Speaking of Midwives

Recorded live at the American College of Nurse-Midwives (ACNM) Annual Meeting in Kansas City, in this episode our host Melissa Avery sits down with Myra DeLuca a practicing midwife, PhD student at Penn State, and former midwifery practice director.Myra breaks down her recent comprehensive review article published in the Journal of Midwifery & Women's Health focusing on interprofessional collaboration between midwivesand physicians. Together, they explore the structural barriers, communication gaps, and liability misconceptions that hinder teamwork, while highlighting the powerful impact of shared leadership, joint patient visits, and interprofessional education on reducing provider burnout and expanding maternity care access.Keywords: Speaking of Midwives podcast, Myra DeLuca, Interprofessional Collaboration, Midwife-Physician Collaboration, Journal of Midwifery and Women's Health, Maternity Care Deserts, Rural Midwifery, Interprofessional Education, ACNM Annual Meeting.Hashtags: #SpeakingOfMidwives #InterprofessionalCollaboration #MaternalHealth #Midwifery #HealthcareLeadership #OBGYN #ACNM #JMWHGuest: Myra DeLuca, MSN, CNM, FACNMwww.linkedin.com/in/[email protected] article:Interprofessional Collaboration Between Certified Nurse‐Midwives/Certified Midwives and Obstetrician‐Gynecologist Physicians: A State of the Science Review - DeLuca - Journal of Midwifery & Women's Health - Wiley Online Library

Recorded live at the ACNM Annual Meeting in Kansas City!!If roughly 30% of our students are neurodivergent, and many never say so, what does that ask of us as educators and preceptors?Kelly Walker, Senior Associate Dean for Academic Affairs at NYU, and Jane Houston, clinical associate professor at the University of Central Florida, join us to talk about their research on neurodivergence in midwifery education. Their work grew out of a trauma-informed pedagogy session where learners began quietly sharing their own stories. They discuss why accommodation-by-appointment can leave students stigmatized and exhausted, and what universal design for learning looks like in practice. They also cover how to bring preceptors in as true faculty, and why supporting learners is also about keeping midwives in the profession.It’s a candid, funny, and hopeful conversation about centering students the way we center families, and building a workforce where more midwives can thrive and stay.Keywords: Speaking of Midwives podcast, Kelly Walker NYU, Jane Houston UCF, Neurodivergence in Midwifery Education, Universal Design for Learning, Trauma-Informed Pedagogy, ACNM Annual Meeting, Midwifery Workforce Retention, Nursing Education, Clinical Preceptors.Hashtags:#SpeakingOfMidwives #MidwiferyEducation #Neurodivergence #UDL #NurseMidwife #MaternalHealth #ACNM #ClinicalPreceptorGuests: Jane F. Houston, DNP, CNM, FACNMKelly C. Walker, DNP, CNM, FACNM

What happens when Black midwives design their dream model of perinatal care? In the city of Alameda, California, Black families enrolled in Beloved Birth had an 8% preterm birth rate, compared with about 14% for Black families in the same health system who didn’t receive this care. NICU admissions dropped from 12% to 5%.Our host, Melissa Avery, PhD CNM talks with Jyesha Wren, CNM founding director and Maya Combs, CNM about their 2025 Journal of Midwifery & Women’s Health article, “A Community-Centered and Anti-Racist Model of Whole Person Perinatal Care." They describe how Beloved Birth Black Centering layers evidence-based strategies on top of midwifery-led group prenatal care, including racially concordant care, wraparound services, and what they call the “gold package of Black love.” They also share how they fund services Medicaid doesn’t cover and how to start building a model like this where you are.Keywords: Black maternal health, birth equity, group prenatal care, Black midwives, racially concordant care, culturally reverent care, midwifery-led care, preterm birth disparities, reproductive justice, Medicaid reimbursementHashtags: #SpeakingOfMidwives #BelovedBirth #BlackMaternalHealth #BirthEquity #BlackMidwives #GroupPrenatalCareGuests: Jyesha Wren, CNM, MSNJyesha Wren, Nurse Midwife | LinkedInMaya Combs, CNM, MSN, RNMaya Combs,MSN,RN, CNM-BC | LinkedInArticle: A Community‐Centered and Antiracist Model of Whole‐Person Perinatal Care: Beloved Birth Black Centering - De Ornelas - 2025 - Journal of Midwifery & Women's Health - Wiley Online Library@Beloved Birth Black Centering Official: Instagram, Facebook, Twitter | LinktreeBelovedbirth.org A collaborative effort of Alameda Health System & Alameda County Health

