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CPM Certified Professional Midwife

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CPM exam Dumps Source : Certified Professional Midwife

Test Code : CPM
Test Name : Certified Professional Midwife
Vendor Name : Medical
: 40 Real Questions

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Medical Certified Professional Midwife

certified nurse midwives create the right beginning for every woman | killexams.com Real Questions and Pass4sure dumps

When three midwives accumulate for a lunchtime damage at St. Mary's OB-GYN and Midwifery health facility, the banter naturally turns to infants — greater mainly, to how newborns enter this world.

The midwives share reports in regards to the joys of recent births. They evaluate notes on the array of aids they offer mothers to make the deliveries as relaxed as feasible — Jacuzzi tubs, pastime balls, aromatherapy, therapeutic massage, music, nitrous oxide. The comfortable dialog underscores the midwife philosophy that childbirth is a herbal method, now not a pathological condition.

Normalization of the beginning procedure is a tenet of the care midwives provide to ladies earlier than, all through and after childbirth. licensed Nurse Midwives, like these on staff at St. Mary's, also are trained to give basic and neatly-girl look after girls all through their lives.

St. Mary's clinical middle has recognized the cost of midwife care by adding these three midwives to its staff in the closing 12 months. one other will be a part of the apply in August. The midwives work independently however also collaboratively with OB-GYN's in the maternity ward, with high-risk Maternal Fetal medicine physicians, and with consultants in St. Mary's Neonatal Intensive Care Unit.

"St. Mary's is now a one-cease store for every little thing related to childbirth. everything is effectively seamless. When ladies walk via their doorways, they've the midwife care, the abilities of OB-GYNs if crucial, and the excessive-risk specialists all in the identical building. That is not discovered anyplace else within the Grand Valley or on the Western Slope," observed CNM Holly chippie.

carpenter and her fellow midwives Anita Sheetz, Katherine O'Reilly, and shortly, Leslie Gibson, have childbirth experience that provides up to greater than three decades and to greater than three,000 little ones. They also have more than 25 years of education between them. each has a string of professional initials following her identify.

They present the epitome of contemporary health facility-linked birth care. They additionally symbolize an historical career.

The time period midwife came about within the middle ages in England. In ancient English 'mid' capacity 'with.' 'Wif' capacity 'woman.' however the follow of experienced ladies attending childbirths was first documented in historic Egypt.

Perceptions of midwifery have changed through historical past. every now and then, midwives were maligned and misunderstood. Some have been considered witches within the early days of this country because they used herbal remedies. Midwives had been marginalized in other eras as caregivers for less than the terrible or for the "hippie" tradition.

at present, the pendulum has swung to certified midwives being diagnosed as pregnancy and start specialists. greater than 12,000 licensed Nurse Midwives (CNMs) presently apply within the united states. They attend 12 percent of all non-Caesarean births. greater than ninety five percent of the births they attend are in hospitals as opposed to buildings.

Sheetz, who has been a midwife for 21 years, said she thinks greater ladies within the U.S. are turning to licensed midwives because of midwives' patient-pushed perspective toward childbirth.

"we endorse women being empowered to have the delivery it really is correct for them. They are attempting to support them in making anything selections they make. they are here to aid guide them of their selections," Sheetz noted.

Jeff Emerson, St. Mary's practice administrator, stated the demand for midwife care is why the medical institution determined so as to add nurse midwives to the group of workers.

"For us, they noticed a necessity within the community that become no longer being met. They saw building a robust midwife follow as a true advantage to the neighborhood," he said.

Having midwives on body of workers at a health center is one other step in normalizing a career that traditionally handled pretty much all births in the united states. It wasn't unless the last half of the 18th century, when the apply of medication grew to be professionalized and clinical interventions grew to become the norm in childbirth, that physicians edged out midwives. by way of the starting of the twentieth century, below half of all U.S. births were attended through midwives.

