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					•   Midwives
      North American

    Regist ry of Midwives
        of North America
                                                                                    news                                                          •



              Providing certification standards for
                                                                                                 Volume IV, Issue 2, July 2001
                Certified Professional Midwives

                                                            •                                                                                     •
                                                            A Tribute to Sharon Wells MS, LM, CPM

                                                            by Robbie Davis-Floyd
                                                                                                         assisted in the births of over 400 babies,
                                                                                                         including her granddaughter. She began
         S U P P O R T E R                                     Apprentice education is one of the        learning midwifery on the Farm in
                                                            most intense educations you can get as       Summertown, Tennessee during the
•                                                       •   a midwife - practical and hands on, es-      1970s, where in 1976 she also became
Inside This Issue                                           pecially if you follow the core compe-       certified as an EMT. In the early 1980s,
                                                            tencies set out by MANA and meet the         she moved to Gainesville, Florida where
Tribute to Sharon Wells . . . . . . . . . . 1               standards of NARM.                           she undertook a two-year apprenticeship
NARM Herstory – Part One . . 3, 5, 10                                        —Sharon Wells, CPM, 1999    with midwife Susan Shapiro. In 1983 the
NARM Policy:                                                                                             DEMs of Florida achieved passage of new
                                                               It is an honor to write this article      legislation, which mandated attendance
Policy on Participation in Statistics
 Projects . . . . . . . . . . . . . . . . . . . . . 4       about Sharon Wells, one of the founding      at a midwifery school. Rising to the chal-
                                                            mothers of American midwifery. Sharon        lenge, Sharon tapped her expertise in
CPM Revocation Information . . . . . 4                      made important contributions to the de-      education to become one of the found-
Policy on Public Education and                              velopment of direct-entry midwifery in       ing mothers and first Administrator of
 Speaking Engagements . . . . . . . . . 5                   the US in three states—Florida, New          the North Florida School of Midwifery. A
Policies and Procedures . . . . . . . . . 5                 York, and Tennessee—and then went on         true midwifery pioneer, she graduated
                                                            to effect change at the national level       from the school she helped to found and
Committee Reports:
                                                            through her instrumental role in envi-       was licensed by the state of Florida in
Applications Report . . . . . . . . . . . . . 6             sioning and creating NARM certification.     1988.
CPM2000 Report . . . . . . . . . . . . . . 6                   Sharon Wells is the homebirth mother         In 1989 Sharon and her family moved
                                                            of 2 daughters. She graduated from the       to New York to help care for her ailing
ACNM Conference Report . . . . . . . . 7
                                                            University of Tennessee with her BS in       father-in-law. While running a thriving
Notices & Announcements:                                    Education in 1966, and obtained her MS       home birth practice on Shelter Island,
Attention All CPMs! You, Too,                               in Educational Psychology, with a special-   she also took on a leading role in the leg-
 Could Be A Qualified Evaluator! . . 8                      ization in Reading, in 1972. She has been    islative efforts of the New York direct-
Would You Like to Serve on the                              a practicing midwife for 19 years and has    entry midwives, becoming a founding
NARM Board of Directors? . . . . . . . 8
National Association of Certified
 Professional Midwives Forms . . . . 8
CPM Professional Organication . . . 9                              Dear Sharon,
Numbers Matter! . . . . . . . . . . . . . . 10
                                                                      The NARM Board wishes to thank and honor you for all the years of
IMPORTANT! New Recertification                                     dedication and service you have given to NARM and the preservation of
 Address . . . . . . . . . . . . . . . . . . . . 10                midwifery in this country. You have been instrumental to the advance-
Certification Revocation . . . . . . . . . 10                      ment of midwifery through the CPM credential. Your vision was part of
Conferences and CEUs . . . . . . . . . 10                          the early impetus for the development of the CPM; your drive and dedi-
                                                                   cation have been important factors in its present success. Over the eight
Address Correction . . . . . . . . . . . . 10                      years of your hard work on the NARM Board, you developed knowl-
NARM Needs Pictures! . . . . . . . . . 10                          edge, wisdom, and perspective that greatly facilitated the increasing
Proof of CPM Status . . . . . . . . . . . . 10                     sophistication and organization of the CPM process, midwives’ legisla-
                                                                   tive efforts in many states, and NARM’s work with state agencies. We
From Your Peers:
                                                                   appreciate you and all that you have done for direct-entry midwives and
Building Relationships Between                                     the women they serve.
 Midwives . . . . . . . . . . . . . . . . . . . 11                                                              With love and appreciation,
RN Researching Friedman’s Curve,                                                                                           The NARM Board
 Requests Input . . . . . . . . . . . . . . . 11
Information Requests . . . . . . . . . . . 12
                                                 Tribute to Sharon
                                               mother and the first president of the          early 1990s the Interim Registry Board
                                               Midwives’ Alliance of New York (MANY).         evolved into the North American Registry

         CPM News                              For four years, until the passage of the
                                               New York Midwifery Practice Act in
                                               1993, she worked to find a way for
                                                                                              of Midwives (NARM). In 1993 Sharon
                                                                                              was invited to become a member of the
                                                                                              NARM board.
                                               DEMs to be included in the proposed               Sharon came to NARM with a vision
                                               legislation. She planned strategy, sat in      and a sense of mission about realizing it.
       CPM News is a newsletter of the         meetings, lobbied legislators, and helped      Her vision included a concrete plan to
    North American Registry of Midwives        to garner a great deal of grass roots sup-     turn the NARM registry process into a
    (NARM) published twice a year in Janu-     port. For a time it seemed as if her ef-       full-fledged certification. She saw that
    ary and July. We welcome submissions       forts would bear fruit, but when the bill      this certification had to be competency-
    of questions, answers, news tips, tid-     was actually passed, the final version did     based—it had to focus on what a mid-
    bits, birth art, photographs, letters to   not open the hoped-for pathways to le-         wife knows and can do, not how she
    the editor, etc.                           galization and regulation for the practic-     learned it. From 1993 when Sharon
       Deadlines for submissions are De-       ing direct-entry midwives in New York, as      joined the NARM board, till 2000 when
    cember 1 and June 1. Send all newslet-     Sharon explains in “The New York Legis-        her term of office ended, she played a
    ter material to: Debbie Pulley, 5257       lative Sellout.” 1                             variety of key roles in creating and imple-
    Rosestone Drive, Lilburn, GA 30047 or         In the midst of this intense lobbying       menting NARM certification. She
    CPMinfo@aol.com                            effort, Sharon also participated in the        authored or coauthored all of NARM’s
       The views and opinions expressed        Interorganizational                                                    major documents,
    by individual writers do not necessarily   Work Group (IWG).                                                      including How To
    represent the views and opinions of        Sponsored by the                                                       Become a CPM and
    NARM.                                      Carnegie Founda-                                                       the application
                                               tion, this group con-                                                  packet. She was
    •                                     •    sisted of consum-                                                      heavily involved in
    Contact Information                        ers, and representa-                                                   designing and imple-
                                               tives from MANA                                                        menting NARM’s
    NARM General Information                   and from ACNM.                                                         1995 Job Analysis,
    (or to order How to Become a CPM)          During their years                                                     the largest survey
    888-842-4784                               of meetings and                                                        ever carried out of
                                               dialogue in the early                                                  practicing direct-
    Applications & Recertification:            1990s, the mem-                                                        entry midwives; the
    NARM Applications                          bers of the IWG                                                        Skills List she had
    PO Box 672169                              attempted to come                                                      compiled was used
    Chugiak, AK 99567                          to some agreement                                                      as the starting point
    907-689-7792                               about educational                                                      for developing the
                                               routes and standards for midwifery.            survey. She interfaced with state regula-
    NARM Board                                 Their efforts were ultimately unsuccess-       tory agencies to help them understand
    Debbie Pulley                              ful, but Sharon came away from those           NARM requirements and to design state
    5257 Rosestone Drive                       meetings and from events in New York           legislation and regulation accordingly.
    Lilburn, GA 30047                          with an enhanced understanding of              And she liaisoned with midwives in vari-
    888-842-4784                               DEMs’ need for a national certification        ous states to help them plan effective
    CPMinfo@aol.com                            that could validate their education, skills,   legislative strategies and to work for in-
                                               and experience, no matter what their           surance reimbursement. Her title was
    Qualified Evaluator information:           educational route. In particular, Sharon       Certification Coordinator.
    Lynn Shay                                  understood that developing such a certi-          After trying unsuccessfully to achieve
    19 Anthony’s Mill Road                     fication would be critical to preserving       licensure in New York under the 1993
    Barto, PA 19504                            apprenticeship. During the IWG meet-           law, Sharon moved back to the Farm. In
    610-845-8181                               ings, Sharon had begun compiling a Skills      addition to her work for NARM, she be-
    Midweif@aol.com                            List, starting with lists already developed    came involved in the successful effort to
                                               by the existing direct-entry midwifery         achieve passage of Tennessee’s new mid-
    CPM News Editor:                           schools.                                       wifery law in 2000. And for several years
    Abby J. Kinne                                 In the late 1980s MANA had created          she has been active in the Maternal Child
    58 South Center Street                     an Interim Registry Board whose charter        Health section of the American Public
    West Jefferson, OH 43162                   was to develop an examination to test          Health Association, working to getting
    614-879-9835                               midwifery knowledge. The original inten-       the APHA to pass a resolution endorsing
    ShortStork@aol.com                         tion was to develop a national registry of     CPM certification. She retired from the
                                               those who had passed this written exam.        NARM board in 2000 when her second
                                               Over 400 midwives were eventually              term of office ended; her work with
                                               listed in this voluntary registry. In the      APHA is ongoing.

