Transcript

SPEAKER_02
0:05

Hey Denise, how are you today? Good afternoon, Ginger. Here we are again.

SPEAKER_01
0:10

Bringing up the information of a fun, fun talk. I know. You know, I was I was counting because I I listened to Isaac's podcast a couple days ago. This is gonna be number 10. No, is it 10? Nine, I think. Nine? I don't know. We can't keep track. Right, right. I don't know. I tell you what, though, we are having fun.

SPEAKER_02
0:29

We are having fun. And I think that's what it's about. That was one of our goals. Make it real, make it fun, and provide a lot of information.

SPEAKER_01
0:36

Yeah. So as you know, and and our ongoing followers continue to say they really love the new news. I uh I've got one for you that I think is also gonna be really germane to our guest, who I can't wait to introduce, talking about the American College of Nurse Midwives and things that really all midwives do domestically and globally. But are you ready, Denise?

SPEAKER_02
1:01

I would I I'm ready, Ginger. I know you're gonna baffle me this time because I couldn't find anything ahead of time.

SPEAKER_01
1:07

So well, this is this is gonna give you a reason why I think it's gonna perplex you. I I have four sons and Denise knows them all very well. And my second son, Reed, I call the Jim Bellucci of the clan. And Reed introduced me to a platform that I started looking at, quite honestly, when I when I did the first RVU podcast or webinar back in I think 2021, because I was trying to learn about RVUs. And he goes, Mom, all the cool people use Reddit. Right, right. Reddit is the best. I'm I'm an old person. I'm not a cool person. So um pretty good for tech though. So you know what I decided to do today because I I am profoundly concerned about folks entering the midwifery profession, growing our profession. We talk about scaling up and strengthening, sustaining our profession. Yes. And I thought, why not go to Reddit and see what the chit chat's about?

SPEAKER_03
2:09

Good idea. Good idea.

SPEAKER_01
2:11

I went through my account and typed in midwives, and I was blown over, Denise, in the particular, I don't know what you call them, their channels or whatever they are. The one that I review has 9.3 thousand weekly visitors. Did you hear that? I did.

SPEAKER_02
2:31

9.3,000 weekly. Okay.

SPEAKER_01
2:34

And and 52 weekly contributors. Wow. And I'm gonna go down the list and read you some of these, and then we're gonna talk about who's asking the questions and who's answering them. Great. So this one was posted four hours ago. Midwife versus OBGYN. Okay. This is somebody in nursing school who's gonna be a BSN in January of next year trying to figure out what might be the best path for her. Then we go down to 12 hours ago. Where can I find a true midwifery model of care? Oh, that's a good one. I mean, reading the answers is about as mind-blowing as the questions. Okay. What are your thoughts about dual CNM FNP programs? I'm practicing intermittent auscultation with an online course, but I can't figure it out very well. Can anybody help me?

SPEAKER_02
3:36

I mean, I could just like go on to I imagine the answers are gonna be just as interesting as the questions there.

SPEAKER_01
3:46

So you know what? Some of the some of the answers are spot on, and some of them are so erroneous, I just want to spend my entire day answering questions. Oh, you're gonna get sucked in, ginger. I can't do that.

SPEAKER_02
3:58

No, you cannot. You have way too many things to do. But we got a we got a problem here. We got a problem. Okay, Houston, we have a problem.

SPEAKER_01
4:07

So, you know, if there are 9,000 weekly visitors and 52 weekly questions, what is the message out there about the midwife profession that is being portrayed really in a non-judgmental but accurate way?

SPEAKER_02
4:29

Well, I think that's I think that's what we're dealing. We've been deal with this for decades, centuries perhaps. Um, so I I'm that question is I think a question that persists over and over and over again. Um and I and even Reddit is posing that question, I suppose.

SPEAKER_01
4:48

So at a much higher volume than anything that I circulate in, certainly in LinkedIn, in in Instagram. I mean, I don't see those numbers. Maybe I'm not in the right spaces to see those numbers. I'm not a TikTok person. So maybe the folks are going there. But you know, one of the creative ideas I had, we'll see if any midwifery education program directors are listening, and our new guest might be able to chime in on this. Maybe, maybe a program we s it circles like once a month the students of UCSF answer the Reddit questions and it circulates because this is a very powerful medium about our profession with no how do I want to say this? Um valid, unbiased responses. Right, right. Oh, this is a big project.

SPEAKER_02
5:40

You got any thoughts? You got any more thing? I do think um I mean, I do think it would take a lot of time to invest in doing that. So um I mean, people are responding, and we want to make sure that I guess accurate information is being given. So maybe it's gonna be schools, maybe it would be affiliates that would be interested in responding, different people.

SPEAKER_01
6:03

Yeah, they're don't let's not count on them today. Not today, maybe maybe, maybe soon, but students, you know, students do have a lot to do.

SPEAKER_02
6:12

And um they're asking for even you know more learning to happen and in the short amount of time that they're actually you know in a program. So I don't know if that would be overwhelming to them, but certainly something to think about. It is. It's who wants to take on Reddit?

SPEAKER_01
6:28

I was totally astounded by it. So we'll we'll leave Reddit to the side, but I I think it's something we all should keep in the back of our minds. I think it's a great idea. Yeah, but who are the voices? Who are the voices out there for us? And who are people wanting information that aren't getting it? Right. So why don't we move into our guest for today? Oh, so very excited. Yeah, this couldn't have been timed any better for our listeners. Uh, Dr. Peter Johnson was inducted as the new president of the American College of Nurse Midwives last week while I was in D.C. I got to be on the tail end of that meeting. Um, and Peter has been around the block a very long time. Uh he and I are kind of contemporaries in some ways. Um and so, Peter, um, I'm gonna let Denise say a few things about you, and then we're gonna ask you to introduce yourself.