Midwifery begun a slow comeback in hospitals within the Nineteen Fifties when practising become professionalized and when some sanatorium administrators developed in-hospital midwifery services to help cope with the put up-warfare baby boom.

Use of midwives still has loads of catching up to do within the u.s.. in lots of international locations, midwives carry nearly all of children. Midwives carry greater than 75 p.c of babies in remarkable Britain, France, Germany and Scandinavia.

Midwives can take credit score for triggering changes in attitudes relating to childbirth within the last half century. They helped to benefit acceptance for the as soon as radical idea that fathers should be allowed in the beginning room. Midwives pushed for babies to be left in mothers' rooms as an alternative of being positioned in nurseries. and they had been instrumental in promotion the return to breast-feeding.

these days, the American school of Nurse Midwives oversees certification and carrying on with schooling for midwives. the most totally expert stage of midwife is licensed Nurse Midwife. These midwives were expert as nurses and earned master's levels in licensed midwifery courses. they've passed national certification checks.

St. Mary's midwives are all during this class of CNMs. because of their stage of coaching, they're allowed to deliver regularly occurring girls's fitness care together with beginning capabilities. they can additionally prescribe drugs.

certified midwives (CM) — have bachelor's degrees in fields apart from nursing and additionally a master's in midwifery. they've the identical midwifery education and move the same country wide exam as CNMs.

certified knowledgeable Midwives (CPMs) — have apprenticeship working towards, or are graduates of a formal midwifery training software. CPMs ought to move a national certification exam, which is distinctive from the look at various for CNMs and CNs. CPMs don't work in a health center surroundings.

Midwives are knowledgeable and have the experience to respect when something isn't correct all through a pregnancy or delivery. If there are complications, the St. Mary's midwives say they could check with, collaborate or refer patients to a much better stage of care, usually an OB-GYN. If a girl is diabetic, wants a C-part or has different circumstances requiring health care provider care, the midwives direct these people to a health care provider and continue aiding their sufferers with the aid of working collaboratively with the medical doctors.

Midwives guide natural childbirth. but if moms choose to have pain medications or epidurals, midwives guide these decisions on the same time they promote attempting comfort measures like whirlpool baths and therapeutic massage. They even have a new choice for ladies — nitrous oxide, in any other case favourite in dentist offices as "laughing gas." ladies in labor can administer it to themselves by maintaining a masks to their faces all the way through contractions. The nitrous oxide passes via their system in seconds and is secure for the child.

"one in all their most crucial jobs," O'Reilly noted, "is to supply women all of the options and aid them make educated choices about what they need."


Nurse Midwives Are expert, Lifesaving professionals. Why Are They maintaining Them back? | killexams.com Real Questions and Pass4sure dumps

photograph illustration with the aid of Slate. pictures by using Thinkstock.

At a time when maternal mortality quotes are decreasing worldwide, they greater than doubled between 2000 and 2014 within the U.S. and specially affected women of color. a simple solution to the skyrocketing prices and scarce entry to maternal care is at their fingertips: nurses. Jessica Henman received her grasp’s and license as a certified nurse midwife in 2010, however when she went to observe within the St. Louis area, she hit a wall. She mandatory to set up a legal “collaborative settlement” with a doctor who would review her charts, approve prescriptions, and be held responsible for her work. however because Missouri doctors are restrained in the variety of superior observe nurses they can collaborate with (three), she had a hard time discovering one. “I contacted over one hundred physicians and couldn’t discover a collaborator,” recounts Henman. In Missouri, a physician should review the work of superior apply nurses; if that doctor gets hit through a bus and isn’t in a position to apply, Henman can’t observe. mockingly, Henman went back to get a lesser degree as a licensed knowledgeable midwife so she could practice without a collaboration agreement. For her first two years as a midwife, Henman operated under a lesser certification and only took low-possibility pregnancies of moms capable of pay out of pocket.

