In 2012, NACPM hosted the first CPM Symposium. Priorities identified by Symposium participants became core commitments and priorities for NACPM for the past five years, and they have helped to shape and influence the direction of the profession in the wider community.
Since 2012, the landscape for both midwives and for people having babies has evolved significantly. Historic US MERA consensus agreements have generated a surge of momentum for CPMs, and have improved relationships with allied professions and stakeholders. After a drought of almost ten years, several states have passed CPM licensing laws aligned with the US MERA accords in the past two years, with more states at work on licensing laws in the 2018 legislative session. New strides have been made in the effort to secure federal recognition for the CPM, a linchpin for all health professions in the U.S. Although under significant duress in the current political climate, the Affordable Care Act continues to ensure access to health care for millions of Americans, including those having babies. In spite of our changed political landscape, innovations in health care delivery and payment continue to drive increased health care quality and access.
Over the past several years, the demographics of people having babies and their infants have changed significantly. As of July 1, 2015, babies of color make up 50.2% of all babies in the U.S., outnumbering non-Hispanic white babies for the first time, according to the U.S. Census Bureau. In America, the day is soon coming when white people will no longer make up the majority of the population. Children of color will be the majority of all children by 2020. By 2044, the majority of the population in the United States will be people of color, and the U.S. will have no clear racial or ethnic majority. These changing demographics present a clarion call to the CPM profession to understand the emerging needs of childbearing, especially those that are most urgent, to address the composition of our workforce, and to ensure access to quality care for all people having babies.
Research clearly shows that CPM care improves outcomes for people having babies, while saving significant health care dollars. Crucially, CPM care holds real promise for reducing birth inequities, including in the most vulnerable populations. There is a critical role for CPMs to play in the care of people having babies in the U.S., and yet CPMs continue to serve approximately 1% of childbearing people, the majority of whom are white and able to pay for services out of pocket. The overuse of expensive technologies and the underuse of many beneficial forms of care continue to drive poor outcomes for people having babies in the U.S. Racial inequities and disparities in birth are increasing rather than decreasing, with the U.S. being the only high-resource country in the world where maternal mortality is on the rise.
With the passage of 6 years since the first CPM Symposium, the time is now for community-wide conversation and planning about how to bring the values of CPM care to bear on meeting the needs of all people having babies.