SPEAKER_02
7:17

Well, I just recently met Peter. I've always heard his name, you know. Um, you don't always hear about the male midwives, not to gender it, but you know, that's always a question that people have. Can can, you know, men or people that identify men be midwives? And so I've always heard Peter's name. It's always been out there for for years. I mean, not to not not to age you, Peter. Um, but um, you know, I've heard it a long time. But then I I really had the opportunity to have a long discussion with Peter, I think a week or so ago. Um, we could have gone on and on talking, but um I I'm very I enjoyed our talk so much and ideas and and you know, maybe even solutions eventually. So, you know, I'd like to introduce Peter Johnson, um, which Ginger already did, but thank you for being here. Um, and I'm I did stay up till the late hours watching you be in inducted, and I was happy to do that. I stayed on for you, otherwise I would have been in bed a long time prior, but it was worth it. So, Peter, thank you for being here.

SPEAKER_00
8:19

I uh I told thank you very much very much for having me, Denise and Ginger. Uh it's so good to be, it's always fun to be with with with you. Uh, and I know that now, Denise, after our conversation last week. I tell you, uh that uh that uh annual business meeting of ACNM last week uh and the bylaws um uh process uh was a diff long and difficult labor. Which was I thought I thought was handled incredibly well from our past president. My message to her afterwards was I'm I'm glad that you gave birth after that long, difficult labor. I didn't want to I didn't want to have to go into the labor again.

SPEAKER_02
8:59

Uh the transition.

SPEAKER_00
9:01

And I was really happy that the you know, back to starting with your your conversation about Reddit, I was so glad that people were staying on, not for me, but for the student report, which we decided to delay until absolutely uh that's so important. And I actually have a had a great conversation with our new student board member, uh Joey. Uh and uh I will put this on her radar uh next time that I see her. I think this it certainly has to be managed. And I'm I'm I not I don't like to say I'm too old for anything, but uh ready You have too much something I never even thought about. I I heard of it. Um so anyhow, introduce myself. I've been a midwife for 40 plus years now, and uh I have been always active with ACNM. Uh I think I took a little bit of a break. Uh I got a little bit frustrated, like a lot of folks did, and needed to give a pause. Uh, but I'm very, very honored to be back in the role that I'm in now. Uh and uh I uh consider myself both a both both a nurse and a midwife. I don't like the term nurse midwife, uh, because I think we're all midwives. Uh and I uh have been a midwifery educator, like you, Ginger. I've been a midwifery educator for a big part of my career. Uh and then I uh I spent 20 years working in global health for Japaigo, an affiliate of uh Johns Hopkins University, working largely in Southern Asia and uh and in Africa and some Southeast Asia as well. I went into that job with my educator hat on. Uh, you know, I was hired as uh director of global learning there. But guess what? I found out after being there for about six months, uh hot second, that uh almost everybody that we were supporting in maternal newborn health were midwives or nurses in the countries that we worked, realized that the issues were the same no matter where you, no matter where you went. Uh, and that's where I really started introducing myself as a nurse or a midwife or a midwife and a nurse, depending on who I was talking to, because nursing and midwifery are all confused uh everywhere you go. Uh and uh I I uh decided it was time to hang that up after COVID uh and you know, a lot of extensive travel. And uh took a took a moment and hiked uh my wife and my Labrador and I hiked the Appalachian Trail. Yeah.

SPEAKER_03
11:43

Oh, no way.

SPEAKER_00
11:45

We uh we did, and it's amazing. And then uh my wife Tina, who uh worked with Ginger at when she was working at ACNM uh for many years. I still we still have your duck that you cast at the board meeting. I was gonna bring it down here. It's it's hanging on our bedpost. Oh that's that's how we feel about you, Ginger.

SPEAKER_02
12:08

But uh we There has to be a story there besides quack, quack. I don't know.

SPEAKER_00
12:14

I don't know. Maybe Ginger can talk about it.

SPEAKER_02
12:16

We'll talk about it another time. Yeah.

SPEAKER_00
12:19

We got we got uh we got home from all the all of our adventures and actually our trip, we did a trip across the country, uh midwife uh tour, and uh I think our last stop was uh overnight with Ginger in her home. Yeah. Uh and I'm just thinking out loud here, but we uh we got back and I was, you know, I was hanging around while Tina went back to work. Uh and uh I you know I I I kind of just got absorbed back in helping them start a midwifery program at University of South Carolina, then got invited up to my alma mater and University of Buffalo and got invited to go back to work there. So I'm a halftime professor now uh with a new giving birth to a midwifery program with my colleague. And I think that uh I can uh I can't uh we're still waiting on our last phase of state approval, but we fully anticipate that we will be uh enrolling our first cohort of midwifery students in Buffalo and Rochester in in the fall. So that's that's that's me, and then uh and then ACNM presidency. So yeah. It's a lot. It's a lot.

SPEAKER_02
13:26

So you know what called you back to the presidency? What called you back for that role? You know, I uh it's a funny story.

SPEAKER_00
13:35

I was at uh in my uh in my position at uh my faculty position at University of Buffalo, I decided to attend a dome meeting. Uh and when Michelle Munro came in and gave her report uh on I was in the room and she saw me in the room. And Michelle was a former student of mine a long time ago at University of Maryland, and she reached out to me about three days later and said, Would you ever consider running? And I thought about it, I talked to my wife about it. I and I I mean the first thing I said is I never anticipated doing this. A B, I don't need it for my ego. And that that seemed healthy. And then the third thing that I thought of is uh if if they this organization is always been it is his my program director when I was a midwifery student, uh uh said to me that this is an organization that is small enough that if you want to make a difference, you can make a difference. And I've always uh I I've always held to that. And you know, I I fear that without a strong professional association with active memberships, uh, that our profession is not going to be around forever. And I just I not on my watch. I just don't want to see that happen.