To do what they’re enormously educated and licensed to do—such as take blood power, perform maternal fitness tests, and, in the case of certified nurse midwives, carry little ones—nurses throughout the nation face distinct suggestions about what components of that practising and licensing they’re in a position to put into observe, and these laws are inspired by way of the American scientific association, which claims it protects affected person safeguard. a brand new analyze within the Journal of health Economics examines the impact these additional rules, or scope of observe laws, have on maternal fitness effects. The reply: none. Being supervised by using a doctor doesn’t enrich maternal health care, but it definitely makes it greater expensive and problematic to get.

The look at’s lead creator, Sara Markowitz, says the analyze indicates that “boundaries aren’t involving care—they’re administrative red tape. The arguments that docs are making—[that they are being] defensive of women and baby fitness—aren't bearing out.” In different words, states that make it extra tricky for nurse midwives to apply don’t event greater maternal fitness. They do, besides the fact that children, see bigger charges of cesarean sections and brought on labor. Markowitz attributes this difference to competition from midwives—doctors change their behavior depending on the habits (and perhaps vigour?) of nurse midwives. When nurse midwives can practice, docs are less likely to recommend excessive-chance cures unless they are very critical.

Markowitz et al.’s study gives proof that the choice between using nursing or OB-GYN care doesn't have an effect on many effects, equivalent to birth weight and gestational age. That’s because lots of the essential care pregnant girls want—counsel to video display stress, take prenatal nutrition, and evade smoking and ingesting—could be given by using a midwife or OB-GYN.

If these suppliers are available and their care adequate, why are so many women having challenge getting access to family planning, care at each and every stage of their pregnancies, and aid after birth? however midwives work throughout the pink tape to be capable of follow, many sufferers who want them can’t afford them. according to Mary Jane Lewitt, CNM and a co-writer of the look at, there are many patients caught in the middle who “make too a lot for Medicaid and never sufficient for private insurance. they could’t find the money for prenatal care and drop into emergency labor and start.” And when labor and birth gadgets close and the variety of obstetricians declines, as they've in rural the united states and across the broader U.S., infant and maternal fitness suffers. a brand new look at by means of Peiyin Hung et al. found that, between 2004 and 2014*, 2.four million girls lived in counties with no obstetric capabilities: 9 percent of rural counties noticed all obstetric services shut, and an extra forty five p.c did not offer obstetric capabilities to start with. Even in D.C., as of October, there were no obstetric amenities within the eastern half of the city.

Rita Ledbetter, a CNM at clinical Arts pals in Moline, Illinois, has additionally struggled with collaborative agreements throughout her 24 years: “For me, we’re on the mercy of their collaborative doctor.” however a CNM establishes a collaborative contract, procuring labor and birth can also nonetheless be an issue. compensation costs from Medicaid are low, and funds are often made late. Ledbetter says that after repayment costs for maternal health care lowered in 2015, her practice, which she describes as “two-thirds indigent, one-third yuppie,” determined now not to take these low-income shoppers any further. “There became a whole cohort of women without care. For me, what that intended, I refused to cease seeing very high-possibility patients. i was basically concerned that I may get fired, because ethically I couldn't do what my area of enterprise turned into requiring. They [Medical Arts] worried about working a company. i used to be worried about dumping patients,” says Ledbetter. And “dumping patients” intended moms and little ones would doubtless go without care.

Kristin Richman, a California-based CNM, additionally struggles with reimbursement charges: “Medicaid doesn’t cowl out-of-health center midwives [in California], and midwives have problem opening private practices due to exhausting regulations.” Medicaid and the children’s health insurance program pay for just about half of all births within the U.S., excluding many people from the use of practitioners like Richman in a state that wants them the most. California anticipates a prime care scarcity by way of 2030.

nonetheless it doesn’t need to be that approach. Mairi Breen Rothman has been in apply along the Washington-Maryland border considering 1996. as a result of Maryland’s legal guidelines had been a lot greater burdensome than the district’s, when she opened her own observe—M.A.M.A.S. Inc.—in 2007, she all started in D.C. because of the efforts of nurses like Rothman, in 2014, Maryland started permitting licensed nurse midwives to observe with simply proof of their training and a license. The outcomes? “We’ve attended over 600 children, have a 5½ p.c cesarean rate, and an eight percent transfer cost.” Translation: loads of match little ones born with less costly, less dangerous tactics.