Blood pressure often peaks after patients have already gone home; yet fewer than half of people with hypertensive disorders of pregnancy receive the recommended blood pressure check within 7 to 10 days of birth. Follow-up is even lower for Black and Hispanic patients, who also face a disproportionate burden of severe complications. Why is that happening, and what can we do about it?In this episode, we speak with Jill Doyle, CNM, PhD candidate and predoctoral fellow at the Boston College Connell School of Nursing, about her integrative review on the subject. Jill draws on 15 years of midwifery practice and her own experience of postpartum preeclampsia and hospital readmission to reframe missed follow-up as a systems problem rather than a patient one.We discuss what ACOG recommends and how it differs from the traditional six-week postpartum visit, how remote blood pressure monitoring works, and what an intersectionality lens reveals about who gets timely care. Jill also walks through the patient, provider, and health system-level barriers and facilitators she found.Whether you're a midwife, nurse, OB, or primary care clinician, you'll leave with practical steps you can use in your next clinic day and a clearer view of how to design postpartum care that meets people where they are.In this episode:-Why early postpartum blood pressure surveillance matters, and what the guidelines recommend?-Remote vs. home blood pressure monitoring: what's the difference?-Using an intersectionality framework to understand inequities in follow-up.-Barriers and facilitators at the patient, provider, and health system levels.-Practical steps clinicians can take now, and the policy and research needed next.Guest: Jill Doyle, MS, CNM, PhD CandidateArticle: Doyle JC, Lee CS, & Canty L. Barriers and facilitators to early postpartum blood pressure follow-up after hypertensive disorders of pregnancy: An integrative review. J Midwifery Womens Health. 2026;71(3):330-343. doi:10.1111/jmwh.70091LinkedIn: https://www.linkedin.com/in/jill-doyle-cnm-ms-6136b419/Keywords: Midwifery care, Hypertensive Disorders of Pregnancy, Preeclampsia, Postpartum Blood Pressure, Postpartum Health Disparities, Black Maternal Health, Telehealth Postpartum Care, Journal of Midwifery & Women's Health.Hashtags: #SpeakingOfMidwives #Midwifery #MaternalHealth #Preeclampsia #ReproductiveHealth #PostpartumCare #HealthEquity

We know midwifery care works. So why isn't it everywhere?In this episode, host Dr. Melissa Avery sits down with Brie Thumm, CNM, PhD, midwife and assistant professor at the University of Colorado Anschutz College of Nursing, to explore this game-changing question: not whether midwifery care improves outcomes, but how to get it adopted, sustained, and equitably integrated across every setting in the U.S?Dr. Thumm breaks down implementation science, which is the study of how to translate proven interventions into everyday practice. She reframes the midwifery model of care itself as an evidence-based intervention ready for rigorous, systematic adoption.In this episode, you'll learn:-What implementation science is (and why it's different from effectiveness research)-How theories, models, and frameworks create shared language for studying midwifery across wildly different settings-Why "positive deviance" studying practices already succeeding may be the key to spreading what works-The four levels of barriers and facilitators to integration: patient, provider, organization, and system-Practical steps any clinician can take today to identify and share what's working in their own practiceWhether you're a clinician, researcher, or midwifery advocate, this conversation offers a roadmap for moving midwifery care from proven to prevalent!Listen now and subscribe to Speaking of Midwives, brought to you by the Journal of Midwifery & Women's Health.Credentials: Brie Thumm, PhD, CNM, RN, MBA, FACNMArticle: A Synthesis of Principles and Approaches From the Field of Implementation Science for Studying Midwifery Integration in the United States - Thumm - Journal of Midwifery & Women's Health - Wiley Online LibraryRelated article mentioned during the episode Curran, G. M. (2020). Implementation science made too simple: a teaching tool. Implementation science communications, 1(1), 27. Social Media: LinkedIn: www.linkedin.com/in/e-brie-thumm-b5580249#Midwifery #ImplementationScience #MaternalHealthEquity #MidwiferyIntegration #JMWH #WomensHealth #NurseMidwife #HealthEquity #MaternalHealth

