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Welcome to MEAC
Midwifery Education & Accreditation Workshop
Interested in becoming a MEAC accredited school or program? If so, mark your calendar for September 26, 2012. MANA pre-conference workshop will be held in Asilomar, California. Nasima Pfaffl will be presenting this all day workshop. This is a mandatory workshop for any school or program administrator planning to apply for MEAC accreditation within the next two years. If you are interested in a private workshop, please contact Sandra Bitonti Stewart for more details at sandra@meacschools.org.
To register for this workshop, please click here
You Are Invitied to Participate in the MEAC Standards Review
MEAC has initiated a review of its Standards for Accreditation/Pre-accreditation. If you have an interest in midwifery and midwifery education, you are invited to participate in this process.
• You can participate in the workgroup for the review. This involves reading the standards and the feedback MEAC has received to date, and through group discussion and analysis decide whether to recommend that the MEAC Board make changes in the agency's standards. Should such a recommendation be made, the following tentative schedule is proposed:
March 2012 – First draft of new Standards ready for MEAC Board review.
April/May 2012 – Draft of revised Standards sent out to stakeholders for comment (using Survey Monkey).
June 2012 – Analyze and redraft Standards as necessary.
July 2012 – Adopt amendments to revised Standards.
September 2012 – Finalization of Standards and adoption by the MEAC Board.
Please direct any questions you might have, or send us your interest in joining in on this process, to info@meacschools.org
How MEAC Supports Midwifery Education
MEAC accreditation is designed to strengthen educational programs and to preserve the many innovative programs designed by and for midwives. To mention only a few areas that are scrutinized for MEAC accreditation and continued accreditation status, a program/institution must meet rigorous requirements for demonstrated student success; being fiscally sound; sufficient faculty, staff, and facility resources; and curriculum.
•Did you know that more than 600 people contacted MEAC last year to find out how they could become midwives through an accredited program?
•Did you know that there are currently more than 500 students enrolled in MEAC-accredited programs and that approximately one half of all new Certified Professional Midwives are graduates of MEAC-accredited programs?
•Did you know that MEAC accredits a wide range of midwifery education programs, including independent schools and colleges as well as programs within community colleges and universities?
•Did you know that MEAC accredits both entry-level and graduate programs; residential, correspondence, and distance education programs?
•Did you know that MEAC is the only accrediting agency recognized by the U.S. Department of Education whose standards meet the eligibility requirements for Certified Professional Midwives?
Public Member for MEAC BOD, Call for Nominations
Term: The Nominations Committee of MEAC is inviting nominations for a representative of the public to serve as a Board Member for one three-year term beginning February 2012, with the possibility of a second term.
Qualifications: Public Members of the Board are individuals who have an interest in maternity care, the education of health care professionals and in serving the public through participation in the accreditation process of midwifery schools. The Public Member may not be affiliated with the midwifery profession by training or practice, or be a member of MEAC or other midwifery professional associations. They should have previous service on community, state or national boards.
Qualifications include the knowledge, skills, and dispositions needed to make high-stakes accreditation decisions including the following: general understanding of board policy and procedures; respect for the confidential, fair and impartial nature of accreditation decisions; and prior service on a community, state or national board.
Personal characteristics include the ability to: work and make decisions in a close collegial relationship; strive for consensus within a group but take responsibility for actions based on a vote by the quorum; express individual questions and concerns and hear the perspectives and opinions of others; consider information and data impartially and make rational and timely decisions; and communicate decisions effectively in written decision reports. In addition, candidates must be willing and able to serve a three-year term.
Responsibilities: The MEAC Board of Directors has the primary charge of rendering accreditation decisions. The Board is a self-managing group, with clear structure, policies and procedures that support the accreditation decision making process. Board Members primarily represent midwifery educators and practicing midwives. Board Members have vested responsibility for the accreditation decision-making process. The Board of Directors also contributes to the accreditation policies and procedures, and the revision of professional standards. MEAC is guided by its own founding principles and mission as well as guidelines for strong education accreditation practice as defined by the Association of Specialized and Professional Accreditors (ASPA) and the U.S. Department of Education.
Board members commit to attend monthly telephone conference calls and one in-person board meeting in the spring (March); to actively serve as a member of working groups if assigned; and to participate in accreditation training and orientation sessions. Preparation for Board meetings includes review and critical assessment of written reports and accreditation materials. MEAC offers a stipend to cover a significant portion of the meeting expense.
Any member of the public may make nominations. Self nominations are encouraged.
Midwives and Mothers in Action (MAMA)
The Midwives and Mothers in Action (MAMA) is a national campaign to gain federal recognition of Certified Professional Midwives. This will provide women with increased access to quality, affordable maternity care in the setting of their choice.
Click here to visit the MAMA website
CPM Issue Brief - Certified Professional Midwives: An Asset to Health Care Reform
We are pleased to announce the release of an Issue Brief: Certified Professional Midwives in the United States.