SPEAKER_01
15:01

So yeah. Yeah, well, thank you. Denise, it ties right into the question I was thinking with Peter. It almost sounds like your career path has been maybe 50-50 domestic and global. Um and and you have seen so much globally, with I would say more developing associations than established. Am I right?

SPEAKER_00
15:24

Yeah, a lot of a lot of the work we did was really support uh professional development countries, those regulatory, you know, regulatory frameworks, the things that we need.

SPEAKER_01
15:34

And and maybe what's germane to today when I I don't think US midwives take their title for granted, like AMCB grants the credential. But when you think about the professional association and the power, the influence, the regulatory components of a professional association, I think sometimes, and I'm just gonna cut to the chase, because folks are so caught up in whatever their angst is, there is this loss of understanding the tangible essence of why we need it. And when you look at these developing countries who are struggling with some of those regulatory issues, is there any any storytelling or any way maybe you can help some of our listeners think about it from um that viewpoint? What if we didn't have it?

SPEAKER_00
16:34

That is a great question, Jennifer. What if we didn't have the association? Yeah. Yeah. I uh I think people um don't quite uh understand what the value proposition is of an association. And quite honestly, a lot of thinking about this. I think the value proposition has changed over time, and there's certain components of it that endure. Um I I used to say when I go to an annual ACNM meeting that it was the one week of the year where I felt like the world was right side up because we're so busy fighting the fight every day. And you know, so that sense of community, I think, has always been there. Uh and that may have changed a little bit. I mean, I think we got away from the community aspect a little bit with COVID uh and not being able to be together. Uh, I think there are other ways for people to uh other ways for people to get community. I uh it may be, maybe more of it is at the state and local level. That might be, you know, that that actually may be a uh a factor of our growth, uh as of you know, well, and while AC and M is not growing, and we can talk about that. The number of AMCB certified midwives, the number of midwives, the the density of midwives in a community is different. I always felt like I was kind of all out there on alone on my own.

SPEAKER_01
18:10

Right. Yes, you're right.

SPEAKER_00
18:12

Uh but uh you know, one of the most important things that we do that I think people don't recognize is the you know, is is the policy advocacy that happens, uh, the connections that we make and the you know, the the collaborative with like-minded organizations and uh and and people, uh, you know, the work the work supporting regulatory frameworks that the it's the old, you know, the uh ICM Education Regulation Association, I think it was from the the Lancet report or the State of Home Medical Report. You know, each of the we we uh we are important as an organization in convening people, engaging people so that we can work on all three of those.

SPEAKER_01
18:58

Yeah. And and yet the the full-time midwife working 54 hours a week getting paid poorly, does the the the connections the connections aren't happening. Right. The the policy issues on a federal level, as we all know, take forever.

SPEAKER_02
19:18

They take forever.

SPEAKER_01
19:20

Um so when you look at it at countries with regions, you know, let's go back globally, because I do think that the work of developing nations is so important to understand that they're developing these for a reason, for a voice, for recognition, uh, for influence, for persuasion. And without that, what happens to what happens to those midwives, Peter?

SPEAKER_00
19:49

They they get lost in the system. They're not necessarily they can't practice midwifery. There you go.

SPEAKER_02
19:56

Right. I mean, I'm I'm just thinking of like Haiti and like, you know, where is, you know, we've talked about it a little bit, but where are we at if we lose, you know, if we lose ACNM and if we lose AMCB? Where would be we be at in the US? Like, you know, who who will be the guiding structure moving forward?

SPEAKER_00
20:19

You know, it's interesting. When I, you know, when I started out and for the good portion of my time working with in this community, ACNM did it all. You know, AC, you know, ACNM certified us in and when at the beginning. I remember taking my cert my writing my certification exam when it was all written out in case studies uh in the ACNM office uh when it was in DC, uh and before it moved to Silver Spring. I so I remember back in those days, and then you know, the uh the accreditation was uh was division of accreditation. Everything was in ACNM. So I think people could see the package. Right and now as Ginger, as you said, AMCB certified gives everybody the certificates. They, you know, you have to be there to get recertified every five years. Uh ACME is doing its thing, uh you know, building uh, you know, maintaining standards. So people take the take away those two big components, and people it's people ask, what is you know, what's ACM for?

SPEAKER_01
21:22

Right. Right. Which gets us back to the idea of association. Those organizations do not write regulations. They do not, they they do not represent um the constituency of the profession. They're they're I mean, they have nothing to do with those things. In fact, they try not to speak about those things.

SPEAKER_00
21:43

They can't.

SPEAKER_01
21:45

So um yeah. It's it's really, really problematic to me. And and I think about it every day. I mean, every time I have an opportunity to talk in front of people about why, and Denise and I are, you know, big believers in In the why Simon Senec's whole movement of you know why is this car better? Oh, because it has six more car hole uh cup holders than the other one. Uh we I think we have to help construct a better why.

SPEAKER_02
22:16

Yes, I do. I do, and I think the why, um I think the why is has to be like promoted or answered for each of the members because I do think you know the members are asking why, and I think creating um, you know, for those who are not sure or who have left or are not sure if they want to return, like creating the why going forward is going to be very important.

SPEAKER_00
22:42

Yeah, and we have those folks that have left and aren't returning, and we have those folks that have never shown up. Right. So I think it's I think one thing is starts at the very beginner. J Ginger, you and you and I have both been midway free educators for for a while. Denise, I don't know, just were you were you a teacher at at at a certain point?

SPEAKER_02
23:03

Um well at at the University of Kansas for a little for a little while, um, and then a little bit at Marquette University.