2                                                                                         N ORTH A MERICAN R EGISTRY   OF   M IDWIVES , J ULY 2001
   At present, there are almost 700 CPMs                COMING A MIDWIFE: GETTING AN               dential was desirable. Guiding principles
in the U.S. and several in Canada and                   EDUCATION. Midwifery Today, Inc.,          were developed regarding numbers of
Mexico; the majority have been educated                 1998.                                      experiences, requirements for a written
through apprenticeship. This interna-                 Nelson, Carol and S. Wells, “Certified       and a skills test, and administrative is-
tional certification is the only one in the             Professional Midwives Can Improve          sues. The standards and practice com-
world that preserves all routes to mid-                 the Quality of and Access to Maternity     mittee called for midwifery organizations
wifery and emphasizes the skills needed                 Care Services for Women Who Desire         to send in their own practice guidelines
to attend out of hospital births. It has                Birth in Out-of-Hospital Settings,”        to be compiled for reference in further
thus become critical not only to Ameri-                 PROPOSED POLICY STATEMENTS                 decision making. They planned a practice
can midwives but also to the interna-                   published in THE NATIONS HEALTH.           survey for 1986 of all midwives. The edu-
tional midwifery movement. The NARM                     September, 1999.                           cation committee began collecting com-
Board wishes to acknowledge Sharon’s                                                               petency models from various midwifery
core contributions to the development                                                              organizations. They also planned to ar-
of CPM certification and thus to the pres-            •                                       •    ticulate the various educational models.
ervation of home birth midwifery and                  NARM Herstory                                The same debate over yes, no, the slip-
apprenticeship. We honor her as pioneer               Part One                                     pery slope to credentialing hell contin-
and Founding Mother, and we conclude                  by Ruth Walsh                                ued. The credentialing committee came
this tribute to Sharon with her own                                                                up with a registry proposal. The whole
words, excerpted from her article                        I have been asked to write a history of   issue was to be voted on by the member-
“Caught in the Middle of the Maternity                NARM. Where do I begin? With a birth         ship in West Virginia at the 1986 meet-
Care Crisis and a Political-Educational               analogy, what else? MANA, of course, is      ing.
Debate”:                                              the mother. Conception, as is often the         In West Virginia the debate was hot
   There is a need for midwives in all set-           case, occurred in mystery. The latent        and heavy, revolving mainly around li-
tings—hospitals, clinics, birth centers               phase I would rather term the pro-           ability issues, discipline and due process,
and homes. Midwifery educators need to                dromal stage. Maybe because it sounds        and educational prerequisites. The de-
be united in the primary goal of increas-             like drone and my memory of this time        bate was fierce but a vote of confidence
ing the number of midwives in a timely                was of a constant everlasting droning of     on the concept of developing a voluntary
fashion. It is not a competition over                 all the pros and cons of credentialing       national midwifery examination was al-
whether midwives should be nurse-mid-                 versus no credentialing, masculine vs.       most unanimously in favor. The outcome
wives or direct-entry midwives or work-               feminine, regulation vs freedom, volun-      was a proposal to appoint an Interim
ing in homes or hospitals. Every midwife              tary vs compulsory. I do not mean to         Registry Board to figure out the liability
is necessary, and all routes of entry into            suggest that it was boring, because in       issues and report back to the MANA
midwifery must be validated quickly if we             that heyday, it seemed the finest femi-      board. In 1987, the first board was ap-
are to make a timely difference in                    nine minds in the country were endlessly     pointed, including Sandra Abdullah-
America’s maternity care crisis.                      articulating with passion and brilliance,    Zaimah, Lisa Hulette, Katherine
                                                      the clearest ideas surrounding these is-     Kaufman, Susan Liebel, Rosemary Mann,
Note:                                                 sues. The debate spilled into the alterna-   Tina Moon and Elizabeth Davis as liaison
1
  Sharon’s published articles are impor-              tive press, I believe, and was not con-      to MANA.
    tant for understanding why she and                fined to midwifery publications. Can it         The IRB decided that the test would
    NARM have fought so hard to pre-                  only have been twenty years ago? It          cover knowledge only, would not certify
    serve apprenticeship as a valid form              seems a life time of meetings have passed    competence but only knowledge. Com-
    of midwifery education. They include:             since the article discussing the pros and    petency was left to local jurisdictions.
“Midwives’ Alliance of New York Educa-                cons of credentialing appeared in the        The IRB also made it clear that it could
    tional Proposal,” MANA NEWS. Vol.                 MANA news in September of 1983.              not proceed without the core competen-
    VIII, No. 3, July, 1990.                             Several committees in MANA were           cies from the education committee. The
“Waban’s Story,” THE BIRTH GAZETTE.                   evolving at this point. The credentialing    MANA budget allocated $100 to the
    Vol. 6, No. 3, Summer, 1990.                      committee reported that they were at an      credentialing committee, $300 to the
“The New York Legislative Sell-Out,” THE              information gathering stage, for indeed,     education committee, and $0 to the IRB.
    BIRTH GAZETTE. Vol. 8, No. 4, Fall,               MANA existed but we hadn’t a clue who           In 1988 I became chair of the IRB. At
    1992.                                             we really were. The standards and prac-      that time we were still waiting for the
“Direct Entry Midwifery Education:                    tice committee was busy and at the an-       core competencies and other guidance
    Caught in the Middle of the Maternity             nual meeting in 1984, in Toronto, 200        from MANA. We were also trying to fig-
    Care Crisis and a Political/Educational           midwives of every stripe, from Shamanic      ure out how to go about developing an
    Debate,” THE BIRTH GAZETTE. Vol.                  to CNM, came to consensus on a State-        exam of national stature. The idea of a
    9, No. 2, 1993.                                   ment of Standards of Practice. T. Charvet    committee or a person writing the exam
“Entry Level Midwifery Skills List Revision           and J. Rooks promoted formal education       did not strike me as having any particular
    # 3,” THE BIRTH GAZETTE. Vol. 9,                  in the MANA News.                            credibility. There was a national organi-
    No. 3, 1993.                                         At MANA’s 1985 annual meeting, the        zation for credentialing (that eventually
“Direct-Entry Midwifery Education:                    membership came to consensus that            ○   ○   ○   ○   ○   ○   ○   ○   ○   ○   ○   ○   ○   ○   ○   ○   ○   ○   ○   ○   ○




