Midwives in AntiquityThe Voices of Midwives in the Colonies (1607–1775) and Early History of the United States (1776−Mid-1800s)The Voices of Traditional African American Antebellum Slave Midwives (1619–1861)The Voices of Granny Midwives (Late 1800s−Mid-1900s)The Voices of Immigrant Midwives and Other Midwives in the Late 1800s and Early 1900s2. Silencing the Early Voices of Midwives: 1600s to 1800sAdvances in Knowledge and Exclusion of Midwives and Women From LearningMidwifery in EuropeStudy Abroad for Physicians and Their Takeover of Midwifery in the United StatesDevelopment of Medical Schools and the Flexner ReportWomen in MedicineProfessionalization of Medicine and the Specialty of ObstetricsPain Relief During Childbirth: Ether and Chloroform3. Silencing the Early Voices of Midwives (Late 1800s–Early 1900s)The “Midwife Problem”Legislation/Rules/Regulations and the Practice of MidwiferyNursing and MidwiferyThe Bellevue School for Midwives“Twilight Sleep”Professionalization of Nursing, Nursing Education, and Public Health NursingProfessionalization of Midwifery Needed to Survive4. Silencing the Early Voices of Midwives (Late 1910s–Mid-1940s)Closure of the Bellevue School for MidwivesRestrictive LegislationThe Continuing Move Into HospitalsSilencing the Immigrant Japanese Sanba MidwivesSECTION II: HISTORY OF EARLY NURSE-MIDWIFERY PRACTICE AND EDUCATION IN THE UNITED STATES (1920s–EARLY 1950s)5. Nursing RootsFlorence NightingalePublic Health NursingPublic Health Policies, Programs, and Public Health NursingChildren’s BureauPrenatal CareMaternity Center AssociationPublic Health Nurses as MidwivesSheppard–Towner Act6. The Nurse-Midwife Starts Practicing (1920s–Early 1950s)Frontier Nursing ServiceLobenstine Midwifery ClinicPractice of Early Nurse-Midwifery Education Program Graduates (1925–1954)Family-Centered Maternity Care and Natural Childbirth7. Early Education for Nurse-Midwives (1920s–1954)Manhattan Midwifery SchoolLobenstine/Maternity Center Association Midwifery SchoolFrontier Nursing School of MidwiferyTuskegee School of Nurse-MidwiferyDillard University Flint-Goodridge School of Nurse-MidwiferyCatholic Maternity Institute School of Nurse-Midwifery and Catholic University of AmericaSECTION III: HISTORY OF THE RESURGENCE OF COMMUNITY MIDWIVES AND EARLY EDUCATION PATHWAYS IN THE UNITED STATES (1960s–1980s)8. Resurgence of Community MidwivesConsumer Demand for Out-of-Hospital BirthResponses to Consumer DemandsMidwife Responses to Consumer DemandsLegal Responses to Consumer DemandsOrganizational Responses to Consumer DemandsVariety of Lay Midwife Practitioners in the 1960s and 1970sCommunication and Networking9. Early Education Pathways for Community and Lay Midwives (1970s and 1980s)Apprentice Education: 1800s to 1970sDefinitionsEarly History of Apprentice Education in MedicineEarly History of Apprentice Education in NursingApprentice Education in Midwifery During the 1970s and Early 1980sKey Issues Related to Apprentice Education in MidwiferyAcademic Models of Lay/Community Midwife EducationThe Maternity Center at El Paso Training Program (1976)Arizona School of Midwifery (1977)–TucsonSeattle Midwifery School (1978)Utah College of Midwifery/Midwives College of Utah (1980)—Salt Lake CityNorthern Arizona College of Midwifery (1981)Maternidad La Luz (1987)—El PasoThe Northern Arizona School of Midwifery (1988)—FlagstaffThe New Mexico College of Midwifery (1989)/National College of Midwifery (1991)—TaosSECTION IV: DEVELOPMENT OF MIDWIFERY ORGANIZATIONS—LIFE-GIVING FORCES FOR MIDWIVESIntroduction and Overview of Professionalism and ProfessionalizationDefinition and Characteristics of a ProfessionKey Characteristics of a ProfessionalProfessionalism and Professionalization10. The American College of Nurse-MidwivesPredecessor OrganizationsFounding of the American College of Nurse-MidwiferyOrganizational DevelopmentIncorporationThe Seal of the American