Rothman contends that if she or other CNMs have been capable of take patients coated by using Medicaid, they might help reduce the chance and price of maternity care through featuring the functions they do—like critical ongoing fitness monitoring—instead of those hospitals decide on, like costly C-sections. “we'd want to offer their capabilities to women on Medicaid, however Medicaid presently requires a prohibitive quantity of legal responsibility assurance that they in reality don’t need because they are not a part of an establishment. If they were able to serve Medicaid consumers, they estimate that we'd be able to keep the state of Maryland somewhat a bit of cash.”

If midwives had the capability to work to the total extent of their practising, their observe would expand access, in the reduction of cost to maternal health care, and supply meaningful job opportunities in the quickest-growing to be sector of the economic climate, care work. but making those alterations received’t be handy, largely since the repute quo is maintained by using effective agencies like the American clinical association. even though the gender breakdowns of the professions have modified, the elevation of historically masculine jobs like docs and a devaluation of feminine jobs akin to nursing may nevertheless be swaying policy toward limitations that are actively hurting care. Polls show that nurses are the most depended on of any occupation. most likely it’s time for policymakers to translate that appreciate into greater wages and independence.

*Correction Nov. 6, 2017: This submit initially misstated that Peiyin Hung’s study on access to obstetric functions lined effects found between 2000 and 2014. It was from between 2004 and 2014.


bill to certify midwives passes after years of effort | killexams.com Real Questions and Pass4sure dumps

Loud clapping and shouts of joy crammed the state house chamber March 13 when a bill to give licensed midwives professional recognition in Kentucky handed after many years of labor with the aid of lawmakers and advocates.

"here's no longer a bill about even if or now not to allow home births; those are going to turn up. this is a bill about making sure households who choose home start have entry to protected and competent care suppliers," referred to Rep. Russell Webber, R-Shepherdsville, who offered Senate invoice 84 in the residence.

The bill became the fourth attempt via Sen. Tom Buford, R-Nicholasville, to certify midwives. several others had tried earlier than him, however unless this yr they were met with strong opposition from the Kentucky clinic association and the doctors' lobby, the Kentucky scientific association.

however each these businesses, and the American school of Obstetricians and Gynecologists, went impartial on the invoice after the condo changed this 12 months's edition to require collaboration between midwives and health providers, guidelines for managing medium- and high-risk births, and an advisory council to advocate rules to the Kentucky Board of Nursing.

one of the council's ideas will consist of instructions for use of medicinal drugs, ordering of scientific exams, and guidelines for transfer to hospitals when necessary, Webber referred to.

as the invoice went to the apartment committee, Weber advised Kentucky health news that midwives and buyers had been persistent of their efforts to show legislators about what they do. "I nearly liken this effort to a David versus Goliath condition," he mentioned.

Rep. Chad McCoy, a Republican legal professional from Bardstown, brought an change that could guarantee that no fitness-care provider would pick up any liability as a result of a midwife, and that each and every person worried in the care of a patient would be liable for his or her own negligence.

Upon last passage of the invoice, Sen. John Schickel, R-Union, chair of the Senate Licensing, Occupations and Administrative rules Committee, referred to that the panel had commonly heard such expenses. He said passage turned into the influence of a long effort that had been contentious from time to time, although everybody concerned endured to work toward the surest result.

"here's basically a historic day I suppose for fitness care, for the midwives, for a new day, [and] for the infants of Kentucky," he spoke of.