    Caught in the Middle,” PATHS TO BE-               some kind of voluntary certification cre-    continued on page 5

J ULY 2001, N ORTH A MERICAN R EGISTRY   OF   M IDWIVES                                                                                                                            3
    NARM Policy
•                                           •        birth reports to the statistics commit-    •                                                •
NARM Policy on                                       tee will be allowed to submit those        CPM Revocation
Participation in the                                 reports late. Recertification will not     Information
                                                     be permitted until the reports are
Statistics Project:                                  turned in. If the statistics are submit-
                                                                                                   According to the Candidate Informa-
                                                                                                tion Bulletin, In the case of dishonesty,
                                                     ted prior to the recertification date,
                                                                                                refusal to inform, negligent or fraudulent
   All CPMs were required to participate             the CPM will receive credit for 25
                                                                                                action of self-interest in which the certi-
in Project 2000, a collection of CPM birth           CEUs toward recertification. If the
                                                                                                fied midwife compromised the well being
statistics for the year 2000. Full partici-          forms are received after the certifica-
                                                                                                of a client or client’s baby, or with non-
pation is required for recertification.              tion has expired, no credit will be
                                                                                                compliance to the NARM Grievance
The statistics committee has been busy               given for CEUs. The expired CPM will
                                                                                                Mechanism, this CPM’s certificate must
collecting the data, and many CPMs have              need to meet all requirements for late
                                                                                                be revoked.
continued to send in their stat forms for            recertification after submitting the
                                                                                                   After two years, the midwife may re-
births in the year 2000 and beyond.                  required statistical forms.
                                                                                                apply for NARM certification by sending
When the statistics committee has com-           3 ) CPMs who did not fulfill the statistics
                                                                                                a letter of intent to NARM Applications.
pleted the input of current data, NARM               project requirements will not be al-
                                                                                                   A request for the current CPM Applica-
will send a Statistics Completion Certifi-           lowed to recertify until they have sub-
                                                                                                tion and a money order for $50.00 (ap-
cate to all who participated as required.            mitted statistics forms on all births
                                                                                                plication packet fee) must accompany
   The response of CPMs to the statistics            done in 2000. These statistics will not
                                                                                                the letter of intent. Complete instruc-
project falls into four categories:                  count as prospective data for the
                                                                                                tions will be sent to the applicant includ-
1 ) Those who submitted all logs and sta-            NARM project, but will count in the
                                                                                                ing the following:
    tistics forms on births done in the              general MANA statistics collection.
    year 2000;                                       Upon submitting statistics forms, the
                                                                                                1 . To complete current General Applica-
2 ) Those who submitted some statistics,             CPM will be allowed to recertify but
                                                                                                    tion Form 100 and
    but have not submitted reports on all            will need to meet all current recertifi-
    births listed in their logs for 2000;            cation requirement including CEUs
                                                                                                2 . NARM Certified Professional Midwife
    and                                              and any applicable late recertification
                                                                                                    (CPM) Application
3 ) Those who did not submit any infor-              fees (see the web page or the Recerti-
    mation for the year 2000                         fication forms for late recertification
                                                                                                3 . The application fee ($700 money or-
4 ) Those who were not practicing and/or             information).
                                                                                                    der or Cashier’s Check)
    had no reports to turn in, but who did       4 ) CPMs who did not attend any births in
    notify the statistics committee that             the year 2000 will be allowed to recer-
                                                                                                4 . Documentation of continuing
    they would have no reports.                      tify upon sending a notice of inactivity
                                                                                                    education IS REQUIRED AND must be
   NARM has offered all CPMs who par-                to the statistics committee. These
                                                                                                    current, dating from the previous
ticipated fully in the collection of statis-         CPMs will need to meet all CEU re-
                                                                                                    CPM credential to the present.
tics the equivalent of 25 CEUs on their              quirements for recertification.
next recertification period. A total of 30
                                                                                                5 . All previous requirements originating
CEUs is required for certification, but 5           All CPMs are encouraged to continue
                                                                                                    from Peer Review findings must be
of the hours must be in peer review.             submitting statistics on a voluntary basis.
                                                                                                    completed prior to reinstatement.
CPMs who receive the credit for statistics       The more prospective births we have in
must still obtain 5 hours of peer review.        the database, the more reliable our sta-
                                                                                                6 . Any complaints that have been re-
Recertification for those who did not            tistics will be. Send logs quarterly, and
                                                                                                    ceived during the period of revoca-
complete the statistics requirement is in        send birth reports 6-8 weeks after the
                                                                                                    tion must be heard by Peer Review
jeopardy. The list that follows describes        birth.
                                                                                                    and documented to the NARM Ac-
each category and what will be required             If you have any 2000 statistics forms
                                                                                                    countability Committee.
for recertification:                             overdue, please send them in as soon as
1 ) CPMs who submitted all logs and sta-         possible.
                                                                                                7 . The Board may decide to implement
    tistics forms on births done in the             More information on the statistics col-
                                                                                                    an initial period of probation during
    year 2000 may recertify at the appro-        lection project may be found at
                                                                                                    which additional education or docu-
    priate time and may count their par-         www.mana.org/narm
                                                                                                    mentation requirements must be met.
    ticipation toward the required CEUs.
                                                                                                    Failure to meet these requirements
    If recertification is due prior to receiv-   Send all statistics forms and logs to:
                                                                                                    could result in suspension or revoca-
    ing the Statistics Recertification Cer-        CPM Stats
                                                                                                    tion.
    tificate, the CPM may write a note veri-       36 Glen Avenue
    fying that the requirement has been            Ottawa, Ontario, Canada
                                                                                                8 . NARM may suspend or revoke the re-
    met, and may then send a copy of the           K1S 2Z7
                                                                                                    instated CPM credential through the
    certificate when it arrives.
                                                                                                    NARM Grievance Mechanism.
2 ) CPMs who have submitted all birth log        Questions may be sent to:
    information but who have not sent all                  CPM2000@ISTAR.CA
                                                                                                9 . A second revocation is permanent.

