Thirty years of global outreach by the American College of Nurse-Midwives.

The mission of the American College of Nurse-Midwives (ACNM) is to promote the health and well-being of women and newborns within their families and communities through development and support of the profession of midwifery. The United Nations Millennium Development Goals 4 and 5 are to reduce infant and child mortality and improve maternal health through universal access to reproductive and reduction of maternal mortality. Significant, multilevel efforts are needed to achieve these goals.

Findings from the analysis of the American College of Nurse-Midwives' membership surveys: 2006-2008.

Introduction: The American College of Nurse-Midwives (ACNM) Core Data Survey is an annual membership survey that collects demographic and selected workforce data about certified nurse-midwives (CNMs), certified midwives (CMs), and students enrolled in midwifery education programs accredited by the Accreditation Commission for Midwifery Education, who are members of the organization. This article presents findings from the analysis of membership data for the years 2006 to 2008.

Methods: An e-mail invitation to participate in the online survey was sent to all ACNM members who provided ACNM with an e-mail address.

The costs and benefits of nurse-midwifery education: model and application.

To promote nurse-midwifery education, it is important for educators to know the value students bring to clinical training sites and academic institutions, the value nurse-midwifery graduates bring to taxpayers who help support nurse-midwifery education, and the value an education in nurse-midwifery brings to the graduate. The first purpose of this study was to develop a model to include all costs and benefits of nurse-midwifery education to: 1) students; 2) clinical sites where nurse-midwifery students obtain clinical experience; 3) academic institutions that house nurse-midwifery education programs; and 4) others (most often taxpayers) who may contribute to nurse-midwifery education. The second purpose of the study was to develop a prototype nurse-midwifery education program to illustrate the use of the model.

#5: Non-Supine (e.g., Upright or Side-Lying) Positions for Birth.

In this position paper-one of six care practice papers published by Lamaze International and reprinted here with permission-the benefit of non-supine positions for birth is discussed and presented as an evidence-based practice that helps promote, protect, and support normal birth. The paper is written for childbearing women and their families. Upright and gravity-neutral positions facilitate rotation and descent of the baby and result in reduced duration of second stage, a reduction in episiotomies, and fewer abnormal fetal heart rate patterns.

Liability concerns: a view from the American College of Nurse-Midwives.

The national office of the American College of Nurse-Midwives (ACNM) is the center of day-to-day administration for the professional organization. Staff members respond to requests for information and assistance from certified nurse-midwives or certified midwives and facilitate the work of the Board, Divisions, and Committees. This article reviews the questions most frequently asked of the Professional Services department about risk management and professional liability issues and summarizes the most important lessons learned from the calls received.

Use of the vacuum extractor by midwives--what has changed in the last decade?

This article provides an update on use of vacuum extraction by certified nurse-midwives (CNMs) and certified midwives (CMs). Research findings from the last decade relevant to the training and use of vacuum extractors are reviewed along with professional guidelines and legal implications.

The American College of Nurse-Midwives' dream becomes reality: The Division of Accreditation.

Recognized continuously by the US Department of Education since 1982 as a specialized accrediting agency, the American College of Nurse-Midwives' Division of Accreditation (DOA) accredits not only nurse-midwifery education programs at the postbaccalaureate or higher academic level as certificate and graduate programs for registered nurses (RNs), but also precertification programs for professional midwives from other countries who are licensed as RNs in the United States. The DOA also accredits midwifery education programs for non-nurses at the postbaccalaureate or higher academic level as certificate and graduate programs, and precertification programs for professional midwives from other countries. The accreditation process is a voluntary activity involving both nurse-midwifery and/or midwifery education programs and the DOA.

A case/comparison study in the Eastern Region of Ghana on the effects of incorporating selected reproductive health services on family planning services.

Objective: to assess the impact on the provision of family planning (FP) services when FP providers were also trained to provide additional, selected, reproductive health services.

Design: case/comparison study.

Participants And Settings: twenty-four FP service delivery points in which training in sexually transmitted infection prevention and control services or post-abortion care services had been initiated (case facilities), were compared to 19 control facilities in which similar provider training had not yet been targeted.

The American College of Nurse-Midwives Domestic Violence Education Project (DVEP).

Objective: The American College of Nurse-Midwives implemented a 4-year Domestic Violence Education Project (DVEP) with the goal of educating all midwives in the USA to respond appropriately to abuse experienced by the women they serve.

Method: A four-pronged set of objectives was used that included policy, basic preservice education, continuing education and activism/advocacy.

Result: The success of this project is the sustainable impact on education of student midwives and a continued commitment to this issue.

Home based life saving skills: promoting safe motherhood through innovative community-based interventions.

In much of the developing world, home birth with unskilled attendants is the norm, and maternal and neonatal mortality rates are high. A comprehensive approach to address this problem needs to upgrade referral facilities and strengthen the skills of trained health care providers. To improve pregnancy outcomes, a program must also provide education, motivation, and mobilization of pregnant women, families, and communities (whose members must come to a common understanding of the need for and the means to prevent death of a woman or neonate).

State regulation of midwives: issues and options.

In the United States, state governments play a central role in determining the extent to which midwives can provide care to women and babies. State laws and regulations establish midwives' scope of practice, set licensure requirements, and frequently determine their ability to get paid and obtain access to health care facilities. For certified nurse-midwives (CNMs), state regulation has evolved from a haphazard patchwork of highly variable regulatory models into a fairly uniform set of rules and requirements from one state to the next.

Preserving midwifery practice in a managed care environment.

Since 1925 when nurse-midwifery emerged as a new health profession in the United States, and over the past 30 years under the auspices of the American College of Nurse-Midwives (ACNM), national standards for education, certification, and practice have enabled nurse-midwives to provide the quality of care that is highly valued by policy-makers and consumers. This paper describes the education and practice of over 7,000 midwives who have received national certification through mechanisms developed by the ACNM, describes the strengths of the profession, and reviews the impact of managed care on the practice of midwifery. Also highlighted is ACNM's development of a partnership, with the Maternal and Child Health Bureau, to study the impact of changes in the health care environment on pregnant women and ACNM certified midwives.

Core competency-based education, certification, and practice: the nurse-midwifery model.

It has been more than 70 years since the first nurse-midwives came to practice in the United States, and over 20 years since the American College of Nurse-Midwives (ACNM) established nationally recognized standards and core competencies for nurse-midwifery education, certification, and practice. Certified nurse-midwives are licensed in all 50 states and in the District of Columbia (DC) and have prescribing privileges in 45 states plus DC. More recent standard-setting activities include the establishment of a national mechanism for continuing competency assessment; adoption of the bachelor's degree as the minimum academic requirement for certification; development of national standards for education and certification of direct entry midwives; and placement of an 8-year time limit on certificates.

Trends in state laws and regulations affecting nurse-midwives: 1995-1997.

This article provides an overview of trends and changes to state laws and regulations governing the practice of nurse-midwifery in the United States from 1995 to 1997. It includes tables documenting state requirements related to education, certification, Medicaid and third-party reimbursement, prescriptive, authority, graduate practice, birth centers, regulatory oversight and postpartum discharge.

Domestic violence. Implications for the American College of Nurse-Midwives and its members.

Domestic violence, as well as other forms of violence against women, has received increased attention from many sectors of society in the past two decades. Estimates that one fourth to one half of all women in the United States are victims of some type of violence are startling. There exists today a broad-based recognition of and response to the impact of violence on the workplace, the health care community, and the woman survivor and her children.