SPEAKER_00
23:10

So I I think we need to do a better job of of in really instilling that why in people uh in our in our young midwives when they're they ought to be able to answer Reddit questions while they're in in school. I think if you catch people, if you kick those folks and uh and engage them while they're students, uh and you can just get them through graduation and stay engaged, you'll probably you'll probably get them. Uh and and then you know there are all those folks that have left, and they've left for you know a whole variety of reasons reasons. One of the one of the things that I want to prioritize here is is working with our affiliates. I'm actually gonna sit with sit down with the I'm gonna attend the affiliate leaders meeting tomorrow evening, and I want to find out how can we how can we engage in some in some town halls uh that will, and if they can help to get people that are not ACNM members, but there's known folks in the community to come and tell us the why. Yeah. You know, what is it that what is it that they what is it that they expect?

SPEAKER_01
24:23

You know, my my experience with with two affiliates, Oklahoma and Maryland, and now I'm I'm I'm about to work with another state, um, maybe two later on this fall, is um intentional organization around attracting members and non-members, just bring in the midwives. It's not an affiliate event, it's a gathering of midwives with an intention to talk about what we have in common. And in that journey of conversation, coming up with some consensus on what I've done is is three to five strategies to work on that can be achieved. They're not pie-in-the-sky ideas. And for Maryland is rocking it right now. They've got this big stakeholder meeting in D.C. I'm going to in a couple weeks, where Johns Hopkins awarded a grant for the DMV area to put on a conference to talk about issues in the in those three practicing regions. And they did that by reigniting five or six officers into their three potentially 300 members in Maryland, as you know them better than anybody on this call, Peter. They've they've woke up and they realized we have to do some things or nothing's going to happen. And I think for immediate short-term gain where where the people who practice down the street aren't too far removed from the national level, it's got to happen at the state level. And the feeder is is is the national activities, but they have to feel it, see it. It has to impact their pocketbook, their practice guidelines for them to find value. That's what I've been hearing, and that's what I see happening. Um it's possible. The book's behind me. It's it's possible. I read it. Yeah, I mean, I I think it's like you have to keep reading it because it's the challenge seems so overwhelming, and yet you you slowly chip away at the discourse to find what, Denise, the golden bridge.

SPEAKER_02
26:30

The golden bridge.

SPEAKER_01
26:32

We have it. We got a lot of them. But we keep letting the floods take over the emotionality of the conversation. It's killing us.

SPEAKER_00
26:46

Well, that's exciting. The the Mehran opportunity is really exciting. That's coming up in just a couple of weeks.

SPEAKER_01
26:52

A couple of weeks.

SPEAKER_00
26:53

How does that fit in with our uh our advocacy day?

SPEAKER_01
26:56

You you guys are like two days before, and I couldn't I could not extend my time away. So I'm flying in like on Wednesday night. It's a is it a Thursday, Friday event maybe? Uh I think you're right at the beginning of that week.

SPEAKER_03
27:10

Yeah.

SPEAKER_01
27:11

Uh yeah.

SPEAKER_02
27:12

So, Ginger, how can we replicate that in other areas? If it sounds like a possible great opportunity of coming together, um walking together, like as William talks about, like, how can that be replicated in other areas? I think this is the goal. Like, I think there's so much um people are really trying to, they do all their clinical work or they're educators, and they have little time left to you know, um, engage in uh this this very important work of connecting and being members. So, how can that happen? Um, how can that happen without taking an extraordinary amount of energy?

SPEAKER_01
27:59

You know, everything takes time and money. Um and so in in these cases, I think that when for Oklahoma, where there was a substantive amount of philanthropic funding that helped, um, it was a very different model than the Maryland model, which was a one-day event at Johns Hopkins. And um I think I think it's like how you write the call to action, how you write the invitation. What does the what are the welcoming words that invite everybody's perspective?

unknown
28:29

Right.

SPEAKER_01
28:29

And then when you see all those perspectives on the wall, and you can pick out what are the common issues we can agree on that really are not controversial. Like Oklahoma is a very red state, and and right to life and abortion are very controversial issues. And people interpret AC and M's position in very different ways. But if that can be set aside and we're going to work on prescriptive authority in the state of Oklahoma, which they conquered the year after their gathering, right? Then there's a common win for everyone. That's how a lot of associations work. We have the difficulty of working in healthcare. Uh and, you know, I think one of the challenges, uh, you know, I don't know how how your your new board will handle this, Peter, is conscious objection uh related to some of the reproductive health statements that AC and M has. And I don't have an answer today. I'm just bringing out things that I'm hearing from a very large movement of over 3,000 midwives who believe in conscious objection. How do we find the bridge to just start the conversation? We don't even have to have an answer.

SPEAKER_00
29:42

Can you clarify the conscious of uh what you mean by conscious objection?

SPEAKER_01
29:46

Sure, sure. Aha ACOG has a statement. A lot of uh physician uh societies have statements that relate to the right to choose not to discuss um this the gamut of reproductive choice.

SPEAKER_00
30:00

You know, we were just talking about that. One of my colleagues and I were talking about that in uh in relationship to our curriculum for our students, uh and uh recognizing that some students will be very interested and they'll have an opportunity opportunity to go beyond core competency and learn abortion. Right. And others won't. And we've heard from students that uh that they uh you know they they even have some conscious objection to family planning. And you know, I you know, well, that's a core competency. We have to know how to people have to be prepared to do it. Yeah, um, you have the right to refer. I think you know, just coming to an ACNM side on this, we we do not very do we don't do a very good job of uh of coexisting within a big tent. Um we have to be able to acknowledge that uh for some uh for some folks, a particular holiday may be offensive, whereas it, you know, 4th of July may be offensive. For others, it may be a you know a you know a part of Americana that they feel really good about. Some people, you know, abortion, some people uh pose, some people feel that it's important. Uh you know, it we we have to we have to figure out how we can how we can agree to disagree uh while we are certainly agreeing on the importance of midwifery.