4                                                                                           N ORTH A MERICAN R EGISTRY   OF   M IDWIVES , J ULY 2001
•                                                •    3)Any information formally presented as
                                                                                                      ○   ○   ○   ○   ○   ○




                                                                                                      continued from page 3
                                                                                                                              ○   ○   ○   ○   ○   ○   ○   ○   ○   ○   ○   ○   ○   ○   ○




NARM Policy on Public                                    part of a conference or workshop,
Education and Speaking                                   which is presented as being about            evolved into the National Organization
                                                         NARM or about the CPM certification          for Competency Assurance or NOCA)
Engagements                                              process, must meet one of the two            that could have told us exactly how to do
                                                         following criteria:                          it but I never managed to contact them.
  NARM is aware that many midwives                                                                    In retrospect, I realize their recommen-
who have become CPMs would like to                        a ) The session must be presented by        dation would have been to hire a testing
share the benefit of their knowledge and                      a member of the NARM board of           company for tens of thousands of dollars
experience with other midwives. NARM                          directors, or must be endorsed by       and that would have been the end of the
encourages CPMs to promote the CPM                            NARM and approved by the NARM           IRB and a national exam. After all, we
certification process by encouraging                          board of directors (presenters          had a budget of $0. However, I knew
other midwives who are interested in or                       may submit a complete outline of        intuitively, that an exam just composed
actively pursuing certification. There are                    the content of the session to the       by a MANA or IRB committee would have
some guidelines that we feel should be                        NARM board of directors to re-          no claim to legitimacy and I agonized
understood by everyone who partici-                           ceive this endorsement), or             over how to proceed. The credentialing
pates in public education regarding the                                                               committee had already reported in the
NARM process.                                             b ) The conference brochure must            MANA news that they were superseded
                                                              clearly state that the session is not   by the IRB and felt their job was done. At
1)Anyone who has been active in the                           endorsed by NARM and is based           some point, MANA allocated $500 to the
   development or administration of the                       totally on the experience of the        IRB but at the same time quite bluntly
   NARM Examinations is prohibited                            presenter(s). When information          cut us off and told us to figure it out. We
   from teaching a specific class in                          is presented in this situation, each    advertised in the MANA news for some-
   preparation for these examinations.                        participant must be given a writ-       one who had testing experience to help
   Item writers, Subject Matter Experts,                      ten handout at the session which        us. We received several applications and
   Cut Score participants, or translators                     states that the information is not      after reviewing them, selected a CNM
   may not teach a course in preparation                      endorsed by NARM and is based           with public health background as the
   for taking the NARM Written Examina-                       solely on the experience of the         most appropriate applicant. But when
   tion or Skills Assessment for three                        presenter(s), and must be given         we contacted her, she declined the posi-
   years after participation at any level.                    the telephone, e-mail, and written      tion.
   NARM Qualified Evaluators may not                          address of the NARM Public Edu-            Meanwhile, between 1987 and 1989,
   teach a course in preparation for tak-                     cation office so that further ques-     the education committee had continued
   ing the Skills Assessment for three                        tions may be addressed by NARM.         to work on the core competency docu-
   years after asking to be removed from                      NARM will provide the brochure          ment. Another new organization, the
   the NARM QE list. Agreement to these                       “How to Become a CPM” to be             educators coalition (the organization
   conditions is part of the non-disclo-                      handed out at the session, upon         that gradually evolved into MEAC), also
   sure statement that is signed by all                       request by the presenter.               reviewed and edited the core competen-
   NARM participants. This does not                                                                   cies. After the 1989 MANA conference in
   prohibit general midwifery                         •                                          •    Boston, the MANA news reported the
   coursework, general conference                     Policies and Procedures                         then current draft as the “most refined,
   teaching, participation in a compre-                 NARM now has select policies and pro-         integrated, thoroughly reviewed core
   hensive midwifery educational pro-                 cedures on the webpage. Available now           competency document that exists for
   gram, or one-on-one teaching through               are:                                            North American direct entry midwives.”
   an apprenticeship.                                   1 . Certification requirements for phy-          In the summer of 1990 I went camp-
                                                             sicians                                  ing and whined to an old client about all
2)Anyone who has taken the NARM Writ-                   2 . Delinquent applications                   the problems of the IRB and how do you
   ten Examination or NARM Skills As-                   3 . Entry level currency                      develop a credible exam blah, blah, blah.
   sessment is prohibited from offering                 4 . Educational policy                        She turned to me and said “well first
   information regarding the specific                   5 . Internationally educated midwives         you...then you do...and then you pre test
   information tested for three years                   6 . MEAC grads - early exam                   the exam and then make revisions and
   from the date of the examinations.                   7 . Practice Guidelines                       administer the final version.” The client
   This does not prohibit general mid-                  8 . Preceptor-Apprentice                      was Mary Ellen Sullivan and she had a
   wifery coursework, general confer-                   9 . Recertification notice                    Master’s degree in testing research meth-
   ence teaching, participation in a com-               1 0 .Revocation                               odology. She applied for the job as test-
   prehensive midwifery educational                     1 1 .Speakers                                 ing consultant and was promptly hired
   program, or one-on-one teaching                      1 2 .Stats participation policy               by the IRB. And then we were out of the
   through an apprenticeship.                           If you have any questions regarding a         latent phase and into labor. We recruited
                                                      specific policy, please feel free to call us    ○   ○   ○   ○   ○   ○   ○   ○   ○   ○   ○   ○   ○   ○   ○   ○   ○   ○   ○   ○   ○




                                                      at 888-842-4784                                 continued on page 10

J ULY 2001, N ORTH A MERICAN R EGISTRY   OF   M IDWIVES                                                                                                                               5
    Committee Reports
•                                           •     was sent to all applicants this year, a       178 re-certification reminder letters
Applications Report                               policy developed by the NARM Board            were sent to CPMs. The reminders were
July 2001                                         during 2000, to keep the application pro-     sent to all CPMs with expiration dates up
                                                  cess within a specific time-frame (to de-     to June 30, 2001. The next batch of re-
Sharon K. Evans, Director of Applications
                                                  ter delinquent applications) and to as-       minder letters will go out again this
   The Applications Department has                sure that application materials are cur-      month, September and December.
grown tremendously since I began pro-             rent (i.e., CPR card, etc.).                     In the last issue of the CPM News a
cessing applications in 1997. Then we                As all those certificates were issued, I   letter went out to all applicants and
had a little over 200 CPMs. Today our             didn’t realize the work necessary to make     CPMs announcing the implementation of
numbers have grown to 667 Certified               the re-certification process run              the NARM Audit mechanism. The audit
Professional Midwives.                            smoothly. It has been an evolving pro-        program was successfully launched in
   We currently have 108 applicants in            cess not without challenges and a few         March 2000. Audits include one (1)
various phases of the process. Because            database errors, to my dismay. I can          CPM per month (approximately 2%) for
we had some applications that were in             foresee certification and re-certification    this year. One out of each 5 applications
process for years, the NARM Board felt it         becoming a department in itself. A total      will be audited during this year.
was necessary to implement new poli-              of 151 renewal reminder letters were             As you can see, we’ve been busy in the
cies. A Delinquent Applications letter            sent out in 2000. On March 1, 2001            Applications Department. I really am
                                                                                                proud of the applicants who cross my
                 CPM Profile, 1994 - July 2001                                                  desk. The documentation, especially for
                                                                                                the PEP process is tedious and for the
                                                                                                most part, most applications are very
      700                                                                                       organized and complete. The applica-
                                                                                                tions do pile up at deadline time, but we
                                                                                                are managing to get through them. I
                                                                                                have also found most applicants to be a
                                                                                                delight to serve. I look forward to our
      600                                                                                       advanced growth as Certified Profes-
                                                                                                sional Midwives take their rightful place
                                                                                                in society.