The U.S. lags behind other developed nations in maternal and infant health outcomes; and Dr. Cynthia Nypaver, midwife, associate professor, and program director at the University of Cincinnati College of Nursing, believes preconception care is a missing piece of the puzzle.In this episode, Dr. Nypaver joins us to unpack her latest article synthesizing the research on preconception health innovations. We explore why care before pregnancy matters as much as care during it, the individual, provider, and structural barriers keeping people from accessing it, and the exciting new tools changing the landscape. F-rom AI-powered conversational agents like "Gabby" to mobile apps, chatbots, and electronic health record prompts that make preconception screening part of routine care.We also dig into policy-level solutions for closing gaps in maternity care deserts, the role of telehealth in reaching rural communities, and practical, ways clinicians can start normalizing preconception care starting tomorrow. Whether you're a midwife, OB, family medicine provider, or nurse practitioner, this conversation offers a roadmap for treating preconception care as what it truly is: primary care for people of reproductive age.In this episode:-Why preconception care affects outcomes across generations-Screening tools every provider should know (reproductive life plan, PHQ-9, IPV screening)-New digital health innovations, from apps to virtual conversational agents-Community and population-level interventions that have workedGuest Credentials: Cindy Nypaver PhD, APRN-CNM, WHNP-BC, FACNMArticle: Innovations in Preconception Care: Optimizing Health for AllIndividuals - Nypaver - 2024 - Journal of Midwifery & Women's Health -Wiley Online LibraryWebsite of interest: https://beforeandbeyond.org/

In this episode of Speaking of Midwives, our host talks with Dr. Nikia Grayson, midwife, chief clinical officer at CHOICES Center for Reproductive Health in Memphis and Carbondale, and associate professor at UCSF, about her article, "The Choices Black Midwifery Fellowship: An Innovative Model for Training Midwives in Reproductive Justice and Community-Centered Care."Dr. Grayson describes how CHOICES, a nonprofit reproductive healthcare organization serving Memphis for over 50 years, and now Carbondale, Illinois as well, built a fellowship grounded in Black feminist thought and reproductive justice to address a gap she experienced firsthand: what happens after graduation, when new midwives need support translating clinical knowledge into confident practice.She walks through the fellowship's five pillars: full-scope reproductive health education, Black feminist thought, leadership and mentorship, neonatal/postnatal care, and community-centered care. She shares candid insights on funding a program that pays fellows a real, livable salary; embedding policy engagement into clinical training; and building an intentionally Black-led midwifery workforce in the South.The conversation also touches on lessons for midwifery faculty and preceptors everywhere: the need for structured mentorship, training beyond hospital-based medicalized settings, and reframing midwifery as inseparable from advocacy and social change.Tune in for a compelling look at what it takes to build a training model designed for midwives to not just enter the profession, but stay, lead, and transform it.CHOICESWebsite: www.yourchoices.orgInstagram: @yourchoicesclinicsFacebook: www.facebook.com/yourchoicesclinicsLinkedIn: linkedin.com/company/your-choicesDr. Grayson's Social Media: Instagram: @nikiagrayson_midwifeLinkedIn: www.linkedin.com/in/nikiagraysonFacebook: www.facebook.com/nikiagraysonArticles:Grayson N, Quinones N, Oseguera T. A Model of True CHOICES: Learnings from a Comprehensive Sexual and Reproductive Health Clinic in Tennessee that Provides Abortions and Opened the City's First Birth Center. J Midwifery Womens Health. 2022;67(6): 689-695. https://doi.org/10.1111/jmwh.13448The CHOICES Black Midwifery Fellowship: An Innovative Model for Training Midwives in Reproductive Justice and Community‐Centered Care - Grayson - 2026 - Journal of Midwifery & Women's Health - Wiley Online Library

The tools we use to counsel patients aren't always keeping pace with reality. In this episode, midwife-researcher Ann Ledbetter joins us to discuss her study, Observed versus Predicted Vaginal Birth After Cesarean for Patients of a Community Health Center, published in the Journal of Midwifery & Women's Health.Ann shares findings from 507 labors after cesarean at a Milwaukee community health center serving a predominantly Latina population. The numbers challenge assumptions baked into the widely used VBAC calculator. Her team found actual VBAC success rates outpaced predictions across the board, with the calculator proving especially inaccurate for patients with higher BMIs and no prior vaginal birth.We dig into what these findings mean for clinical counseling, the risks of discouraging TOLAC based on probability scores alone, and why Ann believes the conversation needs to shift from "fixing the calculator" to examining hospital-level practices driving cesarean variability. She also makes the case for continued midwifery support as a driver of improved VBAC rates, and outlines the research she'd like to see next.A thoughtful, data-driven conversation about equity, autonomy, and trusting birthing people's bodies.Articles:Considering Labor After Cesarean in a Woman with Class 3 Obesity - Ledbetter - 2020 - Journal of Midwifery & Women's Health - Wiley Online LibraryObserved Versus Predicted Vaginal Birth After Cesarean for Patients of a Community Health Center - Ledbetter - 2025 - Journal of Midwifery & Women's Health - Wiley Online LibraryAnn's Substack: A Moderate Midwife | Ann Ledbetter | SubstackAnn is featured on Emily Oster's newsletter Parent DataVBAC: Risks, Benefits, & How to Prepare

