Taking action to increase access to midwifery services in out-of-hospital settings

In 2001 the American Public Health Association cited the benefits of midwifery care and out-of-hospital birth and urged public and private insurance plans to eliminate barriers to the reimbursement and equitable payment of direct-entry midwifery services in both public and private payment systems. Similar recommendations appear in the 2020 Vision for a High-Quality, High-Value Maternity Care System, and the Blueprint for Action published in January 2010. While state recognition of direct-entry midwives who are Certified Professional Midwives (CPMs) has expanded in the last decade and many CPMs receive insurance reimbursement, national policies have not changed. Medicaid covers nearly one-half of all women giving birth in the U.S., but there is no federal requirement to reimburse CPMs, which creates barriers for women of this population who may wish to have a CPM as their care provider. The Midwives and Mothers in Action coalition was formed in May 2009 “to gain federal recognition of CPMs so that women and families will have increased access to quality, affordable maternity care in the settings of their choice.” Coalition partners included professional organizations and consumer groups. Anticipating action on national health reform, the coalition sought Congressional support to mandate Medicaid reimbursement for Certified Professional Midwives. This presentation will provide a glimpse into how a national grassroots network was mobilized to influence healthy care policy. Results of an evaluation of the coalition's work completed in March 2010 will be presented that will highlight the activities, strategies and impact of the Midwives and Mother in Action Campaign.