College of Nurse-Midwifery/Nurse-MidwivesMissionBylaws and StructurePresidentsHeadquarters/National OfficeCommunicationA.C.N.M. FoundationAwardsCore DocumentsDefinitionsPhilosophyFunctions, Standards, and QualificationsCore CompetenciesACNM Code of EthicsPeer ReviewHome Birth, Practice Settings, and Review of Clinical Practice Statement Documents11. Midwives Alliance of North AmericaPredecessor OrganizationsFirst International Conference of Practicing Midwives (January 14–16, 1977)National Midwives Association (June 1977)Second International Conference of Practicing Midwives (March 17−19, 1978)Meeting of CNMs and Non-Nurse Midwives (October 30, 1981)Founding of Midwives Alliance of North AmericaOrganizational DevelopmentMANA GoalsFirst Convention and the MANA ProcessMissionPhilosophyBylawsPresidentsCommittee StructureStatistics and Research CommitteeCommunication/Public Relations (Education) CommitteeCommunication/MANA NewsCentral OfficeEssential (Core) DocumentsStandards and Qualifications for the Art and Practice of MidwiferyCore Competencies for Basic Midwifery PracticeMANA Statement of Values and EthicsMANA Position StatementsDescriptive StatisticsCoda12. National Association of Certified Professional MidwivesEarly History and FoundingOrganizational DevelopmentPurpose and AimBoard of DirectorsStandards CommitteePractice CommitteeCore DocumentsMissionPhilosophy and Principles of PracticeScope of PracticeThe Standards of Practice for NACPM MembersIssue Brief: Certified Professional Midwives in the United StatesNACPM WebsiteCodaSECTION V: HISTORY OF NURSE-MIDWIFERY PRACTICE AND EDUCATION IN THE UNITED STATES (1950s−1980s)13. Nurse-Midwifery Practice (1950s–1980s)Nurse-Midwives Move Into Large City and University Medical Center HospitalsPsychoprophylaxisTechnological Advances and the Continuing Quest for Pain ReliefNurse-Midwives Move Into Private Practice With Births Both In and Out of a HospitalNurse-Midwives Create the Modern Out-of-Hospital Birth CenterPractical Practice Help From the ACNMEvaluation and Effectiveness StudiesDescriptive Studies14. Nurse-Midwifery Education (1955−1980s)Types of ProgramsGrowth SpurtsEducation WorkshopsDevelopments in EducationMastery Learning Using ModulesDirectors of Midwifery EducationA Textbook for MidwiferyDistance LearningSECTION VI: HISTORY OF DIRECT-ENTRY MIDWIFERY EDUCATION AND THE CREDENTIALING OF MIDWIVES IN THE UNITED STATES15. Direct-Entry Midwifery EducationAmerican College of Nurse-Midwives (1978–1996)ACNM Education CommitteeACNM Division of AccreditationMidwives Alliance of North America (1983–1991)MANA Education CommitteeNational Coalition of Midwifery EducatorsAssociation of Midwifery Educators16. Credentialing of MidwivesAccreditationAccreditation Commission for Midwifery Education and PredecessorsCommittee to Study and Evaluate Standards for Schools of MidwiferyCommittee on Curriculum and AccreditationCommittee on Approval of Educational ProgramsDivision of ApprovalDivision of AccreditationAccreditation Commission for Midwifery EducationMidwifery Education Accreditation CouncilCredentialing CommitteeMEAC IncorporatedMEAC Criteria for Direct-Entry Midwifery Education ProgramsUSDOE RecognitionEarly MEAC-Accredited ProgramsCertificationAmerican Midwifery Certification Board and PredecessorsACNM Testing CommitteeDivision of ExaminersACNM Certification Council/American Midwifery Certification BoardNorth American Registry of MidwivesMANA Interim Registry BoardCreation of the MANA Registry ExaminationNorth American Registry of Midwives IncorporatedConversion From Registry to Certification ExaminationNARM Certification of Direct-Entry MidwivesLicensureCertified Nurse-Midwives and Certified MidwivesLegislation CommitteePolitical and Economic Affairs Committee/Government Affairs CommitteeLay and Direct-Entry MidwivesLicensure DebatesState Recognition of Lay Midwifery Practice Prior to 1982State Recognition of