      500
                                                                                                •                                                •
                                                                                                CPM2000 Report
                                                                                                Ken Johnson and Betty-Anne Daviss
                                                                                                   The protocol for data collection has
                                                                                                been very well received at our presenta-
      400                                                                                       tions at the American Public Health Asso-
                                                                                                ciation. Maternity care researchers in
                                                                                                the audience have been encouraged to
                                                                                                see that the CPM2000 design includes:
                                                                                                prospective logs, client consent forms,
      300                                                                                       direct contact of mothers for validation
                                                                                                and satisfaction surveys, detailed data
                                                                                                forms and the two options for depth of
                                                                                                data collection by each midwife. As well,
                                                                                                most CPMs have found that, regardless
      200
                                                                                                of the time factor, it is important and
                                                                                                manageable. Therefore we plan to con-
                                                                                                tinue the tight method by which we are
                                                                                                collecting data and do not foresee chang-
                                                                                                ing the process.
      100
                                                                                                   As a group you are to be congratu-
                                                                                                lated on your hard work and commit-
                                                                                                ment. We have received logs listing more
                                                                                                than 8,000 clients (including into the
         0
                                                                                                year 2001) and received data on more
              1994       1995      1996     1997       1998      1999      2000    2001*        than 6,000 courses of care.
                                                                                                   On this end, we have phoned more
    # CPMs       3        54        133         223     429       534      624       667        than 400 clients to confirm birth details

6                                                                                           N ORTH A MERICAN R EGISTRY   OF   M IDWIVES , J ULY 2001
and ask about satisfaction. More than                 their incredible work during those in-        were Nancy Sullivan and Cecilia Jevitt
4,000 dataforms have been entered into                tense days throughout the month of            who met with Debbie Pulley and I in
the computer and we are readying the                  May! There were often times when we all       Clearwater, FL and a new additon was
data analysis programs. We have con-                  wanted to throw up our hands in disgust       Susan Stapleton, ACNM Board Member.
tacted more than 200 CPMs so far to                   and frustration. But seeing Nancy’s vi-       A fourth member will be named by the
check in and to confirm that all data has             sion come together in a finished product      new ACNM Board. I felt like I bonded to
been sent for the year 2000, and have to              was totally exhilarating, making even our     Susan instantly and hope the ACNM will
continue to do so until we are sure that              worst moments during the process seem         allow her to remain on this committee.
everything is in. The management of                   worth it!                                        The meeting went SO well. I think the
data on this scale with several hundred                  Pam also provided snazzy (and profes-      meeting in Clearwater was focused on
midwives involved, including the entry                sional) business cards for each of us who     feeling each other out and developing
and linking of logs, consents and                     worked at the booth. Although at first we     trust...but by this meeting we were all
dataforms is a rather large task, but we              wondered why we needed them, with             ready to work! In no time at all, we were
have several dedicated and highly com-                some guidance from Pam, we soon               able to work our way through the IWG
petent women employed to help —                       learned that they were quite useful and       document and had no difficulty reaching
Jennesse Oakhurst, midwife and our data               we were able to hand them out gener-          consensus regarding the new language.
entry goddess for the last decade; Carrie             ously to each booth visitor with whom         We agreed to make final changes via
Whalen, mother of all other CPM tasks,                we spoke.                                     email and get the document on the
Shannon Salisbury, data entry and com-                   The MANA posters and T-Shirts were         agenda for both the ACNM Board meet-
puter wizardress who has almost com-                  the BIG DRAW to the booth....providing a      ing in August and the MANA Board meet-
pleted a windows version for those of                 wonderful opportunity to open a conver-       ing in September. It is our hope that both
you who want to enter directly into the               sation with the customer about the Mid-       Boards will once again endorse this state-
computer, and Billy and Tanya, CPM no-                wives Model of Care™ and our reception.       ment. The ACNM representatives were
vitiates.                                             Carol Nelson, Debbie Pulley, Gera             optimistic that the attitudes in the ACNM
   We will present results at the MANA                Simkins, Karen Webster and Sharon             leadership about working cooperatively
2001 meeting in Albuquerque and have                  Wells did a tremendous job of helping         with MANA are shifting with the new
been accepted for an oral presentation                with sales and greeting anyone who ap-        Board members taking office.
of results at the annual American Public              proached the booth; networking;                  The Bridge Club meeting (my first)
Health Association conference in No-                  schmoozing and generally smiling until        was somewhat distressing to me. I think I
vember.                                               their cheeks hurt and talking until they      anticipated a lot of “warm fuzzies” but
   We have been developing a survey to                were hoarse! Most of the time there were      instead felt there was a lot of negativity
find out about clinical and billing proto-            six of us at the booth, and believe me,       and hurt feelings expressed. I suspect
cols to compliment the data collected to              most of the time (especially the first        that this “safe space” to air these feelings
date and will send that to you sometime               night) all six of us were kept hopping!       is perhaps the most important reason for
in the next couple months.                               The MANA Reception was awesome!!!!         its existence. Both Nancy Sullivan and
   Due Dates: For those CPMs who have                 We printed 300 postcards to advertise it      Susan Stapleton attended this meeting.
chosen to continue contributing to the                and distributed ALL of them! Having Ina          On Wednesday night, I attended the
CPM database (thank you), the next due                May Gaskin there as the draw was truly        Closing Ceremonies, which included a
date for logs, consent forms and                      inspirational! Karen did an incredible job    live, loud band and wonderful food!
dataforms is June 30th. We will continue              of planning the reception. The food was       They DO know how to throw a party!
to follow a schedule with similar due                 exquisite.... breads and cheeses, great       However, shortly after we arrived, Susan
dates to the ones on the year 2000 log                varieties of snack foods, chips and salsa,    Stapleton came in and asked if she could
forms, but now it will be four times a                chocolate cookies, incredible chocolates,     sit with me. For the next three hours, she
year: March 31st, June 30th, September                hot chocolate fondue with a huge tray of      and I yelled over the band (Did I say the
30th, and December 31st.                              fruit to dip in it, fresh vegetable trays,    band was loud???) She is definitely an ally
                                                      dips, coffee, soft drinks and wine.           and we really got to know one another,
•                      •                                 By 7 pm when the reception was to          talking much of that time about strategy
ACNM Conference Report                                begin, the room was already packed in         to help the ACNM and MANA join forces
Abby J Kinne, CPM
      .                                               like sardines....this, in spite of the fact   in the future....identifying common
                                                      that the room was kind of out of the way      ground. Though I would have liked to
   The Midwives Model of Care™ Booth                  and difficult to find. Over and over again,   dance and sing (especially after a glass
was a hit! It was so satisfying to see our            I heard tremendous compliments about          or two of wine) the time with Susan was
Materials Committee work come to life in              what a great spread we had and how            irreplaceable!
a beautifully coordinated and very pro-               much everyone enjoyed it. It definitely          Debbie and I were finally able to leave
fessional looking booth. Let me take this             went a long way toward encouraging            the hotel for the first time Wednesday
opportunity to once again thank Nancy                 good relations with the CNMs! Well            afternoon for a 3 hour whirlwind tour
Creel, Pam Maurath, the Documents Re-                 worth the cost!                               just so we could say we had been in DC!
view Committee and especially Tina Will-                 On Sunday, the ACNM-MANA Liaison           The whole experience was amazing.
iams and the Materials Workgroup for all              Committee met. The ACNM members