SPEAKER_01
31:36

Yeah, exactly. Exactly. If you take the reproductive justice issue, Peter, there are several Jesuit midwifery programs in our nation. Marquette's one, Seattle, Boston College, Loyola. I mean, I can go on and on. Yeah. And they navigate that road. They have to navigate that road.

SPEAKER_00
31:56

And we have I've been in the balcony thinking about this one. Okay. I'm up for I'm up for uh taking a walk together. Yeah, yeah. It's a huge issue because I think we're, you know, I went into this in all of last year's president-elect. Thank goodness for a year of president-elect that you have. Uh but I think workforce is we we need to workforce, workforce, workforce are the issues that I care about. Yeah. And I don't just mean pipeline, I mean comprehensive workforce. And that's huge. But I also know that step back, we're not going to even begin to touch that and make differences if we don't have the member recovery that we need and active, you know, actively midwise in way, way greater numbers. You started out talking about the uh the other night and our bylaws conversation. We had a nearly 200 people there at the peak. Yeah. Uh and think about, you know, think about how that how many of those 200 are compared to the 4,000 plus members that we have. And then think about that in relationship to the 15,000 foot soldiers that we could have out there.

SPEAKER_03
33:10

Yeah.

SPEAKER_00
33:11

Uh and we we uh have to get those folks not just back, it'd be great if we got their dollars because it will, you know, that's that's resource. Right. But we really need the people actively working together.

SPEAKER_01
33:26

Yes.

SPEAKER_00
33:27

And and we're not gonna do that until we cut the cancer out of our organization that is really it really relates to what your people not being able to agree.

SPEAKER_01
33:38

Um I I think I, you know, I witnessed that in Oklahoma. I I I I mean, we knew on the wall where where the where the opposition was. We knew that in Maryland as well, because we had done a survey ahead of time. And um, you you you you prompt you prompt the the room and then you let people speak. And as they continue to sit and eat together, as William Urey would say, you know, on the walk, they begin to just let the guard down and you listen differently. You're not quite as angry. Uh, but maybe you begin to shift towards, well, what what might we be able to agree on? So people answer the problems themselves. They're not told what to do.

SPEAKER_03
34:24

It's a beautiful thing to watch.

SPEAKER_01
34:28

And and it happens, but you have to set the tone. And to do that on a national level, I think, Peter, is impossible. I think you do it on a state level. That's my bias.

SPEAKER_00
34:38

Yeah.

SPEAKER_01
34:38

Um, but you can set up the states to be able to do that.

SPEAKER_00
34:43

Exactly. I mean, I think a lot of things have to happen even smaller uh communities than the state level, depending on the states they on the size of the state.

SPEAKER_01
34:52

That's right.

SPEAKER_00
34:53

But you can provide you can provide tools, and I yeah, you know, and I hope that you can set the tone nationally. If we could set the tone for people who Yeah, I agree.

SPEAKER_01
35:05

I agree. Um well let's let's talk about some things that that have been going on that are that are sort of diminished because we can't see through the forest. Um anything you want to highlight, Peter, that you really would love for for uh midwives to hear about?

SPEAKER_00
35:27

Well, uh we we have a new board with transitional leadership. Uh so that's a good thing. We and uh and we will be uh we will be working over the next six months uh with with members to build a new strategic plan for 27 to 29. So this is an opportunity for us to be thinking about you know what's that immediate future. Um I know uh you know, some so I I'm really excited about the number of states that are choosing to regulate the uh the certified midwife.

SPEAKER_01
36:08

Yeah, that's growing fast.

SPEAKER_00
36:10

It's growing fast. Unfortunately, uh I think with everything that's exciting and new, there's also challenges that you can associate with them. The challenge on that is I'm in the state of Virginia. Yeah, and I well, I'll give you two states that I'm in. I'm in Virginia and New York. New York has had uh has had regulation for life and recognition since the 1990s, early 1990s. Yeah, and in fact, I think that's why the I think that was the push for AC and M establishing the the CM in '94. But um uh it's still, it, it's still uh, I am not able to convince my dean in our education program to uh to develop a a certified midwife path, even though we have our physicians in our in one of our affiliated clinical uh hubs that has asked us if he could send PAs to our program. They know that they need them in the workforce. And they'd rather see them be they'd rather see them be midwives. Uh so that's that's New York, even when things have been around for a while. And then in Virginia, CM is fully regulated by the Board of Nursing. Uh and I appreciate the Board of Nursing taking taking it on. Uh, but it is um uh but it was done with no thought of an educational pathway, so no pipeline that's been established. So I was out at the University of Colorado and met them, and they had the foresight of working with the dean at University of Colorado, where they had a program to, and they said that there was the uh the the it was kind of like a carrot and a stick, both worked together. Knowing that there was a program in that was willing to do it made it easier to get it regulated, and knowing it was being regulated was for the program. So, you know, that so that's our our our capacity to grow the workforce is important. Another thing I'm excited about is we have a name change strategy task force.

SPEAKER_01
38:13

Okay.

SPEAKER_00
38:14

I think it was around your time when you I went through, I was charged uh in my president elector year for going and doing an analysis of you know the the Q10 years uh uh analysis that was done, the voting. Uh and uh but we you know we we are at a different point now. We have the American Midwifery Certification Board, we have the Accreditation Commission for Midwifery Education, and now we have the Midwife Foundation.

SPEAKER_01
38:44

Right.

SPEAKER_00
38:44

And so we are the only ones that have nurse in our name.

SPEAKER_01
38:48

Right.

SPEAKER_00
38:48

And while it's uh I'm excited about the work that our task force is engaged in right now. Uh it's not without conflict and challenge, but uh I, you know, I hope we're getting close we're getting close. Yeah. We really do.