The changes the condominium made to the invoice even allowed Republican Sen. Ralph Alvarado, a doctor from Winchester, to vote sure, after being certainly one of its loudest opponents in prior years and voting no on the normal edition.

The bill passed on a vote of 96-1 within the residence, with handiest Rep. Kim King, R-Harrodsburg, vote casting against it. The Senate concurred with the adjustments the following day on a 35-1 vote, with best Sen. Stan Humphries, R-Cadiz, vote casting towards it. The normal Senate vote on Feb. 21 become 32-four. The bill now strikes to Gov. Matt Bevin for his signature or veto.

Buford referred to when proposing the bill to the Senate in February, "here is a personal alternative made by these families for a lot of causes. They must ensure the households who choose this option have entry to excellent care via … the licensing of midwives."

as it stands, Kentucky has no guidelines or rules for midwives. When providing the invoice on March 6 within the apartment committee, Buford mentioned, "consider it or now not, I could be a midwife today, and i comprehend nothing about it."

Mary Katherine DeLodder, a frontrunner of the Kentucky home delivery Coalition, advised the committee that the invoice is set legitimizing midwifery, for the reason that right now you do not know what you are getting for those who hire a midwife and communications about them are typically shared via social media. "it's such as you should recognize the secret handshake now and again to locate your midwife," she observed.

She spoke of Kentucky has about 700 domestic deliveries a yr, and 33 states have already got certified knowledgeable midwife programs. A letter on the coalition's web page in regards to the bill's passage says Kentucky has about 20 certified professional midwives.

Elizabeth Regan, president of the Kentucky Chapter of countrywide affiliation of licensed expert Midwives, informed Kentucky fitness information that SB 84 become about entry to midwifery care: "here's what they comprehend makes home births safe, integration into the higher health care device and building collaborative relationships."

Kentucky health news is an independent information service of the Institute for Rural Journalism and neighborhood concerns, primarily based in the school of Journalism and Media on the college of Kentucky, with aid from the basis for a healthy Kentucky.


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Certified Professional Midwife

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Kentucky home birth families celebrate midwife law | killexams.com real questions and Pass4sure dumps

LOUISVILLE, KY (WAVE) - A new Kentucky law is trying to bring a once-regulated industry, which was forced underground, out of the shadows.

Advocates want to create the safest experience possible for mothers who decide they want give birth at home instead of in a hospital.

Leacoln Bale said the law brings Kentucky midwife standards up to par with surrounding states.

Bale, a mother of two, said it was not long ago when she was deciding how to bring them into the world.

“When I was pregnant the first time, I realized I wanted a home birth,” Bale said. “I wanted as natural a birth as possible, and I wanted someone who is an expert in natural birth. That is a midwife.”

That's exactly what she did. Bale said home births, like the one she had, aren't for everyone, but she now wants others in Kentucky to have the same safe options she did.

"Well, right now, anyone could attend your home birth and call themselves a midwife," Bale said.

That’s something Bale said took the industry underground, making it possibly more risky, but it’s also something she said is about to change for the first time since 1975, when midwifery stopped being regulated in Kentucky.

Senate Bill 84 passed through the legislature with ease this year and has been signed into law by the governor.

It will license certified professional midwives in Kentucky, lay out framework for how home births will be transferred to hospitals if needed and provide oversight through an advisory board.

“Now, myself as a consumer, when I hire a midwife for my home birth, I can ask her if she is licensed,” Bale said. “If she is licensed, then I know she meets a certain standard of care.”

Bale said that may improve relationships between doctors and midwives, ultimately benefiting mothers giving birth.

The legislation is an accomplishment many have been working towards for decades.

It’s something Bale, a Kentucky Home Birth Coalition volunteer, said she’ll cherish for years to come.

"It was surreal, it was amazing," Bale said. "I'm so glad that I volunteered for this and worked for this. I have two daughters myself and I can't wait to tell them the story of how they helped."