J ULY 2001, N ORTH A MERICAN R EGISTRY   OF   M IDWIVES                                                                                       7
    Notices & Announcements
•                         •                    •                        •                       ing Group to organize a CPM profes-
Attention All CPMs – You,                      W ould YOU like to serve                         sional organization, the missing compo-
Too, Could Be a Qualified                      on the NARM Board of                             nent in the professional triad for CPMs.
                                                                                                Named the National Association of Certi-
Evaluator!                                     Directors?                                       fied Professional Midwives (NACPM), it is
                                                                                                intended to function as an independent
   Are you interested in becoming a               NARM encourages all CPMs to con-              professional organization for CPMs, set-
Qualified Evaluator for the NARM Skills        sider serving on the NARM Board of Di-           ting standards and promoting the inter-
Assessment? If so, sign up to take the         rectors. Some experience in organiza-            ests of CPMs in the legislative arena. We
Qualified Evaluator training at the MANA       tional or political areas is helpful but not     are hoping that every CPM will join in
conference this year. The QE training          necessary. NARM has board positions              this effort.
will be offered as a full-day pre-confer-      for CPMs and for public members. Pub-
ence workshop on Thursday, September           lic members should not be midwives, but          Why did members of the Interim
20, 2001.                                      should have some affiliation with mid-           Working Group decide to take the ini-
   To qualify for the QE workshop, a           wifery (parent, author, activist, etc).          tiative in forming a professional orga-
CPM must be currently certified and               Board members should expect to                nization?
have beyond the minimal experience re-         spend approximately ten hours a week                The Massachusetts Midwives Associa-
quirements for certification. The addi-        on board work, including a required two-         tion, in coalition with the eastern and
tional experience requirements are two         hour conference call on Friday morn-             western Massachusetts chapters of the
years of midwifery practice, 30 births,        ings. Board members need access to a             ACNM and the Massachusetts Friends of
300 prenatals, and 30 postpartum exams         computer and e-mail, and some familiar-          Midwives (MFOM), is working on a legis-
as primary midwife. The experience re-         ity with MS Word. The NARM Board                 lation that will create a joint midwifery
quirements may be met before or after          meets just prior to the MANA conference          board in the Commonwealth of Massa-
obtaining the CPM credential, but must         and, some years, again in the Spring.            chusetts. In working through the details
be in addition to the 20/20 births, 75            NARM is looking for CPMs with a vari-         of the bill, both the legislative sponsors
prenatals, and 40 postpartum exams             ety of life and midwifery experience. The        and the coalition partners have asked
documented for certification.                  ability to write and/or speak in public is       about the CPM practice guidelines and
   After passing the QE training, the QE is    as asset, and a strong sense of commit-          standards. It did not take much inquiry
placed on the active QE list that is sent to   ment to the midwifery community is es-           to figure out that in fact there were no
all NARM PEP candidates when they be-          sential. Potential board members may be          national practice standards for CPMs,
come eligible for the Skills Assessment.       interviewed at the MANA conference in            and that if Massachusetts CPMs were go-
The candidate then chooses a QE and            September. If you would be interested in         ing to meet this requirement in time for
together they arrange a schedule for ad-       serving on the NARM board, or know               passage of the Massachusetts legislation,
ministering the Skills Assessment. The         someone you would like to nominate,              we needed to step up to the plate and
candidate is responsible for providing all     please call Debbie Pulley at 1-888-842-          accept the challenge of creating a profes-
the required equipment, and for provid-        4784 or write CPMinfo@aol.com.                   sional organization that could then en-
ing a pregnant woman and a newborn                                                              gage in a broad-based process to set na-
baby for the assessment, but the QE may                                                         tional practice standards for CPMs.
assist in making these arrangements if         •                                         •         A few phone calls later, it became ap-
needed. The skills assessment takes            National Association of                          parent that the idea and need for setting
about 3-4 hours to complete. The QE            Certified Professional                           national practice standards extended
receives a $50 reimbursement from                                                               beyond Massachusetts. In fact, Massa-
NARM for administering the Skills Assess-      Midwives Forms                                   chusetts was only the immediate instance
ment.                                                                                           of a legislative effort that was stalled for
   To register for the QE Workshop, the           Direct-entry midwives have come a             lack of national CPM practice standards.
CPM must call NARM for an application          long way in the past five years. Of the          CPMs from Vermont felt that national
(1-888-353-7089) and must register for         three components that are the hallmark           standards would have strengthened their
the QE workshop through the MANA               of a profession – certification, an educa-       hand in getting less restrictive rules and
conference. To receive a MANA confer-          tion accreditation council, and a profes-        regs and that experience would be sec-
ence brochure, please contact Julia            sional organization – two have already           onded by the other 16 states that regu-
Knight-Williamson at 505-265-2782 or           been established. The Certified Profes-          late CPMs. The point is that time spent
abq2001@aol.com. More information              sional Midwife (CPM) credential is legally       now to establish standards of practice
about the MANA conference can be               recognized in 17 states, with total num-         will help avert roadblocks in the future.
found at www.mana.org. For more infor-         ber of CPMs nationwide nearing the 700
mation about becoming a QE, call the           mark. The Midwifery Education Accredi-           Why is it important to convene a task
NARM Test Department at 1-888-353-             tation Council has been officially recog-        force to define the process for setting
7089.                                          nized by Department of Education as an           standards?
                                               education accreditation council. Now,              The members of the Interim Working
                                               four of us have formed an Interim Work-          Group were keenly aware that setting


