BACKGROUND Benefits add to the total compensation received by midwives for their professional work in global settings. Some benefits are commonly offered as a package by employers as components of employment contracts. Some benefits may be individually negotiated or may be self-funded by midwives who own their own businesses. PURPOSE Identify benefits associated with midwifery employment. METHODS Benefits data available to certified nurse-midwives (CNMs) and certified midwives (CMs) in the United States were collected in online surveys conducted in 2004, 2007, 2010, and 2014. Benefits types received and benefits cost-sharing for midwives and their families were compared descriptively. RESULTS More than 90% of respondents employed full-time in 2014 reported that they received at least 1 of 16 types of benefits in their midwifery-related employment. Professional liability insurance, paid vacation (paid holiday), and paid time off for continuing education were the only benefits reported by 75% or more of respondents in each of 4 survey years. Trends over time reported by U.S. CNMs/CMs employed full-time suggest a decrease in employer contributions to benefit costs. Nearly half of all CNM/CM respondents reported not knowing the basis for calculation of their salary and compensation package. CONCLUSION Changes appear to indicate increasing employee cost-sharing of benefits packages in recent years for U.S. midwives. Similarities and differences identified for midwives in global settings are discussed, although information on benefits in global settings was limited. Midwives in all settings may gain from education about strategies for negotiation of salary and compensation packages.

Data from national level salary surveys can provide information about compensation and benefits for midwives and equity to other healthcare providers who share certain core responsibilities for women's healthcare services. Findings from this study suggest midwives' salaries have kept pace or, at times, exceeded inflation, and are equitable to nurse practitioners and physician assistants.

The American College of Nurse-Midwives represents two cadres of midwifery professionals: certified nurse-midwives who are educated in both midwifery and nursing, and certified midwives who are educated in the discipline of midwifery. Certified nurse-midwives are designated by nursing professional organizations as advanced practice nurses. The United States nursing profession is advancing toward adoption of the Doctor of Nursing Practice degree, as the entry into practice credential for advanced practice nursing. There is no evidence to date to demonstrate differences in clinical practice outcomes between certified nurse-midwives and certified midwives. A secondary analysis of data from a series of compensation and benefits surveys did not demonstrate differences in salaries between respondents who held a practice-focused doctoral degree compared to a master's degree. The requirement of the practice-focused nursing doctoral degree for entry into midwifery practice for certified nurse-midwives would require additional evidence to support both a professional and a business case for such a change in policy. It would also require consideration of the professional and business impact that such a policy would have on certified midwives who do not hold the nursing credential. Equivalent entry into practice pathways would need to be developed.

PURPOSE: This exploratory project aimed to provide an up-to-date list of global midwifery research priorities to inform the International Confederation of Midwives' (ICM) research strategy for development of its research agenda.DESIGN: An online survey conducted in 2014 asked ICM Research Advisory Networking members (who then disseminated it to a wider midwifery research interest group) to grade the importance of research priorities and provide further suggestions. Research priorities listed were based on those identified in previous scoping exercises and a recent literature review.FINDINGS: Two hundred seventy-one respondents from 37 countries completed the questionnaire including midwifery practitioners, researchers, lecturers, and service providers. Promotion of normal birth, prevention of maternal and fetal/neonatal morbidity and mortality, and psychosocial aspects of maternity care were identified by the respondents as the top three important themes. Subanalysis by country, region, and continent found promotion of normal birth the greatest priority in more resourced regions, whereas prevention of maternal and fetal/neonatal morbidity and mortality was the most important research priority in less resourced locations.CONCLUSION: This study provides a systematic global mapping of research priorities from midwives' perspectives which will inform the ICM research agenda. Geographical variation in key research priorities reflect midwives working in very different settings with specific local health and resource related challenges such as staff shortages, human immunodeficiency virus, or obesity. Future research should aim to address these priorities to improve maternal and infant health. Limited number of respondents from some geographical areas should be borne in mind when interpreting the global implications and further research with an optimized scoping for inclusion is required to ensure adequate representativeness from all countries.

Unacceptably high rates of adverse outcomes persist for childbearing women and infants, including maternal and newborn mortality, stillbirth, and short-term and long-term morbidity.1 In light of the challenges to achieve the UN Sustainable Development Goals, it is timely to reconsider priorities for research in maternal and newborn health. Are we asking the right questions?2 Recent evidence indicates the importance of seeking knowledge beyond the treatment of complications, to inform better ways of providing sustainable, high quality care, including preventing problems before they occur.

INTRODUCTION This article describes the process of developing consensus on a definition of, and best practices for, normal physiologic birth in the United States. Evidence supports the use of physiologic birth practices, yet a working definition of this term has been elusive. METHODS We began by convening a task force of 21 individuals from 3 midwifery organizations and various childbirth advocacy and consumer groups. A modified Delphi approach was utilized to achieve consensus around 2 research questions: 1) What is normal physiologic birth? and 2) What practices most effectively support its achievement? Answers to these questions were collected anonymously from task force members during multiple phases that included a preliminary briefing, an initial face-to-face roundtable, 9 iterative Delphi rounds, and reciprocal feedback from a wider audience of stakeholders at national and international conferences. Content analysis identified specific statements and concepts in the first Delphi round, which were subsequently ranked in following rounds. An initial draft was constructed based on the priorities that emerged and presented for feedback to peers and childbirth advocates whose comments were incorporated into the final document. RESULTS Four key themes were identified from our initial questions; these provided the framework for the document: 1) definitions of normal physiologic birth, 2) mechanisms and outcomes of normal physiologic birth, 3) factors that influence normal physiologic birth, and 4) recommendations for increasing normal physiologic birth. These areas comprised the final sections in the multi-organizational consensus statement. DISCUSSION The modified Delphi approach we employed allowed for the development of a consensus statement that will serve as a template for education, practice, and future research in maternity care. The completion of this statement marks the beginning of a project to promote systemic changes that support normal physiologic birth, and thus, have the potential to improve outcomes for mothers and infants.

