We are facing a maternal health crisis in New Jersey and the hospitals (all but 3 in the entire state) are refusing to be part of the solution. It is unacceptable.
The fact is that the way obstetrics is currently being practiced in New Jersey has put us at the bottom of the country for birth outcomes. Our maternal mortality rate is scary. We are the 4th WORST state in the country! In the United States, our maternal morbidity rate is 17.2 deaths per 100,000 births whereas in the Netherlands, Norway, and New Zealand, that rate drops to 3 or fewer women per 100,000.
Cesarean delivery is associated with 2.7 times the risk of severe maternal morbidity (95% CI: 2.6, 2.7), compared to vaginal delivery, and was estimated to contribute to 37% (95% CI: 36, 38) of severe maternal morbidity cases in the population (source).
New Jersey’s cesarean rate in 2019 was 33.2%. The Midwives of New Jersey consistently has a cesarean rate between 10 and 15% (our stats), this is 1/3 to ½ of the state norm. We can assume that the overall cesarean rate in the general population would be higher when high risk situations are taken into account but despite that, there are still way too many unnecessary surgical births. Midwives are trained to respect the physiologic nature of childbirth by avoiding unnecessary interventions. It’s simple: lowering interventions results in more vaginal births.
The Solution is Obvious: Access to more Midwives
The Midwifery Model of Care has once again been acknowledged as THE answer to the disastrous birth outcomes in New Jersey and the rest of the country. The Burke Foundation in partnership with the New Jersey Health Care Quality Institute (organizations that work to improve the lives of families in New Jersey) published a report calling to advance the midwifery profession in New Jersey. Reports like this one from the Burke Foundation have been published many times before and yet there continues to be NO change. Talk is cheap and action is needed!
As it stands, Midwives have been doing about 10% of the deliveries in the USA for the past 30 years. We have so many barriers to practice, we cannot grow. Among the many reasons Midwifery growth has been stymied is a lack of understanding of the profession across the board. Women, doctors, facility administrators and law makers have no idea what we do and what they DO “know” is often wrong.
The ACNM, ACOG & New Jersey Have Recognized the Barriers Preventing Access to Midwifery Care
The Certified Midwife (CM) credential is a solution to the low numbers of Midwives in New Jersey.
Up until recently, anyone who decided to become a Midwife in New Jersey had to go to nursing school beyond their current bachelor’s degree before they could even begin the Midwifery program. That is a huge deterrent to highly motivated people becoming Midwives. It is incredibly expensive and time consuming to pursue a degree that you do not intend to use.
The ACNM has recognized that being a nurse is not essential to practicing Midwifery. The credential Certified Midwife was created to shorten the path to Midwifery. A CM is considered equal to a nurse Midwife. They have the exact same education, and exact same certification, they just are not nurses. This credential has been endorsed as equal by the American College of Obstetricians and Gynecologists. The state of New Jersey licenses Certified Midwives to practice in New Jersey.
This path to Midwifery allows people who already have an undergraduate degree that is not in Nursing to enter the Master’s degree Midwifery program as soon as possible. With 2 CM schools in close proximity to New Jersey-SUNY Downstate and Thomas Jefferson University-we have a pool of graduates who could help MNJ and other Midwifery practices grow.
A Barrier to Growing Midwifery Care Still Remains in New Jersey
This would seem to be great news except NJ hospitals will not allow CM’s to practice. Midwives of New Jersey hired Yenniffer Moreno-Lugo CM after the NJ DOH signed a universal waiver recognizing the practice of Certified Midwives in December of 2020. This waiver should allow CMs the same authority as CNMs to practice in licensed facilities in the State. Morristown Medical Center will not process Yenniffer’s application for privileges stating that “Certified nurse midwifes (CNMs) have education and training in nursing which is absent from the training of someone licensed as certified midwife (CM). Because of that nursing experience and background, CNMs are well-suited to act as patient advocates and to further a holistic delivery of health care.” Why does the hospital get to decide that CM’s are substandard Midwives when ACOG and the Board of Medicine say otherwise?
Midwives of New Jersey is a private Midwifery practice that is working against much opposition to provide the families SAFE, satisfying maternity care. If you would like to help advocate for greater access to Midwifery Care, please read and sign the petition below.
Petition in Favor of Certified Midwives Gaining their Lawful Right to be Credentialed in NJ Hospitals.
In New Jersey, only Certified Nurse Midwives can practice in hospitals apart from 3 hospitals. Becoming a CNM is a huge investment of time and money that many cannot afford.
The CM credential eliminates a huge barrier to entry by allowing people to go directly to graduate school to become a Midwife. With the cooperation of the hospitals, CM’s could increase the number of Midwives practicing in New Jersey and allow for a more diverse group of Midwives.
Certified Midwives are unable to practice in most New Jersey hospitals due to a misunderstanding of their credential and to antiquated bylaws. The CM credential requires the same education and board certification as CNM’s and is recognized by the American College of Obstetricians and Gynecologists as equal to Certified Nurse Midwives (Source).
Additionally, in December of 2021, upon Nurture NJ’s recommendation 5.11.1 (Source), the Department of Health signed a waiver recognizing the practice of CM’s in NJ – giving them the same practice authority as CNM’s in licensed facilities in the State (Source).
Midwifery is associated with better birth outcomes, and increased patient satisfaction. Our care is cost effective. Yet despite the clear benefits of Midwifery care, New Jersey hospitals’ refusal to recognize the CM credential as identical to CNM is creating significant barriers to accessing Midwifery care.
I support the Midwives of New Jersey request for the support of the NJ Department of Health to help Certified Midwives gain their lawful right to be credentialed in NJ hospitals.