The Midwifery Education Accreditation Council (MEAC) co-authored this important document with the Midwives Alliance of North America (MANA), the North American Registry of Midwives (NARM), and the National Association of Certified Professional Midwives (NACPM). These four national organizations have played essential roles in the conception, formation, promotion and maintenance of the Certified Professional Midwife (CPM) credential.
The United States faces a deepening crisis in the quality, cost and availability of health care. Maternity care in particular reflects the basic inefficiencies of the current model – on the one hand too many women receive unnecessarily expensive care due to the overuse of technology, while others cannot access even the most basic services. Midwives are poised to address this problematic distribution of care by providing essential health services that result in excellent outcomes at lower cost than typical care. Any plan for health reform should include support for and expansion of midwifery services.
Certified Professional Midwives (CPMs) are a fast-growing segment of the midwifery profession in the United States today. Certified Professional Midwives are trained and credentialed to offer expert care, education, counseling and support to women for pregnancy, birth and the postpartum period. They have particular expertise in out-of-hospital settings. CPMs practice as autonomous health professionals working within a network of relationships with other maternity care professionals who can provide consultation and collaboration when needed.
The purpose of this document is to provide information about Certified Professional Midwives: their qualifications, philosophy and scope of practice; the best available evidence regarding the safety and quality of their care; and a brief exploration of how increased utilization of their services will address America’s health care needs.
Click here to link to a pdf of the CPM Issue Brief
CPM Study
TITLE: Outcomes of Planned Home Births with Certified Professional Midwives: Large Prospective Study in North America
Click here to read the Study Abstract and for a link to the article.
The Case for Midwifery Education & Certified Professional Midwives
MEAC believes that midwives provide care that is essential to the health of the nation. The future of midwifery depends on the education of midwives who are prepared to provide high quality care that is responsive to the needs of women, and who can participate effectively in the transformation of our system of maternity care.
Midwifery schools and programs accredited by MEAC prepare midwives for national certification as Certified Professional Midwives (CPMs). These midwives are earning recognition in ever-widening circles. Just this month, the Milbank Memorial Fund, a nonpartisan institute devoted to health policy analysis, issued a new report titled “Evidence-Based Maternity Care: What It Is and What It Can Achieve.” The report cites data from the landmark study of CPMs published in 2005 and concludes:
The low CPM rates of intervention are benchmarks for what the majority of childbearing women and babies who are in good health might achieve.
The report also cites an Issue Brief co-authored by MEAC this year that provides useful background information on CPMs, describes the organizations that support the credentialing and recognition of CPMs, and discusses midwifery and health policy issues.
We are pleased to report that the number of students enrolled in accredited midwifery programs is growing. MEAC currently accredits eight freestanding institutions and two programs that reside within universities, providing excellent midwifery education for more than 500 matriculating students. Four new schools have applied for accreditation within the last year and at least two others have indicated their intent to apply.
As the number of midwives is growing, legal recognition is also expanding. Nearly half of all states now regulate direct-entry midwifery, and at least fifteen other states are considering legislation. At the same time, midwives are working to improve access to care by tackling the complex challenges of insurance coverage, equitable reimbursement, and employment opportunities.
Scroll Down or Click Below to Read:
•The Issue Brief on Certified Professional Midwives
Milbank Report Reveals Serious Problems in Maternity Care Quality and Value
Overuse of Cesarean Section and Other Interventions Puts Women and Babies at Risk, Increases Costs
Over 31% of U.S. births are now by cesarean section although a 5% to 10% rate is best for mothers and babies. The extra cost is well over $2.5 billion per year. The excess cesareans buy no reduction in maternal and newborn deaths. But they cause unneeded exposure to the dozens of adverse effects more common with c-sections. This is just the most striking example of how health care provided to mothers giving birth exposes them to avoidable harm and expense. These conclusions are found in Evidence-Based Maternity Care: What It Is and What It Can Achieve, a report released today by Childbirth Connection, The Reforming States Group, and the Milbank Memorial Foundation.
To view the full Milbank Report titled, Evidence-Based Maternity Care: What It Is and What It Can Achieve, click here.
The report cites an extensive body of evidence to make the case that, despite paying top dollar, American women do not receive the best maternity care. It is the most comprehensive review to date of how maternity care is delivered, financed, and experienced by mothers, families, and health care payers. It concludes that maternity care can be significantly improved using evidence-based care.
Main Recommendations for Improvement
To speed adoption of evidence-based maternity care, the report recommends:
• Develop a standardized evidence-based set of maternity care performance measures to address overuse and underuse.
• Incorporate these measures into Medicaid quality improvement activities, and encourage private insurers and other entities to adopt them.
• Reform the reimbursement system – with such strategies as reducing payment for overused services, increasing payment for underused services, and rewarding high-performing providers and facilities.
• Support more research into evidence-based maternity care, including long-term effects of common maternity practices.
• Increase the use of evidence-based maternity care by educating a wide range of stakeholders.