Direct-Entry Midwifery Practice After 1982Certified Professional MidwivesThe Big Push for Midwives Campaign (2008)SECTION VII: EXTERNAL/INTERNAL RELATIONSHIPS AFFECTING MIDWIFERY17. Federal Legislation Affecting Midwifery PracticeThe American College of Nurse-Midwives’ Involvement in LegislationWashington Task ForceLegislation CommitteeMaster Plan and ACNM Legislative Response MechanismsACNM LobbyistEarly Federal LegislationMidwives-PACDirect-Entry Midwifery Groups’ Involvement in LegislationMANA Legislative CommitteeMANA Legislative ConferencesMANA Legislative Lobbyist, 1994NACPM and the Midwives and Mothers in Action CampaignCollaborative Efforts in Maternity Care LegislationSafe Motherhood Acts, 1996, 2002Affordable Care Act of 2010Coalition for Quality Maternity Care18. Midwives With Women and Childbearing FamiliesConsumers and Midwives Working Together for Safe Choices Among Childbirth AlternativesMaternity Center AssociationLa Leche League, 1958, and La Leche League International, 1964International Childbirth Education Association, 1960American Society for Psychoprophylaxis in Obstetrics/Lamaze, 1960National Association of Parents & Professionals for Safe Alternatives in Childbirth, 1975Other Partnerships Supporting Safe Alternatives in ChildbirthListening to WomenACNM Ad Hoc Committee on Consumer AffairsACNM’s Listen to Women CampaignCitizens for Midwifery, Inc.Childbirth Connection 2005Public Policy Agenda for WomenMidwives With Vulnerable PopulationsACNM Position Statements on Health PolicyAmerican Public Health Association Policy Statements on Midwives and Women’s HealthSafe Motherhood Initiatives, USA19. Midwives (CNMs) With PhysiciansHistorical EvolutionJoint StatementsCoda20. Midwives (CNMs) With Nurses and NursingEarly Confusion With Identity of Nurse-MidwivesNurse Practitioners, Physician Assistants, and ANANational Federation of Specialty Nursing Organizations and ANAANA and Early Certification EffortsACNM’s Continuing Internal Struggle With Self-Identification and the Working DocumentNurse-Midwives and OB-GYN Nurse PractitionersANA Develops a Credentialing CenterANA Defines Nurse-Midwives as Nurse PractitionersACNM Defines Nurse-MidwivesANA Defines Nurse-Midwives as Advanced Practice Registered NursesAACN and AccreditationNursing Response to ACNM Involvement in Direct-Entry MidwiferyNurse-Midwives Included in APRN RegulationSelf-Identification and Loss of AutonomyCoda21. Midwives With Midwives: United StatesCarnegie Meetings Stimulate Midwifery Dialogue in the United StatesFirst Carnegie Meeting: July 16 to 18, 1989MANA–ACNM Activities Between the Two Carnegie MeetingsSecond Carnegie Meeting: July 22 to 24, 1990The MANA-ACNM Interorganizational Workgroup on Midwifery EducationCarnegie Funds AwardedGoals of IWGSelection of Workgroup MembersThe IWG MeetingsFactors Mitigating Against Achievement of Carnegie and IWG GoalsDifferent Organizational ProcessesWords and Concepts Without Common MeaningPhilosophy of InclusivenessLevel of Midwifery EducationUniversity Affiliation for Midwifery EducationMisunderstanding on Who Develops Education ProgramsSuspicions About IWG ActivitiesFinal Outcomes of IWG MeetingsThe Grand Midwife StatementMidwifery Certification DocumentLiaison Planning DocumentContinuing ACNM and MANA DialogueThe Bridge ClubACNM–MANA Liaison GroupUnited States Midwifery Education, Regulation, and Association22. Midwives With Midwives: InternationalThe International Confederation of MidwivesBrief HistoryAim and Strategic ActionsOrganization and StructureICM Activities and DocumentsICM International Definition of the MidwifeICM Mission and VisionICM International Code of Ethics for MidwivesICM Philosophy and Model of Midwifery CareICM Essential Competencies for Basic Midwifery PracticeICM Global Standards for Education and RegulationThe Three Pillars of Education, Regulation, and AssociationACNM’s Role in International MidwiferyIndex