8                                                                                            N ORTH A MERICAN R EGISTRY   OF   M IDWIVES , J ULY 2001
national practice standards would not be              that CPMs themselves would set practice        querque, New Mexico. If you have not
an easy task. Most importantly, it would              standards.                                     yet received a conference brochure, you
require a process that allowed maximum                   Currently, the 17 states that regulate      may find one at www.mana.org
input from existing CPMs. There are cur-              direct-entry midwives have some kind of
rently 650 active CPMs, so organizing                 practice standards defined in their rules      Sincerely,
anything inclusive with that number of                and regulations. Many of you have par-         Interim Working Group of the National
people was by definition a challenge.                 ticipated in these state processes, and           Association of Certified Professional
Therefore, the Interim Working Group                  therefore know that often it is the doc-          Midwives (NACPM)
limited its role to four administrative               tors and state agency personnel, not the       Terri Nash, CPM - Massachusetts
tasks:                                                CPMs, who have the upper hand. In              Dolores Carbino, CPM - Maine
• Create a name for the new organiza-                 many cases these rules and regs are in         Marilyn Greene, CPM – Tennessee
   tion                                               fact very limiting. While there is no guar-    Mary Lawlor, CPM - Vermont
• Write and publish an article in the                 antee that states would immediately
   CPM News calling all CPMs to become                adopt the practice standards developed
   charter members of this new profes-                by a national CPM professional organiza-       •                                          •
   sional organization                                tion, it is likely that over time they would   CPM Professional
• Create a means to collect contact in-               do so, because for most other profes-          Organization
   formation for CPMs interested in be-               sions, the state rules and regs refer to       by Ruth Walsh, CPM
   coming charter members of this orga-               the practice guidelines and standards of
   nization - see the enclosed stamped,               the professional organization. However,           I have been reading old MANA news-
   addressed postcard                                 because there is no national professional      letters for a history of NARM. It is aston-
• Organize, i.e. reserve a room and set a             organization, and therefore no national        ishing to see that the efforts of decades
   date for an initial meeting of a Task              standards, these states do not even have       of work of MANA committees has re-
   Force whose initial agenda would be:               the option to choose to adopt CPM cre-         sulted in today’s reality of Department of
• Determine and approve the sequential                ated practice standards in their rules lan-    Education endorsement of MEAC and a
   steps needed to engage in a broad-                 guage.                                         national certification process managed
   based, inclusive process to set na-                                                               by NARM that certifies over 600 mid-
   tional practice standards and guide-               Why is your participation important?           wives.
   lines for CPMs                                        Members of the Interim Working                 Now there is a movement to establish
• Elect a board of directors for the                  Group thought that it was time to stop         a professional organization for CPMs.
   newly formed National Association of               letting others define the practice stan-       From the experience of our past , I have
   Certified Professional Midwives                    dards for CPMs. That meant taking re-          some advice:
                                                      sponsibility for creating a professional          Be sure to be as inclusive as possible
Why is it important that as many CPMs                 organization for CPMs that could in fact       in developing this organization. Mobilize
as possible participate in this process?              create a process for creating practice         the power of every CPM.
   All of the organizers of this effort rec-          standards that would be by and for                Use consensus decision making pro-
ognize that setting national practice stan-           CPMs. The Interim Working Group is             cesses. The power of documents and
dards has been viewed with significant                committed to facilitating this open and        organizations comes from the bits of
trepidation by most CPMs. Most CPMs                   inclusive process for CPMs. We also            power of each midwife consolidated into
see standards as limiting their practice.             know that unless all or most of the exist-     one focused force.
They wonder, will VBACs, breeches and                 ing CPMs participate in this process it           Build on the work that exists. As we
twins be outside the scope of practice                will not truly reflect the practice stan-      used documents from other midwifery
standards? Does this mean that I will                 dards of the profession. Therefore, we         organizations, refer to the Job Analysis,
lose the flexibility to use herbs, or that I          urge, we beg, we plead, we implore you         the Core Competencies, the Ethics State-
will have to carry more equipment? In                 to attend the task force meeting on            ment. Look the ACNM documents re-
fact individual members of the working                Thursday, September 20. The purpose            garding their professionalism.
group had the same concerns, fears, and               of this day-long meeting is to establish          Separate from MANA. NARM and
trepidations. However, they also realized             and set in motion the process for devel-       MEAC were able to fly when they left the
that it was possible to create a process              oping standards, not to set or discuss         nest.
that would be as inclusive as possible so             specific standards, and to establish the          Stay close to MANA. Minimize cost and
that any practice standards would reflect             working committees that implement the          maximize participation by tagging your
the practice of the entire CPM commu-                 ongoing work of this new professional          meetings onto the MANA annual confer-
nity. More importantly, they recognized               organization. If you cannot attend the         ence.
that while setting standards was the next             September 20 meeting, consider volun-             Know that you really will be speaking
step in establishing the CPM as a profes-             teering for one of the working commit-         for CPMs and do it right.
sional credential, it did not have to mean            tees.                                             Join this organization and take your
that CPMs would be unduly restricted in                  We hope to see lots of CPMs at the          turn at doing the work. MEAC, NARM
their practice. Instead it would mean                 task force meeting on Thursday, Septem-        and MANA board members, committee
                                                      ber 20 at the MANA Conference in Albu-         chairs, and newsletter coordinators are


J ULY 2001, N ORTH A MERICAN R EGISTRY   OF   M IDWIVES                                                                                         9
  Notices & Announcements
just ordinary midwives who TAKE THEIR         •                                      •        ○   ○   ○   ○   ○   ○




                                                                                             continued from page 10
                                                                                                                      ○   ○   ○   ○   ○    ○   ○   ○   ○   ○   ○   ○   ○   ○       ○




TURN doing the work.                          IMPORTANT! New
    Remember, there are many profes-          Recertification Address:                       subject matter experts, requested dona-
sional organizations that function with                                                      tions of test exam questions from various
very small percentages of practitioners                                                      schools and licensing agencies. We re-
                                                 The NARM Application Department
as members and this skews their output.                                                      viewed, revised and rewrote. We invited
                                              moved from Oregon to Alaska two years
If you want a CPM organization that is                                                       candidates to take the exam. We charged
                                              ago. Any correspondence that has the
true to your ideals, that will not irritate                                                  the unbelievable fee of 150 dollars. Un-
                                              Oregon address (including recertifica-
you, you had better be an active part of                                                     believably high then, and incredibly low
                                              tions) should now be sent to Alaska.
it.                                                                                          now. But those 150 dollar checks, com-
                                              Please note the new address for sending
                                              applications and recertifications is:          ing in at the rate of a couple each week,
•                                        •             NARM Applications                     for a test that didn’t yet exist kept the
Numbers Matter!                                        PO Box 672169                         bills paid and the ball rolling. I appreci-
                                                       Chugiak, AK 99567                     ated then and appreciate now the sup-
   MANA is the only national organization                                                    port and faith of all those early test tak-
that is open to all midwives. The ACNM’s        Recertification forms can be found on        ers.
membership has surpassed 8000 while           the NARM Webpage.                                 The pretest was given in September of
MANA’s membership has held steady at                                                         1991. After extensive revisions, it was
around 1000 for nine years.                   •                                      •       officially administered as the North
   In order to continue to provide an         Certification Revocation                       American Registry Exam for Midwives in
effective counterbalance to the                                                              El Paso, Texas, in November of 1991. We
medicalization of midwifery, and to pro-         The North American Registry of Mid-         applied for incorporation as a non profit
mote the Midwive Model of Care™ and           wives Board has revoked the CPM cre-           organization totally separate from MANA
the CPM, MANA must grow.                      dential from Valerie El Halta. She may no      called the North American Registry of
   Only half of all CPMs currently belong     longer refer to herself as a NARM CPM,         Midwives. The IRB had accomplished the
to MANA.                                      Certified Professional Midwife, or CPM,        mission assigned by MANA. A national
                                              and is advised to honestly and responsi-       exam to measure midwifery knowledge
        JOIN MANA, SO THAT WE                 bly inform current and prospective cli-        was a reality, the IRB was a separate en-
         CAN STAND TOGETHER                   ents that her CPM credential has been          tity, protecting MANA from the liability
           AND BE COUNTED!                    revoked.                                       factor, and the stage was set for further
                                                 After two years she may apply for her       development into a full certification
Benefits of membership include:               CPM credential to be reinstated.               granting organization.
· The MANA News – a primary source
  of information about political issues       •                                      •       Look for part two in the next CPM News.
  affecting CPMs                              Conferences and CEUs
· Ensuring that MANA represents the                                                          •                                                                                 •
  interests of CPMs                             Workshop Webpage: Ollie Hamilton,            NARM Needs Pictures!
· Being part of the Sisterhood of Mid-        CPM, has put together a wonderful web
  wives                                       page that lists many workshops. The ad-           NARM is in the process of redoing its
· Fostering midwifery as a social move-       dress is http://www.birthwithlove.com/         materials. The consulting firm has rec-
  ment                                        resources/workshops/                           ommended we use plenty of pictures.
· Helping to preserve out-of-hospital                                                        Do you have special pictures that typify
  birth                                          MANA SE Regional Conference:                the Midwives Model of Care™ that you
· Being counted in the national tally of          “Handing Down the Tradition”               would be willing to share? If so, send
  direct-entry midwives                         August 23-26, in Lucas, Kentucky             them to NARM, 5257 Rosestone Dr.,
                                                Contact Candy Brunk at 859-737-              Lilburn, GA 30047, along with a release
  Ask not what MANA can do for you –              1836 or c_sbrunk@bellsouth.net             authorizing NARM to use them on its ma-
 ask what you can do for midwifery                                                           terials and/or webpage.
           by joining MANA!                     MANA 2001: A Midwifery Odyssey,

To join, contact:
                                                 Albuquerque, New Mexico                     •                                                                                 •
  Kelley Daniel
                                                September 20-23, 2001                        Proof of CPM Status
                                                Contact ABQ2001@aol.com                        If your state requires proof of your
  5426 Madison St.
  Hilliard, OH 43026                          •                                      •       CPM status, please contact NARM for an
  (614) 777-0246                              Address Correction                             authorization form. This form is also
                                                 If you know a CPM who is not receiv-        available on the NARM Webpage.
  Birthlady@aol.com
                                              ing the CPM News, please have them con-
                                              tact us to verify we have the correct ad-
                                              dress.

