Cigars All Around — The PushChart is Born!

by PushGirl Friday on April 29, 2012

Yes indeedy, today is an exciting day!! It is the day when the separated-at-birth companion to the PushMap — the brand new PushChart — is born.

PushChart you say? Never heard of it? …

Push for Midwives State Regulation PushChart Download and Share!


… Well, to provide a bit of background, we were sitting around at The Big Push for Midwives Campaign war room, reviewing the daily strategy, analyzing the newest headlines, checking the statehouse-sausage-making reports, when we hit upon the need to create an entirely new visual aid that shows the basics of our cause — the nuts and bolts, if you will, of our movement:

  1. Where are Certified Professional Midwives (CPMs) licensed?
  2. Which state groups are presently in the active pushing stages?
  3. Which state groups are busy making plans to push forward in the next legislative sessions?
  4. For states with CPM licensure or where CPMs are legal, what dates were those laws enacted?

After all the calls, emails, letters, and messages we’ve gotten from journalists, bloggers, researchers, moms, dads, midwives, and supporters, it seemed like a PushChart such as this could go a long way to more readily identifying the status of CPMs in each state (and territory). Frankly, it seemed clear that the PushChart was long past due.

Beyond these basics above, we saw how the PushChart format would lend itself well to answering other pressing research questions, such as the “per-state percentage increase in the rate of out-of-hospital births correlated with that state’s licensure status.” Among the most helpful aspects of the new PushChart as we considered it, was that legislators could plainly see — in a handy one-page format — what their fellow state legislators are doing and when exactly they did it.

What’s the Big Deal about CPM State Licensing Laws??

The PushChart project highlights the fundamental importance of state licensing laws. While we all share in the excitement of the news that CPMs and the CPM credential are making headway in the U.S. Congress and in the halls of government in Washington, D.C., the excitement is more than a little tempered by the reality that unless and until CPMs are licensed in a particular state, no federal legislation will take effect in that state.

To wit, as birth centers are learning, state Medicaid plans will NOT cover freestanding birth center services unless the birth center holds a state license, and state Medicaid plans will NOT cover professional services of midwives in birth centers unless the midwives are licensed.

The same will inevitably be true with education loan repayment programs and other federal initiatives. The National Health Service Corps is simply not going to place a CPM in a maternity care shortage area of a state where CPMs are not licensed, and CPMs who are not licensed by their state cannot be eligible for Medicaid reimbursement.

Likewise, in January 2014, when the provider non-discrimination provision of the health care reform law went into effect — it is requiring all health insurance companies and managed care plans to include all categories of state-licensed health professionals in their networks — CPMs will NOT qualify for inclusion with other health professionals unless they are licensed.

U.S. ConstitutionUnder the U.S. Constitution, only state legislatures — not the federal government — can license health care providers. The Constitution reserves this power strictly to the states. Ultimately, it is state licensure that will ensure that all women have access to CPMs, making them easier to find by legally qualifying them to practice under state agency standards, and making them more affordable by covering their services under private insurance and Medicaid.

So, now is the time for us to re-double our “in-state” efforts. Walking the halls in state legislatures is the most important thing that can be done — right now — to advance midwifery in the United States.

Here at The Big Push for Midwives Campaign nerve center, we are inspired by all of the incredible efforts performed daily by the hard-working, dedicated, unsung, and amazing PushState advocates. What each of you are doing for mothers and babies (and their babies and their babies) every day, against nearly insurmountable odds, in so many states across this great country — well, it’s certainly more than possibly can be shown in this simple little PushChart. But it is important to note: we see you, we honor you for all that you are doing, and we are here from sea to shining sea to support you in any and every way that we can.

Please download and share our newest little bundle of joy:
Push for Midwives CPM State Regulation PushChart_APRIL 2012
Push for Midwives CPM State Regulation Push Chart_MAY 2013
Push for Midwives CPM State Regulation Chart_SEPT 2013


{ 1 comment… read it below or add one }

Estaka May 23, 2012 at 9:35 am

My understanding is that you aren’t criticizing education but the current model of education – and I couldn’t agree more. I am not a fan of standardized anything, especially education. Standardization breeds mediocrity as we can see when we step into any restaurant chain that expects the food and atmosphere to be standardized at every location. I understand that we all want to be ensured a qualified professional but, IMHO, standardization does not promote this goal, in fact it inhibits this goal. Standardization requires that everyone be taught the same things in the same way – and this is not conducive to real learning. Programs that center on apprenticeship with classroom learning in a small, enrichment type role would not be standardized but would, again IMHO, create more competent professionals. At the end of the day I’d much rather have a midwife with 100 hours of experience with another competent midwife and a few hours of classroom instruction than one with 100 hours in a classroom and a few hours assisting another midwife. But this model would not be standardized because no two births are alike and therefore a program that relies on apprenticeship would result in varied experiences for all professionals. But those varied experiences would provide opportunities to problem-solve, learn to communicate well with laboring mothers and other birth attendants and confidence in one’s abilities. I applaud you for pointing out the need to rise above the mediocrity of standardization. Keep fighting for what’s truly best for women and babies!


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