SPEAKER_01
39:07

Uh can I throw you a wild card? Yeah. This is gonna be fun to talk about because Denise and I had a very, very brief conversation uh when Isaac was on um about unionizing and how that is just rapidly growing with not just midwives, but even residents and and physicians. The Royal College of Midwives is a union. Oh. Right, Peter?

SPEAKER_00
39:33

Yep, it is.

SPEAKER_01
39:34

What do you think about that?

SPEAKER_00
39:36

You know, I was just thinking about this yesterday when I was listening to another podcast, and uh it was with the uh it was a it was an extended long-form interview with the mayor, the new mayor for Seattle, who was uh who was a community activist and never in politics, and uh she unionized the uh the the uh commute the commuting community. The community commuters in the city.

SPEAKER_01
40:05

Yeah. And then I I was thinking to myself, uh Hey, it's happening everywhere, and what we're discovering is people come to us and we're like, we can't give you advice, but we can tell you who can.

SPEAKER_00
40:15

Right.

SPEAKER_01
40:15

But you know, it's happening across the country for midwives.

SPEAKER_00
40:19

Yeah.

SPEAKER_01
40:20

And they don't know what to do.

SPEAKER_00
40:21

And you know, the other thing that does is I'm thinking out loud, no, but it gives another value proposition for uh for for whatever we call ourselves.

SPEAKER_01
40:30

Yes, absolutely.

SPEAKER_00
40:32

Yep.

SPEAKER_01
40:33

You should talk to you should talk to the to the British midwives, Peter.

SPEAKER_00
40:37

Well, we're another big piece of news is we have our International Confederation of Midwise meeting coming up in June. And that's right. That's a great opportunity. A great I I I'm looking forward to commuting with my global colleagues.

SPEAKER_01
40:52

Yeah, you I mean you must know ha half or more of them. But you know, I thought to myself, Denise, man, it's never too late to do something. And if you want to rally a bunch of angry midwives who are overworked and underpaid, what a better topic.

SPEAKER_02
41:08

I think I I think it's very much it, I think it's worth looking into. Um, I just keep thinking of I think the rally is the good idea, Ginger. I was just thinking, even like on the state level, just getting people together unified. I just think we need unification, um, bringing people together instead of everything that's just separating. So what better way? Um a rally. I mean, we're great at rallies in this country.

SPEAKER_00
41:34

I have a question for you guys. Um what about the uh um the connection or lack of connection with and conflict between the certified professional midwife community and the uh our community of CNMs and CMs? Um how how do we how do we bring how do we bring those two communities together?

SPEAKER_02
42:01

Yeah. We talked about that a little bit, Peter, right? Didn't know you were gonna throw it back at me.

SPEAKER_00
42:07

Well, I think it's important in terms of, you know, when you start talking about issues of unionization and uh com you know, rallies, community activism around making it.

SPEAKER_01
42:16

Yeah, well, you know, I I I will I will be underground and I will have this on my tombstone. We don't know what a midwife is in our country, and that's a disadvantage to all of us. Yep. And all of our pathways into the profession. Um and I uh this is unpopular, but people know I say this. I think there has to be uniform definition of the title. That doesn't mean you can't have different pathways to the title. Um and until we until my four sons know what a midwife is and they don't, um we got a problem. I mean, I their mom has been one for 45 plus years.

SPEAKER_02
42:59

I have to, yeah, I have to agree. I just think um I think again, there's just everything is just like we are this pocket, we are this pocket, this we are this pocket. I I think we have to come together somehow, but also agree to like I I guess it's definition, but also like you know, standards and regulations, and so that um there isn't just people aren't pitting one against the other all the time.

SPEAKER_01
43:28

I just read yesterday, Peter, and I was almost going to bring it up, and I thought, no, I don't want to complicate things, but now I am. Oh, just complicated. There's an organization, it's not ICM, obviously, but it's a certifying body for an international definition of a midwife. Do you know who I'm talking about, Peter?

SPEAKER_00
43:46

No, I don't. I don't know.

SPEAKER_01
43:47

It's global. They have four names from the United States. They are training traditional birth attendants, doulas, and lactation consultants. It's it's a pretty heavy. But they are using the verbiage on their website to indicate a degree of certification that remains vague, but titled midwife. And I thought, yeah, Denise's Denise's, hmm. I'm like, who are these people? And I could never really find a good enough detective layer to understand who was leading this. But is Maternova M-A-T-E-R-N-O-V A? Do you know who that is, Peter?

SPEAKER_00
44:31

No.

SPEAKER_01
44:31

They are a they are a fiscal supporter. I'll send it to you. So you can do some investigating. But it's a global certification being marketed worldwide.

SPEAKER_00
44:43

I will.

SPEAKER_02
44:45

And so the global certification of a midwife, where what where will this be implemented? Where can this be implemented?

SPEAKER_01
44:54

Anywhere in the world, they can call themselves a midwife.

SPEAKER_00
44:57

Yeah, but but yeah.

SPEAKER_01
45:00

So again, another level of components. Another level, another layer, another confusing, you know, you take the ICM definitions and and all of the components, which which ACOG agreed to, right? The ICM definition. I I I I don't think we can go backwards. And yet that does pose some difficulty for indigenous midwives, you know, in Alaska, um and and maybe other places. How do we integrate those? Well, there are ways to integrate those that have regulatory exception or exemption to be able to make that happen. But we seem to get sort of stuck in the quagmire in the conversation.

SPEAKER_02
45:43

I have another question. Um, when we're thinking about like ACNM membership, I know I'm going backward to a topic we talked about. Like historically, do either of you have any awareness about like how initially recruitment occurred for ACNM? And could any of those kind of tenants be replicated to increase the membership now?

SPEAKER_01
46:08

We don't have any handcuffs, Denise. Uh unless you want to be a union. However, you know, I back in the day there were some, Peter, I don't think KU never did. We couldn't have gotten it through our student governance, but it was a requirement to be a member of ACNM. Okay. As a student. Uh some programs did require that.

