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MIDWIVES AT EVERY TABLE: CELEBRATING NATIONAL MIDWIFERY WEEK 2025

Updated: 3 days ago


Meet four Fresno Midwives, Brittany Burris CNM, WHNP, Brittany Mbong, CNM, WHNP, Katee Finks, MSN, CNM, and Elizabeth Reinholt, CNM, C-EFM!

As we reflect on this year’s theme for National Midwifery Week 2025, “Midwives at Every Table: Practice, Policy, and Research” we cannot ignore the history and experiences of midwives who have been intentionally excluded from practice, research and through policy. We must also acknowledge that because of systemic oppression and historical campaigns to delegitimize midwifery, there is often confusion around midwives, their education, training, what they do, how they work, where they can work, etc.  

 

Midwives are more than birth attendants, they are clinicians, educators, researchers, and policy changemakers. We hope this article will give you a new appreciation for the necessity of midwives and encourage you to support efforts that increase access to (lifesaving) midwifery care.   

 

A Short History of Midwifery in the US

Midwifery is one of the oldest professions in history, practiced in diverse ways across cultures and countries. In the early history of the United States, many practicing midwives were enslaved Black women, often referred to as ‘Granny Midwives’ who were the healers, advocates, and pillars of their communities. In Southern and rural states, Black midwives attended around 75% of all births until the 1940s. Learn more about the history of Black Midwifery here. 

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In the early 1900’s, midwifery care, especially Black midwifery came under attack. Obstetric and gynecological (OB-GYN) medicine was becoming more common and dominated by white male doctors. Campaigns were waged and laws were passed to push out midwives labeling them as unsafe and uneducated. Even when midwifery was later formalized through nurse-midwifery programs in the 1920s, Black women were excluded. This has had huge impacts on midwives who practice, even today as less than 5% of midwives in the US are people of color...Black Midwifery in the US – Western Center on Law & Poverty 


A major consequence associated with the decline of midwifery care was an increase in maternal and infant mortality rates and decrease in health outcomes. For many years, white physicians blamed maternal deaths during childbirth on midwives. In 1930, the White House Conference on Child Health and Protection published research that showed midwives did not influence high maternal mortality in any area of the country. Even so, the attacks were very successful, and the number of practicing midwives dropped dramatically. This negatively impacted access to care and health outcomes for Black mothers and babies.  

In more recent history, rising awareness of maternal mortality, infant mortality, racial/ethnic disparities (especially for Black women), preterm birth, low birthweight, etc., has led to research for models of care that produce better and more equitable outcomes. We now have a large and growing body of research that shows how midwifery improves maternal and infant health outcomes.


Pictured: Elizabeth Reinholt, CNM, C-EFM and Brittany Mbong, CNM, WHNP, Fresno Women’s Medical Group/Clovis Community Hospital
Pictured: Elizabeth Reinholt, CNM, C-EFM and Brittany Mbong, CNM, WHNP, Fresno Women’s Medical Group/Clovis Community Hospital

Midwifery Today: California and the Central Valley 

In California, both Certified Nurse-Midwives (CNMs) and Licensed Midwives (LMs) provide comprehensive, person-centered maternity care.

 

What is a Certified Nurse-Midwife (CNM)? 

Nurse-midwives, or "certified nurse-midwives" (CNMs), are masters-prepared or doctorally-prepared nurses who have first completed training in nursing and have taken the registered nursing license exam. In addition to training as a nurse, the nurse-midwife has completed a higher education program (either a master's or doctoral degree focusing on midwifery) and performed hundreds to thousands of additional clinical hours managing both primary care patients and attending births during their training.  

 

Certified Nurse-Midwives have an increased scope of practice that allows them to diagnose and treat patients within their area of expertise, including independently managing the birth of a baby. The area of expertise for a nurse-midwife includes both primary care and maternity care for healthy women across the lifespan and their families. They typically practice in hospitals but can provide care in out-of-hospital settings like birth centers and home births as well.  

 

Learn more about CNMs here. 

What is a Licensed Midwife? 

Licensed midwives' scope of practice includes normal, low-risk maternity care (prenatal, labor, birth, postpartum, newborn) in out-of-hospital settings: home births, freestanding birth centers. LMs are more limited, for example when complications arise, they must refer to higher level care. LMs do not have the same prescriptive authority as CNMs and must rely on collaborating physicians or transfer in cases needing medical management.  


The Need for More Midwives, Especially Midwives of Color  

Even with the resurgence of midwifery and the evidence to back up its necessity, we still face a massive shortage. There is currently only one master’s degree program for nurse-midwifery in California, creating a major barrier for aspiring midwives and limiting access to care statewide. According to a report from the California Healthcare Foundation, in 2023, there were only 30 practicing midwives (both LMs and CNMs) per 10,000 births in California. The report pointed out a low of 11 practicing midwives in the San Joaquin Valley.


The lack of representation of Black midwives is also a major issue as approximately 774 of the licenses issued in California, fewer than twenty went to Black midwives. 


Read Understanding California’s Midwife Workforce here.  

 

Midwives at Every Table: Supporting SB 520 

Addressing the shortage of midwives has become a key focus for California Senator Anna Caballero who introduced SB 520, the Nurse-Midwifery Education & Workforce Act in March 2025. By expanding midwifery education programs, SB 520 will strengthen the pipeline of nurse-midwives and expand access to maternal and infant health care in the communities that need it most. Learn about SB 520 here.

 

In July, Brittany Mbong, CNM from BWPC, offered testimony at the California State Senate in support of SB 520. She is a perfect example of how midwives provide more than direct care; they lead and advocate for their communities as well. Brittany's testimony at the capitol highlights the importance of legislative support in addressing the maternal health crisis and expanding access to midwifery care. In September, SB 520 passed the Legislature and is on its way to the Governor’s desk.  


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Watch Brittany's full testimony here.

 

Culturally congruent midwifery care is a critical part of improving maternal and infant health outcomes, especially in communities of color. SB 520 will help build a stronger more diverse pipeline of midwives for communities experiencing disparities and ultimately improve health outcomes. 

 

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The Future of Midwifery 

Access to educational programs is just one of many barriers limiting the growth of the midwifery workforce. According to the World Health Organization (WHO) midwives could be providing 90% of sexual and reproductive care in the United States but the healthcare system is not set up to support midwives or midwifery-led care models.  


Midwives also face significant barriers due to restrictions on their autonomy and scope of practice, often limiting the full benefits of their care. In most states, midwives cannot admit patients to hospitals, which is where most births occur. Some hospitals even exclude midwives and choose to not offer midwifery care all together. Midwives are also reimbursed less than physicians by both private and public insurers. Consequently, practices are less likely to hire midwives since they generate less income than doctors. 


Professional associations like the American College of Nurse-Midwives have outlined policy strategies and priorities to address these barriers midwives face. You can check out more about their advocacy work here.  


What you can do!

Individuals can also play a role by raising awareness and advocating for policies that expand access to midwifery care and support the integration of midwives into the broader healthcare system. 


Follow us on social media to check out our National Midwifery Week videos highlighting Central Valley Nurse-Midwives. You can also check out the hashtag #NMW25 to check out what other midwives and orgs are doing to celebrate this week!  



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