Adapting Group Prenatal Care for Telehealth: Lessons from a Federally Qualified Health CenterWhen COVID-19 made in-person group prenatal care impossible, the midwifery team at Mary's Center, a federally qualified health center serving a predominantly a Spanish-speaking community in Washington, DC, didn't just adapt they innovated.In this episode of Speaking of Midwives, our host Dr. Melissa Avery talks with Dr. Katherine Daly and Dr. Christina Marea (both of Georgetown University) about their two companion articles on rebuilding Mary's Center's group prenatal care program for telehealth. This model included Zoom-based sessions, at-home blood pressure monitoring, bilingual facilitators, and preserved in-person touch points for essential care.The results were striking: the telehealth group care clients completed significantly more prenatal visits than those in individual telehealth care (15.6 vs. 10.3) and were far more likely to receive adequate care. Qualitative findings added the rest of the story. The participants felt genuinely connected, supported, and seen.Dr. Daly and Dr. Marea also discuss what it takes to sustain this kind of model, from funding and digital literacy support to the policy changes needed to reimburse group and telehealth care fairly, especially as Medicaid and DC Alliance cuts threaten access. Tune in to hear how a team of midwives turned a crisis into a model of care worth replicating.The articles:Daily C, Gresh A, Hamilton ER, and Marea CX. Adapting Group Prenatal Care for Telehealth: A COVID-Era Innovation to Address Barriers to Care for Latinx Clients. J Midwifery Womens Health. 2024: 69(6); 945-951. https://doi.org/10.1111/jmwh.13701Daily C, Gresh A, Hamilton, E.R., Crowell, N.A., Martinez, G.G.A. and Marea, C.X. (2026), Evaluating the Impact of Telehealth Prenatal Care at a Federally Qualified Health Center. J Midwifery Womens Health. Published online May 21, 2026. https://doi.org/10.1111/jmwh.70107Catherine (Katie) Daily DNP, CNM, FACNMwww.maryscenter.orghttps://gufaculty360.georgetown.edu/s/contact/00336000014Ry8mAAC/catherine-daily-dnp-cnm-facnm?asPublic=truehttps://www.linkedin.com/in/katie-daily-a15036351/Christina Marea PhD, CNM, MA, MSN, FACNM https://www.linkedin.com/in/christina-marea-95a978239https://gufaculty360.georgetown.edu/s/contact/00336000014Tp5cAAC/christina-x-marea-phd-ma-msn-facnm

Every midwife knows the tension. How long is too long in second stage, and what does the evidence actually say about letting someone labor down? In this episode of Speaking of Midwives, our host Dr. Melissa Avery sits down with Dr. Elise Erickson, midwife, PhD, and associate professor at the University of Arizona, to discuss her research published in the Journal of Midwifery & Women's Health examining the role of passive descent and epidural analgesia in outcomes associated with prolonged pushing among nulliparous midwifery patients.Drawing from a prospectively collected dataset of nearly 1,500 births across a midwifery practice in the Pacific Northwest, Dr. Erickson unpacks what the data reveals about prolonged pushing, cesarean risk, obstetric anal sphincter injury, and the nuanced, and often underdocumented time between full dilation and active pushing. Elise issues a compelling call to action for midwives everywhere who are benchmarking their outcomes: your data matters, and the profession needs it. This is exactly the kind of midwifery-led, practice-informed research that is building the evidence base one dataset at a time.Article: Erickson EN, Hersh SR, Wharton MR, Bovbjerg ML, Tilden EL. The Role of Passive Descent and Epidural Analgesia in Outcomes Associated With Prolonged Pushing Among Nulliparous Individuals in Midwifery Care. J Midwifery Womens Health. 2024; 69(4): 499-513. https://doi.org/10.1111/jmwh.13624Citations for two other articles Elise mentions in this episode:Cahill AG, Srinivas SK, Tita ATN, et al. Effect of Immediate vs Delayed Pushing on Rates of Spontaneous Vaginal Delivery Among Nulliparous Women Receiving Neuraxial Analgesia: A Randomized Clinical Trial. JAMA. 2018;320(14):1444–1454. Doi:10.1001/jama.2018.13986Montfort E, Nallet C, Cot S ...Active second-stage duration under 15 minutes in spontaneous vaginal deliveries with delayed pushingAmerican Journal of Obstetrics & Gynecology, 2025; 234, 1470-1477Dr. Erickson's Links:website is www.mumhlab.com Instagram at @mumhlab