An Open Letter to the MEAC Board of Directors

Midwifery, Midwifery students, Reflections on racism and oppression in midwifery

The National College of Midwifery is encouraging preceptors and alumni to write letters to the MEAC board of directors using the following language:I am writing to voice my strong opposition to your proposed ban on all out of country clinicals for MEAC students.” Their suggested letter template is not only inaccurate in calling this a proposed “ban,” but this act by NCM is also divisive and fails to acknowledge the careful process that has led to MEAC’s proposed moratorium.

The suggested statement is divisive in that it forces an unneeded dichotomy of extremes. One “camp” decries all out-of-country service learning activities as unethical and the other “camp” assumes that these activities are mutually beneficial for students and the communities they serve.

We are arguing for a third “camp”, one in which MEAC, MEAC schools and other stakeholders including potential host countries/ sites, approach this complex issue with open minds and hearts, and agree to thoroughly explore the concept of culturally competent and ethical care in the context of service learning, whether here in the US, abroad, or both.

We commend MEAC for recognizing the complexity and multi-layered nature of the problem:

“It is clear from the evidence presented by the workgroup that, due to language and cultural barriers, disparities of power, wealth, and privilege, and the difficulties of obtaining informed consent when students are practicing upon a vulnerable or disadvantaged population, many out-of-country clinical placements for student midwives have caused significant harm to the mothers and babies being cared for, to host communities, and to the students themselves. The MEAC Board is deeply concerned about the possibility of students from our member schools perpetuating or being involved in ethical violations, abuses, and exploitation in pursuit of their clinical education.”

We look forward to a creative and collaborative exploration of these complex issues while ensuring that we are not currently engaging in potentially harmful activities. The moratorium proposed by MEAC affords our profession this opportunity. We applaud the MEAC leadership for this bold and appropriate action.

  1. Kathryn Haines, LM, CPM
  2. The Rev. Patricia Ross, OSL, CPM
  3. Marijke van Roojen, LM, CPM
  4. Makeda Kamara, CNM, MPH, M.Ed
  5. Erin Ryan, LM, CPM
  6. Claudia Booker, LM, CPM-PEP process
  7. Wendy Gordon, LM, CPM, MPH
  8. Krystel Viehmann, LM, CPM
  9. Jaqxun Darlin, student midwife
  10. Laura Marina Perez, CPM, LM
  11. Shauntée Henry
  12. Silke Akerson, CPM, LDM
  13. Audrey Levine, LM, CPM
  14. Anne Hirsch, LM, CPM
  15. Kelly Milligan, CPM
  16. Amy Rae Zimmerman
  17. Maria Teresa Noth
  18. Dionne Corcoran, CPM, LM
  19. Annie Moffat
  20. Meg Novak, CPM
  21. Brooke Casey, LM, CPM, IBCLC
  22. Jennie Joseph, LM
  23. Rachel Zazlow
  24. Brenda Burke, CPM, MSW, RN
  25. Grace Hannon, CPM, LM
  26. AnnMarie RianWanzeck, LM/CPM
  27. Kayla Quinlan Frawley, LM, CPM
  28. Cheryl Clearwater, LM
  29. Tiffany Shank, student midwife
  30. Angelique Chelton
  31. Connie Wakaluk, student midwife
  32. Lorrie Leigh, RN
  33. Joelle Ceremy, LM
  34. Nicole Morales, LM CPM
  35. Neva Gerke
  36. Rachael Cook
  37. Helena Wu
  38. Racha Tahani Lawler, LM
  39. Janine Stiles, CPM
  40. Angelita Nixon, APRN, CNM
  41. Jeanette McCulloch, IBCLC
  42. Susan Smartt Cook, CPM
  43. Holly Arends Murphy, CPM
  44. Mary Helen Ayres, CPM
  45. Donna Mitchell, CPM, CLC
  46. Angela Miller, LM
  47. Amy Jo Rist, CPM, LDM, LM
  48. Treesa McLean, LM
  49. Katherine Bramhall, CPM
  50. Michele James-Parham, Traditional Midwife
  51. Kristin Kali, LM, CPM

6 thoughts on “An Open Letter to the MEAC Board of Directors

  1. I am in agreement that out of country sites can be beneficial to both American and Canadian student as well as both midwives in training and clients in host countries. I believe that the exchange of knowledge and cultural information can be obtained while providing sensitive and high quality care to the women we serve. I have worked in birth centers on the border of the U.S. as well as in Guatemala where all parties were benefited and honored. This can be accomplished in a way in which the host nation benefits by an increase in both the number of local midwives but in the increase in skills and knowledge of all involved.
    Thank you for the forum to express these beliefs.

  2. Although MEAC may recognize the complexity of the OOC problem, as stated in your blog, I am seeing a lack of an appropriate level of governance on MEAC’s part commensurate with the complexity and gravity of the issue at hand. Evidence of this is seen by how convoluted the problem has become. Furthermore, MEAC may be out of compliance with the U.S. Dept. of Education and the National Advisory Committee on Institutional Quality and Integrity (NACIQI) regulations by which MEAC is bound, as the accrediting agency, which has been brought to MEAC’s attention.
    Two issues of primary concern include 1) a possible circumvention of their own process when MEAC suggested that schools ‘…consider taking immediate action, without waiting for the lengthy process of MEAC standards revision to be completed’ when the U.S. Dept. of Education states that agencies must ‘have effective controls against inconsistent applications of decision making’. And, 2) the format of MEAC’s questionnaire/survey does not provide an effective mechanism for stakeholders to share their thoughts or explain their perspective for MEAC to adequately examine as required by the U.S. Dept. of Education’s regulations which states; ‘The agency must have effective mechanisms for evaluating.’ Concerns regarding the survey include;
    a. The questions are closed-ended because people are limited to a list of responses (e.g. Yes / No), so the feedback produced is mainly quantitative rather than qualitative. People who want to participate in the survey are restricted to answering questions using the categories provided by the survey presenter. The survey provides a comment ‘box’ but it also shapes the way comments are provided.
    b. The questions concerning the specific out-of-country subject matter are disproportionate respective of addressing the significance of an important issue. Only 4 questions of the 17 total questions or points in the survey deal with the specific out-of-country issue.
    c. Adequate provision for lengthy input by the stakeholder is grossly lacking.
    I do agree with your proposal for a ‘third camp’ and I appreciate your willingness to offer such. We do not believe evidence supports a systemic problem, and we support any appropriate and equitable efforts on the part of MEAC necessary to stop such action without jeopardizing the validity and continuance of out-of-country sites not involved in these claims.

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