“If implemented, these recommendations can help close the evidence-practice gap in maternity care,” said Maureen Corry, co-author and Executive Director, Childbirth Connection. “There’s a role for everyone - clinicians, health systems, payers, policymakers, consumers and the media. It’s time to seize the opportunities to ensure that all mothers and babies receive safe, effective and satisfying maternity care.”
“The report shows maternity care is one more example of what’s wrong with American health care. We’re paying too much and getting the worst results in the developed world because of unneeded care,” said Reforming States Group Vice Chair, State Senator Charles Scott of Wyoming. “The main causes are that providers earn more from unneeded care while fear of malpractice litigation encourages the same unneeded care. In my state nearly half the births are paid for by the taxpayers through the Medicaid program. If we can implement the recommendations of this report, we can both reduce costs and improve the care our mothers and babies get.”
Overused Maternity Practices
Cesarean section is one notable example of frequently overused maternity care interventions documented in the report. C-sections are now the most common operating room procedure in the US. Although clearly beneficial and life-saving in selected circumstances, the absolute indications for cesarean section apply to only a small proportion of births. Yet rates have steadily risen from 20.7% in 1996 to a record high of 31.1% in 2006, a 50% increase.
Wide variation in medical practice exists – for example, differences in rates of performing cesarean section vary across physicians, hospitals, or geographic areas. Just a fraction of these differences are due to differences in the health needs of mothers and babies. Rather, this variation reflects differences in professional styles of practice and other factors such as the number of providers and hospitals offering the surgery, concerns about being sued, and financial incentives that favor surgery. The evidence showed that areas with higher rates of cesareans had more inappropriate care and more surgery in healthier women.
The report clarifies that many other common maternity interventions, e.g. labor induction and epidural, are also overused. It can be accessed atwww.childbirthconnection.org/ebmc/
Underused Maternity Practices
The analysis also found underuse of many effective practices with few or no known adverse effects. These practices include continuous support throughout labor (such as provided by a doula), numerous measures that increase comfort and facilitate labor progress, upright and side-lying positions for giving birth, delayed cord clamping, and early skin-to-skin contact between mother and baby. More frequent use of these beneficial forms of care would lead to improved outcomes for many mothers and babies. Best available evidence also supports providing access to vaginal birth after cesarean (VBAC) for most women with a previous cesarean, but such access has fallen off sharply in recent years, despite demand from women, and more than nine out of ten women with previous cesareans now have repeat cesareans.
"Hundreds of rigorous systematic reviews of best evidence assess the safety and effectiveness of maternity practices," said Carol Sakala, lead report author and Director of Programs, Childbirth Connection. "Yet, all too often the evidence is ignored.”
Maternity Care is Major Segment of Hospital Market
Most maternity care provided to women who give birth in US hospitals — a large and primarily healthy population — is resource and technology intensive. Six of the fifteen most commonly performed hospital procedures in the entire population are associated with childbirth. Hospital charges for maternal and newborn care are greater than charges for any other condition: $79 billion in 2005, jumping to $86 billion in 2006.
Maternal and newborn care are the most costly hospital conditions for both Medicaid (which pays for 42% of all births in the country) and private insurers (shouldering 51%). And, the proportion of Medicaid-covered births is growing, making the quality and cost of maternity care a significant public policy issue. The report finds that lower intensity care, like that provided by midwives, is safe and effective, avoids many procedures with established risks, and is cheaper. Yet, just a fraction of women who give birth in hospitals today receive low intensity care.
And while the US spends much more on health care, its performance lags far behind other developed nations on quality indicators including low birthweight, perinatal and maternal mortality, and cesarean rates. The report spotlights the market influences and other factors contributing to what has been called the "Perinatal Paradox: doing more and accomplishing less" (Rosenblatt 1989).
To visit Childbirth Connection who provided the press release for this news story, click here.
To view the full Milbank Report titled, Evidence-Based Maternity Care: What It Is and What It Can Achieve, click here.
Qualified Home Birth Providers
Medscape Today in their article "Science and Sensibility: Choice of Birth Place in the United States: Qualified Home-Birth Providers" states "Fortunately for the American public, evaluations that compare professional competencies and practices among maternity provider groups have found more similarities than differences in the basic skills and components of care that are offered to healthy women across birth settings.[37,38] Scopes of practice and educational pathways to certification and licensure differ among certified nurse-midwives (CNM), certified midwives (CM), certified professional midwives (CPM), family physicians, and obstetricians, but similar standardized competency assessment, quality assurance, and professional accountability measures are in place for each credential. All of the credentialing bodies for these US-based maternity health professionals expect candidates to demonstrate acquisition of both theoretical content and specific clinical skills that are appropriate to their scope of practice."
To read the remainder of this article, follow the link below. If you are not already a MedscapeCME member, you will be asked to create a free membership login and password. Off you go to www.medscape.com/viewarticle/717516_2?src=emailthis