Bale said she expects the first certified professional midwife to be licensed by the summer of 2020.

Copyright 2019 WAVE 3 News. All rights reserved.


Gov. Bevin signs law to certify professional midwives | killexams.com real questions and Pass4sure dumps

FRANKFORT, Ky. (WKYT/WAVE) – Governor Bevin has signed a new bill into law that will license midwives in Kentucky, in an effort to help new mothers.

WAVE3 News reports that advocates say the legislation will provide parents with peace of mind, by allowing mothers who choose home birth over a hospital to do so more safely.

Being a midwife was never illegal in Kentucky, but the industry hasn't been regulated in the state since 1975. That means pretty much anyone could attend your birth, and call themselves a midwife, until now.

Senate Bill 84 lays out a framework for home birth, and equips certified professional midwives with a license.

An advisory board will also be put in place to uphold these new standards.

Advocates hope the new law will improve relationships between doctors and midwives, and ultimately benefit future moms.

"As a consumer, when I hire a midwife for a home birth, I can now ask her if she has a license. If she is licensed, then I know that she meets a certain standard of care," says Leacoln Bale, with the Kentucky Home Birth Coalition.

The goal is to start issuing licenses in Kentucky by the summer of 2020.


Black Maternal Health Week: Meet women who are working to improve maternal mortality rates | killexams.com real questions and Pass4sure dumps

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April 8, 2019, 6:20 PM GMT / Updated April 11, 2019, 4:42 PM GMT/ Source: TODAY

By Gabrielle Frank

No woman is turned away from Commonsense Childbirth in Orlando, Florida, no matter her financial status or prenatal risk factors. This open and easy access to prenatal care is just one of the elements of midwife Jennie Joseph’s goal of improving the survival of mothers and their babies.

It’s a method of care that has led Joseph, 59, an internationally-trained professional midwife, to become one of the rising voices in the demand for change in maternal health, especially for mothers of color.

"There is no reason they won't let you in the door, period," Joseph said. "You could be uninsured, no money, homeless, 35-weeks pregnant, whatever. They will see you."

Moms in America are dying before, during and after childbirth at rates far exceeding other developed countries. The statistics are more dire for African–American women: In the U.S., the risk of pregnancy-related deaths for black women is 3-4 times higher than white women, according to the Centers for Disease Control and Prevention. And their babies are at risk too: Infants born to African-American mothers are dying at twice the rate as infants born to non-Hispanic white mothers.

Over the last year, numerous reports have brought the tragedy of maternal deaths in America to the center of research and new legislation. But Joseph knows it beyond the statistics.

"This is not a new crisis. This has been here. It's just never been taken care of," she told TODAY.

None of this attention has helped to change the alarming statistics — yet. But there are women in the maternal health community nationwide who are taking action now through research, advocacy, policy change and efforts to improve the basic standard of care. Their hope is to create lasting, life-saving change for future mothers.

Just how long will it take?

Jennie Joseph and one of her patients at her practice in Orlando, Florida.Zach Read Meet Jennie Joseph, a midwife and maternal health advocate.

As a practitioner in Florida, Joseph sees the issues with prenatal care daily — and her frustrations are evident. Her mission is to raise awareness and call out one of the largest issues relating to African-American mothers: racism.

"Many of the studies, research will come up with, oh, well, black — being black is a risk factor. No. Racism is a risk factor," Joseph said.

"I feel strongly about how they are, as women, treated in a system where they don't know what to ask. They haven't got a voice. We're not heard. Black women, especially, are not heard. Native women — Hispanic women, Latinas, any woman who is other is not heard. The system is not set up to hear her," Joseph continued.

Joseph has recently spoken at panels at South by Southwest and at the Center for American Progress, highlighting how racism and the health care system work to disenfranchise African-American women specifically. Pointing to her method of care, "The JJ Way," she is hoping to raise awareness that simple changes can have lasting results.

