Innovations to Support Growth in Midwifery Education

Abstract

Welcome to the first of 2 theme issues highlighting Innovations in Midwifery Education. The last time the Journal of Midwifery & Women's Health focused on midwifery education was a special supplement to the November/December 2016 issue on Clinical Education. The call for proposals for manuscripts resulting in Parts I and II of Innovations in Midwifery Education was in direct response to a request from the Directors of Midwifery Education to share current advancements. Part II will be published in print in Spring 2026; many of those articles are already published online at jmwh.org.

Presenting a collection of articles on midwifery education could not be more timely. The number of midwifery education programs is growing. A review of the 49 midwifery programs listed on the Accreditation Commission for Midwifery Education (ACME) website reveals that 4 of those programs received preaccreditation status (initial approval to admit students and begin a midwifery program) in 2025.¹ In addition, a May 2025 ACME website notice requesting third party comments about pending midwifery program reviews includes 3 institutions with preaccreditation site visits scheduled during the remainder of 2025, potentially adding 3 new preaccredited programs in early 2026.² The number of midwifery program graduates is also growing. The American Midwifery Certification Board reports an overall 64% increase in new certified nurse-midwives/certified midwives (CNM/CMs) since 2000. More recently, 643 new CNM/CMs were certified in 2020, and 750 were certified in 2024.³

The growth in midwifery programs and certification of more midwives comes as the call to integrate midwifery more completely in the US health care system is being amplified. The World Health Organization recently called for global transitioning to midwifery models of care, within interprofessional systems, so that women would “receive equitable, person-centred, respectful, integrated and high-quality care, provided and coordinated by midwives working within collaborative interdisciplinary teams.”^4(p5) The Centers for Medicare and Medicaid Services is currently funding the Transforming Maternal Health program to improve maternity care outcomes for persons insured under Medicaid while reducing costs in 15 states over the next 10 years.⁵

Respected publications have highlighted the ability of midwives to expand access to care and help improve outcomes in the United States. In 2019, the highly regarded Scientific American published an editorial titled The U.S. Needs More Midwives for Better Maternity Care.⁶ The Commonwealth Fund's May 2023 issue brief on advancing health equity described how midwives could address the maternal health crisis in the Unted States.⁷ That same year, the American Journal of Obstetrics and Gynecology published an article, primarily authored by midwives. The article presented the practice of midwives in the labor and birth setting along with evidence and recommendations for models to further integrate midwives into US health care to address the perinatal health care crisis.⁸ An additional article examining outcomes and costs associated with midwifery care in multiple hospitals in one region of the United States estimated a potential cost savings of $340 million annually if midwives attended all low-risk US births.⁹

Nearly every publication addressing the improved outcomes and cost savings that could be attained by further integrating midwifery practice into US maternity care includes the need for more midwives. The American College of Nurse-Midwives’ (ACNM) recent workforce study addresses the barriers that must be overcome to expand the midwifery workforce across the country.¹⁰ A bold new campaign promoting 50% of newborns in the United States to be born with the care of midwives by 2050 was recently launched.¹¹ ACNM is among many other groups and organizations that have signed on to that audacious goal. And why not?

Although the articles published in the 2 theme issues addressing Innovations in Midwifery Education do not directly address expanding the number of midwives educated and certified to practice in the Unted States, the authors share a range of sometimes fun and always innovative ways to educate midwives. Readers will appreciate the timely opportunity to learn about new ideas for simulations, uses of artificial intelligence in midwifery education, abortion training, as well as the education of midwives and interprofessional colleagues after basic education, and a couple of innovations related to global health. Several articles explore how our midwifery programs can be inclusive and welcoming to all learners, including ways to help students appreciate biases, both systemic and their own, that contribute to less than optimal health care and outcomes, along with strategies for making much needed changes.

We invite you to sit back and open your print or online journal. These theme issues are offered as an opportunity for continuing education for CNM/CM readers and possibly others depending on specific professional requirements. Although written primarily about, for, and by midwives, these topics will also be of interest to other health care professions educators and are intended to be read widely. Enjoy learning something new! If you are an educator, appreciate these advances in midwifery and other health care professions education as we educate more midwives in the United States. If you are primarily a clinician or policy advocate, take the time to review articles and consider opportunities you may have to promote midwifery education growth. Can you mentor a student, serve as a preceptor, partner on pay equity or state legislative advocacy, or volunteer some time sharing your expertise with these learners? They are the future of our midwifery profession.

Melissa D. Avery, CNM, PhD

Editor-in-Chief