10                                                                                        N ORTH A MERICAN R EGISTRY                  OF   M IDWIVES , J ULY 2001
  From Your Peers
•                                                •    assess a situation can give valuable feed-       •                         •
Building Relationships                                back. If we have ears to hear and we are         RN Researching Friedman’s
Between Midwives                                      willing to learn and if there is a trust built   Curve, Requests Input
                                                      between midwives, we can all improve.
By Gaye McMichael, CPM
                                                      And going back to the heart of our work,
                                                                                                          My name is Sandy Cesario and I have
   Midwives are a unique and peculiar                 we know that we all want to do a good
                                                                                                       been a labor and delivery nurse for ap-
lot! We tend to be very strongly con-                 job.
                                                                                                       proximately twenty-five years. Currently,
vinced of what we believe. We are                         There are those moments when we
                                                                                                       I am an educator and researcher at
fiercely protective of that which means               “just need to vent” … about the long la-
                                                                                                       Texas Woman’s University. A project that
the most to us. We are intuitive and yet              bor that just ended in a transport
                                                                                                       I am about to undertake involves investi-
very down to earth in our decision-mak-               ...about a client unwilling to pay for ser-
                                                                                                       gation of labor support and re-evaluation
ing. We care deeply for those with whom               vices in a timely fashion ...about how
                                                                                                       of the antiquated Friedman’s Labor
we have a relationship. Yet we are easily             hectic life is ...about things that are going
                                                                                                       Graph.
hurt, put on the defensive. Insecurities              on in our lives. Having a friend who can
                                                                                                          I am looking for midwives who might
haunt us along the way. All of this goes              understand because of similar life-calling
                                                                                                       be willing to complete a brief descriptive
into making us who we are. The rest of                is a treasure.
                                                                                                       survey about the agencies in which they
the world sometimes has a difficult time                  Practical information, peer review and
                                                                                                       practice (if doing deliveries in an agency
interpreting this creature known as mid-              educational sharing are logical reasons
                                                                                                       setting) and a brief summary of the
wife. We often feel as though we cannot               for networking with other midwives. The
                                                                                                       lengths of labors for five women who did
explain our deep feelings accurately to               wealth of information that is available is
                                                                                                       not receive any major medical interven-
others who are not familiar with the kind             best gleaned and shared by all who are in
                                                                                                       tion (i.e. pitocin or epidural anesthesia).
of life we live.                                      their own process of continuing educa-
                                                                                                       A copy of a form and a return envelope
   This is why we need each other. Mid-               tion. It’s great to pick up the phone and
                                                                                                       will be mailed directly to participants
wives can benefit in many ways by estab-              find out from another midwife “the
                                                                                                       and participation will remain strictly con-
lishing and maintaining healthy relation-             scoop” on something of interest. It’s nice
                                                                                                       fidential. Client information will be com-
ships with other midwives. In some ar-                to be able to meet together and share
                                                                                                       pletely anonymous and only minimal in-
eas, this is geographically difficult. In             birth stories and information.
                                                                                                       formation about each woman will be col-
other areas, different philosophies of                    We are sensitive, strong, caring and
                                                                                                       lected, making it impossible to identify
practice may inhibit networking. But the              influential people who take our work
                                                                                                       individuals or agencies.
bottom line is, wherever there is an op-              seriously and value our clients. And be-
                                                                                                          Your help with this project is greatly
tion to be in contact with other mid-                 cause of this, we tend to give all we have
                                                                                                       appreciated. If you would be willing to
wives, a valuable interchange can take                of ourselves. Sometimes we get tired.
                                                                                                       complete this survey, please email your
place.                                                Sometimes we have fascinating stories
                                                                                                       name and mailing address to:
   First of all, we just need to have an-             that need a certain audience to appreci-
                                                                                                       SCesario@twu.edu
other person in our life who is walking a             ate the tale. Our husbands and children
                                                                                                          The form and a return envelope will
similar path. There will come a time for              don’t often desire to hear about the
                                                                                                       be mailed directly to you.
each of us, as a midwife, where we will               amazing cervix that went from four to
                                                                                                          Thank you very much for your consid-
question ourselves or need the input of               ten in twenty minutes! Yet these are the
                                                                                                       eration! I am looking forward to hearing
another midwife. Sometimes we need an                 kinds of experiences we want to share
                                                                                                       from you.
understanding shoulder to cry on. Some-               with someone else. We want affirmation,
times we need someone else to tell us,                approval. Other midwives with whom we
                                                                                                         Sandy Cesario Assistant Professor,
“Don’t worry about that, you’re a great               can build a relationship can give us the
                                                                                                         College of Nursing Texas Woman’s
midwife!” Sometimes we need another                   support and strength we need in our joys
                                                                                                         University, Houston Center
caregiver to tell us what they think about            and our tears. Let’s make an effort to
                                                                                                         1130 M D Anderson Blvd
a scenario we give them. Sometimes we                 seek out others who are willing to enter
                                                                                                         Houston, TX 77030
just need to know there is another per-               into this kind of companionship and all
                                                                                                         Office Phone: 713-794-2110
son out there that we CAN talk to. Rela-              benefit, learn, share and become stron-
tionships with one another as midwives                ger and better in our work and in our
enhances and enriches our own practice                own lives.
and can help with the emotional needs
we all have.
   Another thing we can give each other
is honesty. This can be a “difficult gift”
because it requires each of us to be will-
ing to hear the truth. But are we inter-
ested in growing? Are we interested in
doing things a better way? Sometimes,
another midwife who can objectively



J ULY 2001, N ORTH A MERICAN R EGISTRY   OF   M IDWIVES                                                                                        11
•
  Information Requests                                                                                                           •
Can NARM Give Your Name to Those Who Request Information?
   NARM often receives requests from people who want to find a CPM in their area. Because of the volatile legal situations in
some states, NARM has a policy of not releasing names of CPMs unless permission has been received from the midwife. If you
wish to give permission for the release of your name, you must notify NARM’s public education office. You may do this by send-
ing the statement below to <CPM info@aol.com> , or by mailing it to Debbie Pulley, NARM Public Education, 5257 Rosestone
Drive, Lilburn, GA 30247.


•                                                                                                                                •
Release Form
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  becomes effective on (date)___________________. I understand that to revoke this permission, I must send notice in

  writing to the same address.

  Current address:_______________________________________________________________

  Current city, state, zip:__________________________________________________________

  Current phone:_______________Current e-mail (if available):_____________________________

  Current status: ___ legally recognized (licensed, registered) by state, or___ no legal recognition by state




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