Jennie Joseph speaks on a panel at the Center for American Progress in Washington, D.C., about eliminating racial disparities in maternal and infant mortality in December 2018.Zach Read

Joseph has been practicing in Orlando since 1994, when she opened a home birth practice. A few years later, she wanted to see a more diverse population, and opened her first easy access clinic in 1999.

One singular goal

Joseph's vision has been focused on providing care to women who were under served or unable to pay for proper prenatal care.

Over the years, she developed "The JJ Way" as a standard of care for pregnant women. In 2007, the Health Council of East Central Florida analyzed outcome data for 100 low-income clients of Joseph's practice. Results found that Joseph's practice of patient-centered care improved the percentage of low-birth weight and preterm babies, all while keeping the mothers healthy too. A further analysis of her program funded in 2016 by the West Orange Healthcare District showed that following The JJ Way resulted in the elimination of health disparities in preterm birth outcomes and reductions in low-birth weight babies in at-risk populations.

Her method has four parts:

1. Access: No woman who is in need of services is ever turned away, regardless of insurance or financial situation, citizenship or perinatal risk status.

2. Connection: The connection of women to services and support begins at the first visit. The patient’s family or supporters are invited to participate in the prenatal care process.

3. Knowledge: Information is delivered to patients in a way that is culturally-responsive to their needs and enables them to make decisions about their treatment at a pace that feels safe to them.

4. Empowerment: Empowerment results from having access to high-quality, cost-efficient services, and a connection to support which leads to an increase in knowledge, agency and self-determination.

"It doesn't cost any money," Joesph said, referring to her model of care, which is in the process of being adapted by a handful of maternal health providers. "It's an agreement that they are here only to center the mother. We're here only to get that full-term healthy baby that she's looking for ... We're all on the same page."

The message of "The JJ Way" is spreading.

Brittany Tru Kellman, 32, is a certified-professional midwife and founding director of Jamaa Birth Village, a pregnancy resource center for women of color in Ferguson, Missouri. In mid-July, Kellman plans to open a birthing village where they can provide direct care — and her practice will follow The JJ Way.

"The JJ Way builds a level of trust and empowerment that helps to shape the rest of a woman's life," Kellman explained. "If a woman is traumatized every time she goes to a doctor, that affects the rest of her life, and her child's care. (The JJ Way) empowers women to take the biggest push forward to pull women out of this health crisis."

The Black Mamas Matter Alliance brings awareness, starts Black Maternal Health Week

While Joseph delivers healthy babies to mothers at her clinics, there are also national groups such as the Black Mamas Matter Alliance and SisterSong advocating for and sparking conversations around black maternal health.

"We envision a world where Black mamas have the rights, respect, and resources to thrive before, during, and after pregnancy," the Black Mamas Matter Alliance website states. The Atlanta group is comprised of 60 different organizations designed to advocate and drive research for black maternal health, rights and justice.

The BMMA staff and advisory committee pose for a photo at their Black Maternal Health Conference and Training Institute in 2018.Courtesy of The Black Mommas Matter Alliance

The organization grew from its “anchor” organization SisterSong, which started in 1997 to improve policies and systems that affect the lives of marginalized communities.

Monica Simpson, 35, Atlanta-based executive director of SisterSong, stressed the importance of BMMA and their goals.

“It shouldn’t matter how conservative or progressive you are. This is one of those issue areas that crosses the aisle — and work needs to be done. (BMMA) is working to build the bridge from those on the ground to folks in office,” said Simpson.

BMMA's first major project, in conjunction with the Center for Reproductive Rights, was creating the Black Mamas Matter Toolkit, a resource for anyone concerned about the health and well-being of black women and girls.

In 2018, BMMA created the first Black Maternal Health Week, which Sen. Kamala Harris introduced to the Senate as a formal resolution to bring national attention to the maternal mortality crisis.

