Active Participation in Seeking Legislative Change

Reflections on racism and oppression in midwifery

There are a variety of paths and opportunities for midwives seeking involvement in efforts to improve health equity for communities of pregnant, birthing, and postpartum persons that have been historically attacked and marginalized by the maternal healthcare system. The process of getting involved is multifaceted. Because the attack on certain communities occurs at all levels, legislative advocacy is important at all levels, be that local, regional, state, national, or global. A midwife interested in becoming involved with legislative advocacy should evaluate what level they are connected to and interested in, as there are many opportunities for legislative advocacy.

In an era of technology, online research is a frequently used method of familiarizing oneself with existing advocacy organizations. Most of them have an online platform for education and communication, such as the Black Women Birthing Justice website. Their campaign goals are clearly listed and include many calls to action that require multiple moving parts, one of them being legislative advocacy. Another resource is the website of the National Latina Institute for Reproductive Health, which describes the movement’s missions, goals, campaigns, and ways to get involved. As a midwife, reaching out to these campaigns and movements through establishing connections as a student, provider, and/or volunteer is a way to seek legislative change. In an interview with D’Almeida (2016), Alicia Bonaparte states that the birth justice movement is focused on legal and policy level action, such as forcing insurance companies to cover midwifery-led care. While there are several ways to support this legislative agenda, one strong and influential way to contribute is by working with state midwifery associations.

While some states have an active and well organized state midwifery association that works with lobbyists for legislative change, not all states have the ability to do so. One way to get involved with legislative change is to support and/or start state organizations. While states where Licensed Midwives are legal and licensed have a state professional organization, the ability and spectrum of advocacy for legislative change varies. Therefore, midwives who live in states where legislative advocacy is limited can begin constructing ways to address legislative agendas through working with their local associations. They can also work with a lobbyist or other legal professional to advance the midwifery profession by addressing issues related to oppressed and marginalized populations. On a similar note, there are currently 21 states that have a National Association of Certified Professional Midwives (NACPM) chapter, but for those working in states that do not have one, working with other midwives to begin a chapter could be influential for policy change.

Research and projects devoted to addressing health inequity for pregnant, birthing, and postpartum persons through a midwifery lens are influential for legislative advocacy as well. Bennett (2016) delves into the ways in which midwifery care for incarcerated individuals seeking prenatal, birth, and postpartum care can improve outcomes. This kind of project sheds light on a subject that can be presented to local, regional, state, and national midwifery organizations which can further bolster the building blocks of legislative agendas. Staying connected to ongoing midwifery care research allows midwives to back up legislative agendas with relevant, evidence-based information and present it to state or national midwifery associations.

The idea of seeking legislative advocacy change as a midwife in the United States can seem daunting. The U.S. community midwifery profession is not nationally recognized which poses problems and obstacles with legislative advocacy efforts. However, it is crucial for midwives to connect with their local, state, and national midwifery associations to assist in the time and effort it takes to create and execute legislative agendas and change. There are a variety of paths to go down to assist in legislative advocacy for health equity. Midwives are in a unique position to do this work, especially because there is ample evidence indicating that community midwifery provides more equitable, quality care for communities at risk. Still, it is a marginalized profession seeking wider recognition. The first step is to find out how communities that have historically been attacked by the maternal health care system have the potential to benefit from midwife-led care. From there, one can directly support relevant campaigns by volunteering or establishing connections between existing campaigns and their state midwifery association. Furthermore, a powerful use of time and effort is assisting in the development of state-level midwifery associations in order to formulate and act on legislative agendas.

Written by Emily Jones, Bastyr University Midwifery Student



Bennett, R. B. (2016). Locked Out of Options: Advocacy & Utilization of the Midwifery Model of Care for Pregnant Prisoners in the United States (Unpublished master’s capstone). Bastyr University: Kenmore, WA.

D’Almeida, K. (2016). Exploring birth justice: A conversation with Julia Chinyere Oparah and Alicia Bonaparte. Retrieved from

Morton, C.H. & Basile, M. (2017). Medicaid coverage for doula care: Re-examining the arguments through a reproductive justice lens, part one. Retrieved from

National Latina Institute For Reproductive Health. (n.d.). Retrieved from

Oparah, C., Jones, L., Hudson, D., Oseguera, T., & Arega, H. (2017). Battling over birth: Black women & the maternal health care crisis in California. Retrieved from

Leave a Reply

Fill in your details below or click an icon to log in: Logo

You are commenting using your account. Log Out /  Change )

Google photo

You are commenting using your Google account. Log Out /  Change )

Twitter picture

You are commenting using your Twitter account. Log Out /  Change )

Facebook photo

You are commenting using your Facebook account. Log Out /  Change )

Connecting to %s