SPEAKER_00
46:29

Yeah, it was a requirement for me when I was a student. I was in the Air Force at the time. They they owned me. Um, but I think another important factor for me was that all of my faculty were not just members, but active members in the organization and talked about it all the time.

SPEAKER_02
46:47

Influencers, Peter. They were influencers.

SPEAKER_00
46:49

Yeah, I would have been embarrassed if I hadn't uh engaged. And and they we we had to go to the ACNM annual meeting. Ginger, I remember I remember seeing you with all of your students at somewhere. And yeah, I just remember them all following around behind you.

SPEAKER_01
47:08

And I thought this is the way Hey, and they they chose to be there. We couldn't, we could, we could give them a little bit of credit or clinical something, but we couldn't make them go. And they, I mean, we just had fun.

SPEAKER_02
47:18

And I remember I remember going for many, many years as a new midwife, and then in and and also the name, the debate about the name of ACNM and Dorothy and Lang, um, and people having pieces of paper on their back and the business meetings about the name. Um, I mean, it's crazy. So, like these things keep cycling, cycling back. So, so then we have how so I think um we have how to be how to increase membership in ACNM and how to kind of bring CPMs and CNM CMs together as two major like working projects, right? Um that's a golden bridge I'd like to build. I I know I agree. Um, and you know, I just I want to throw everybody into a big, huge field and um, you know, have everybody work it out.

SPEAKER_00
48:10

Okay, there's many topics, too much work to do, but I'm also aware of the fact that you know, two years of being president, you know, and a strategic plan, uh, you gotta be thinking about what you can do in that window of time, but where can you plant seeds that will grow uh as well? And if we could just, you know, if we could just, you know, build we talked about building trust within the organization. If we could build trust between the communities, yes, uh, that would go a long ways too.

SPEAKER_01
48:40

Yeah. Yeah. I I'll go back to featuring successful affiliate new affiliates. California's been rocking it. Like they they they to me are almost the gold standard. They also have a lot of members. That means they have a lot of money and they're doing a lot of work.

SPEAKER_03
48:59

Yeah.

SPEAKER_01
48:59

Um, but I I think some of these newly refreshed affiliates could help tell their stories, their honest stories, um, in ways that might incentivize other people.

SPEAKER_02
49:14

Um there are ways to do that. Could that be part of the you know, the AC and M annual meeting take out maybe one educational session and do a lot of storytelling networking?

SPEAKER_01
49:29

I do think, Peter, there's something to say here. And and I I mentioned it a couple weeks before the the board meeting and the bylaws. Um if you want robust discussion, it's not gonna happen virtually. I agree. It's just not. And I I I think despite the fact we don't have a business meeting as a part of the annual conference, which is now CME and a war and awards. If there's any possible way, I mean, I'd give up a session and and I'm speaking in three. If there's any possible way you could have one opportunity for two hours to just let people speak, it might move mountains.

SPEAKER_02
50:13

I 100% agree. People need to hear their vo have their voices be heard and hear other people's voices.

SPEAKER_00
50:20

Just kind of an open mic. Open mic. Open open open mic to the board.

SPEAKER_01
50:24

Yeah. Yeah. And it and it may be that you have to do some pre pre pre-survey homework, like what might be five or six key areas and and just sort of that that truly are what you all perceive, maybe some of the roadblocks and challenges, the balcony view of it all, right? And but I don't, you know.

SPEAKER_02
50:43

Maybe to have some guidelines about it.

SPEAKER_01
50:45

I understand that that it's that it's very difficult in a shortened abbreviated meeting now. And there's costs, right? But uh there's also cost to not letting people feel like they're being heard.

SPEAKER_00
50:59

Well, the I will tell you that uh uh handling a handling bylaws at an annual meeting in virtually impossible. It it was impossible. And I think it was certainly done with uh with integrity as an intent, uh but it was uh it was an imperfect, imperfect process. Uh and I think we're going to have to have conversation about what the future looks like. Um we are, I mean, we another piece of good news is we are in a better financial place than we have been for the last several years. In 2023, we were almost a million dollars in debt.

SPEAKER_01
51:45

Yeah.

SPEAKER_00
51:46

And most of that is most of that has been cleared away. Uh and we have the opportunity, I think, maybe to think about what can we what can we do that we haven't been able to do.

SPEAKER_01
51:58

Yeah.

SPEAKER_00
51:59

And maybe what would what's what's worked going back and saying what's worked in historically for us. Right.

SPEAKER_02
52:06

That's yeah, I'm very interested in that part.

SPEAKER_00
52:09

Yeah.

SPEAKER_02
52:09

Yeah. As I'm getting older, I'm looking toward our legacy midwives and and the organization to say what worked and how can we like bring everybody back together with this common goal of what we do as midwives, you know, what we do as midwife. Could that just be the gold star that brings us all together and re-guides us? I mean, I have hope. You wouldn't be on here if you didn't, Denise. I have so much hope. And I I I personally like um, you know, I personally am working my own clinical, like my practice group because they're growing and um, you know, reinvesting in our affiliate because like we now have a fantastic, you know, dedicated new president of our affiliate. And she's called me to the carpet because she said, You said if I became president, you would help. And I said, I I will. Like, I you became president, I will now.

SPEAKER_03
53:02

Yeah.

SPEAKER_02
53:03

Yeah. So I I do have a lot of hope. I just think we need the space to talk.

SPEAKER_00
53:10

What the one thing that I like, uh that I'm seeing that I like is that there uh there are more small uh regionalized community-centered education programs that are being established.

SPEAKER_01
53:24

Oh my gosh, Peter. They're all they're popping up everywhere.