"(It) was designed to spark a nationwide conversation about black maternal health that centered on the voices and the perspectives of the people affected by the issue," said Elizabeth Dawes Gay, 32, a co-director of the alliance. "It took so long to get the conversation about racism to come into the public space."

The Black Mommas Matter Alliance is comprised of existing organizations and individuals working toward reproductive justice.Courtesy of The Black Mommas Matter Alliance

BMMA has also helped to provide resources and leadership to impact change.

“Senator Kamala Harris has reached out to BMMA and SisterSong for their input — there are folks who are willing to say, ‘We don’t want to do this (legislation) without them,” said Simpson. “The conversation about maternal health has shifted the microphone to those most impacted by the issue — and that is a shift they need across the board.”

How research creates change

The sobering statistics have led to new research into why more mothers are dying in the U.S., while rates are decreasing in the industrialized world.

"We're spending over $250 million on research that relates to maternal mortality," said Dr. Janine Clayton, the director of the National Institute of Health Office of Research on Women's Health. "It's a complex topic that requires a coordinated effort across disciplines."

She pointed to several ongoing studies:

The NIH has also commissioned research on the health of women populations who are understudied, underrepresented and underreported.

Clayton acknowledges that confronting causes of maternal mortality — especially racism and the chronic stress of poverty — is overdue.

"I wish I could tell you why it took so long for (racism) to be part of this conversation," Clayton told TODAY. "Some people's voices are not heard."

In February, the NIH released the 2019-2023 strategic plan for women's health research.Courtesy of Office of Research on Women's Health, National Institutes of Health

Sociologist Juanita Chinn noted that it's not only obvious racial disparities contributing to black maternal deaths.

"We need to talk about solutions at the structural level — the institutions, institutional practices, policies and cultures that allow for bias to exist and take place," said Chinn, the program director in the populations dynamics branch of the Eunice Kennedy Shriver National Institute of Child Health and Human Development.

What's next

Perhaps the most powerful voices in the world of maternal health are those left behind.

Charles Johnson's wife Kira died of hemorrhaged a day after giving birth to her second son via Cesarean section at Cedars-Sinai Medical Center in Los Angeles. Nearly two years later, Johnson, 38, has become a well-known figure in the maternal mortality conversation. He testified to Congress in September 2018 about the need for better maternal health care and created an organization, 4kira4moms, focused on driving legislation for the cause.

"We know so much about the statistics — and they're horrifying," Johnson said. "My road map was to make this personal, to see beyond the statistics to the precious souls whose families need them. There is nothing that can replace these mothers."

Johnson worked tirelessly with legislators on the "Preventing Maternal Mortality Act," which became law in December 2018. It will establish a program under the U.S. Department of Health and Human Services (HHS) that may make grants to review pregnancy-related and pregnancy-associated deaths, establish and sustain a maternal mortality review committee and more.

"When I got involved, everyone told us this would never happen. They said 'Women's health issues are not a priority right now.' I took every opportunity I had to look people in the eye and say: 'This is not a women's health issue, this is a human right's issue,'" Johnson recalled.

Today, there are other bills in the works that could spur further change. In August 2018, Sen. Kamala Harris introduced a bill to the Senate, the "Maternal CARE Act," that would require HHS to award grants for training that addresses implicit bias in obstetrics and gynecology.

In September 2018, several senators introduced a bill, "Maximizing Outcomes for Moms through Medicaid Improvement and Enhancement of Services (MOMMIES) Act," which would extend coverage for pregnant women covered by Medicaid to a full year after childbirth.

"I'm inspired daily, and I'm more hopeful now that I ever have been before," said Johnson.

While there's no knowing how long it will take for those bills to move forward, Jennie Joseph feels her work is paying off.

"I'm pleased," said Jennie Joseph. "Finally, we're thinking about it, we're talking about it. We're on their way."



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