SPEAKER_00
53:27

We're starting to see we didn't see growth all the time. You know, Denise and Jinder, we'd have one grow one open and one closed. Oh my gosh.

SPEAKER_01
53:36

It's it's crazy making, Peter. They're I mean, we're talking to three right now.

SPEAKER_00
53:40

And all of our I'm talking to a couple right now.

SPEAKER_01
53:43

I mean, there's like no way. I mean, it it it is, yeah. It it's that's exciting.

SPEAKER_00
53:48

And so exciting. And thank you for the work that you've done there. Uh grow mid go grow midwives, because you know, for a long time our uptake in number of certificates were was largely due to a couple of programs. That's honestly not I I have great respect for the uh for you know for those programs, but uh it's it's not healthy to have it's not healthy to have all your eggs in one basket. Yeah. Yeah. And and I think you know, programs that can prepare folks within that community for that community, uh, I think that I I think that helps to engage midwives and you know, clinical midwives in building the next generation.

SPEAKER_01
54:34

Well, they and I think they become stronger influencers because they know they've been there. They've they've they've lived it side by side.

SPEAKER_00
54:41

Yeah. So if they get those folks in those students into their state affiliates and they're working locally, uh, you know, these we we have so, so many uh good good folks out there that are capable, have great capability.

SPEAKER_01
54:58

I I think our growth is is is going to continue. Everything I read, all the forecasts I read, we're we're not ever gonna be like the same numbers of the CNS, but our growth is continuing. And so the formula is how do we how do we move that growth into uh uh membership and contribution as as a member? And that changes with where you are in your career, but I have hope. I I mean I we encourage people all the time, and we're not gonna stop. So yeah, we are to a point, however, we're about the top of the hour, Denise. I can't believe how fast that went.

SPEAKER_02
55:37

I I you know we all could keep talking for a long time. Maybe we'll we will I know.

SPEAKER_01
55:43

You know, Peter, uh, you've listened to our podcast, so we do this call to action round robin of what we really want to leave our listener with that that they can actually think about doing. What would you like to call out?

SPEAKER_00
55:58

Well, I'll start with my new mantra. ACNM belongs to all of us. We need all of us rolling up our sleeves and doing the work uh that needs to be done. Uh I this is for the people midwives that aren't ACNM members. Uh if you uh if if you want if you want to make a difference, if you want to uh if you want to see a future, uh come give us give it a give it a chance, give ACNM a chance. Uh and if you are a member, sign up for a volunteer uh leadership opportunity. There uh there are all sorts of there are all sorts of places that there's a great deal of need. And uh there we're only asking for a one-year commitment now. You don't have to sign up for life. If you don't like what you're doing, you can try something, try something else out. But we we need everything. And I guess the other thing, call to action would be if you are a regulator in a state and you are working with particularly those boards of nursing out there, uh, think about regulating the certified midwife. If you're a dean out there in a nursing program, there's no reason that you can't you can't educate folks that uh that come from a background outside of nursing. We that's right. Nursing's an important pathway, but we don't have the luxury of not including others.

SPEAKER_01
57:25

Yeah, that's that's my call.

SPEAKER_00
57:27

I could keep going, but I'll stop.

SPEAKER_01
57:29

Thanks, Peter.

SPEAKER_02
57:30

Denise, do you wanna do you wanna go next? I I think my call to action is really just every, you know, a a group of people is what, more than two, right? So every group um of every clinical group, practice group, um, you know, begin having the discussion of how we can really unify midwives across the US and and start to make some change. Like even small groups can can make can have you know objectives and goals to move forward to the greater good, and then bring those together. So if you're two or more, let's do something.

SPEAKER_01
58:11

I like that. I like that. Um, I'm gonna end with you know, this has gone around a lot with a lot of a lot of ways to interpret it. If you're not part of the conversation, you're part of the problem. And so one of the things I would I would ask midwives who have been members and left or who have never been members is send your um send your affiliate president and your ACNM president, Dr. Peter Johnson, an email and share what your frustration is. I mean, I'm I'm reading them on social media. I I know you have frustrations, but maybe the message needs to be conveyed in a way that um you feel like there's another opportunity, even if you don't get direct feedback or an answer to solve it, there is an opportunity to be heard. And lots of times I think we give up and just walk away because um you've tried too many times. And I'm gonna say you need to try again. One more time. One more time. One more time.

SPEAKER_00
59:21

Give me a chance.

SPEAKER_01
59:22

Yeah.

SPEAKER_00
59:23

President at CNM.org.

SPEAKER_01
59:25

There you go. You got his email. And actually, if you're okay with it, Peter, we're gonna put it on our Buzz Sprout website so people can find it very quickly. We we can't thank you enough. We know, Peter, you're overwhelmed and busy. And also, it was a perfect time to have you join us. So thank you.

SPEAKER_00
59:43

Thank you. Thank you so much, Peter. We will stay in touch. We we are behind you. Okay.

SPEAKER_01
59:49

And beside you. And we'll hold you up all times. All right, Denise. Uh thank you so much. Our next podcast, uh, we we think we know who that is. Shall we announce it or not?

SPEAKER_02
1:00:02

Um Ginger, do it.

SPEAKER_01
1:00:06

Okay. We are um we're excited to bring on um Dr. Neil Shaw, who many of our listeners know um is an OBGYN that now is the CMO of Maven. Uh, but um, I I now fondly call him Neil. He's sort of like my fifth son, um, is gonna come on and talk about the maternal health crisis and midwifery as part of the solution. So we're very excited to have you along and continue these opportunities of sharing with um our listeners how midwives make a difference.

SPEAKER_02
1:00:41

So we're excited for him to come in.

SPEAKER_01
1:00:44

All right. Well, it's good to see you, Peter. Thanks, Denise, and thank you both.

SPEAKER_02
1:00:49

Bye. Bye now.

View original transcript source