INTRODUCTION Core data are crucial for detailing an accurate profile of the midwifery workforce in the United States. The American College of Nurse-Midwives (ACNM) and the American Midwifery Certification Board, Inc. (AMCB), at the request and with support from the US Health Resources and Services Administration (HRSA), are engaged in a collaborative effort to develop a data collection strategy (the Midwifery MasterFile) that will reflect demographic and practice characteristics of certified nurse-midwives (CNMs) and certified midwives (CMs) in the United States. METHODS Two independent datasets, one collected by ACNM in 2012 and one by AMCB in 2013, were examined to determine key workforce information. ACNM data were collected from the online Core Data Survey sent to ACNM members. AMCB data were extracted from information submitted online by applicants seeking initial certification in 2013 and applicants seeking to recertify following 5 years of initial certification. RESULTS The ACNM 2012 survey was partially or fully completed by 36% (n = 2185) of ACNM members (N = 6072). AMCB respondents included 100% of new certificants (N = 539) and those applying for recertification in 2013 (n = 1323) of the total 11,682 certificants in the AMCB database. These two datasets demonstrate that midwives remain largely white, female, and older in age, with most engaged in clinical midwifery while employed primarily by hospitals and medical centers. Differences were reported between the ACNM membership and AMCB certification datasets in the numbers of midwives holding other certifications, working full-time, attending births, and providing newborn care. DISCUSSION The new collaboration among HRSA, ACNM, and AMCB, represented as the Midwifery MasterFile, provides the opportunity to clearly profile CNMs/CMs, distinct from advanced practice registered nurses, in government reports about the health care workforce. This information is central to identifying and marketing the role and contribution of CNMs/CMs in the provision of primary and reproductive health care services.

INTRODUCTION Projected shortages in the primary care workforce underlie a need for more women's health care providers. In order to prepare more midwives to address this deficit, educators require additional clinical placement sites for students. The purpose of this study was to determine factors that influence practicing midwives to serve as preceptors. METHODS An e-mail invitation to participate in an online survey was sent to 7658 current and lapsed members of the American College of Nurse- Midwives (ACNM), who provided ACNM with a valid e-mail address. The survey assessed factors that enabled or were barriers for midwifery preceptors. Forced-choice questions were analyzed using descriptive statistics. Participant comments were analyzed using qualitative descriptive methods. RESULTS There were a total of 1517 surveys completed, for a response rate of 19.8%. Participants were primarily certified nurse-midwives (96.0%) who were in clinical practice (83.9%), with 78.0% in full-scope clinical practice. Participants represented all geographic regions of the United States. The majority of the participants indicated they or someone in their practice could precept a midwifery student. A commitment to the midwifery profession was the most commonly identified motivating factor (58.5%). Larger practices were more likely to precept midwifery students and to accept more than one student at a time. The most frequently identified barrier to precepting was the need to maintain a high patient volume (6.9%). Write-in comments were provided by approximately 500 participants and coded into 9 themes: payment, barriers to precepting, incentives, student characteristics, mechanisms for placement, communication, giving back, preceptor qualifications, and professional issues. DISCUSSION There is a strong commitment from preceptors to give back to the profession through the teaching of the future generation of midwives. Many of the barriers to precepting could be addressed by ACNM, the Accreditation Commission for Midwifery Education, and individual midwifery education programs.

INTRODUCTION The American College of Nurse-Midwives (ACNM) Core Data Survey is an annual membership survey that collects demographic and selected workforce data about certified nurse-midwives (CNMs), certified midwives (CMs), and students enrolled in midwifery education programs accredited by the Accreditation Commission for Midwifery Education. These data are aggregated and published every 3 years. This article presents findings from the analysis of membership data for the years 2009 to 2011. METHODS An online survey is sent annually to all ACNM members who provide ACNM with an e-mail address. The survey instrument for 2009 to 2011 focused on 5 categories: demographics, certification, education, employment, and licensure except for 2011, in which licensure data were collected separately. RESULTS ACNM members responding to the surveys during 2009, 2010, and 2011 continued to remain predominantly white and female. The average age of CNMs/CMs in 2011 was 51.2 years. The majority had a master's degree as their highest degree, and 9.3% had a doctoral degree. Approximately two-thirds of respondents in each of the 3 survey years identified attendance at births as one of their primary responsibilities. DISCUSSION Very little change in diversity was observed over the 3 survey years. The number of CNMs earning the doctor of nursing practice degree is increasing, whereas other doctoral degree categories remain stable. The majority of CNMs/CMs continue to identify a broad domain of clinical midwifery practice as their primary responsibility in their employment. The majority of respondents attend births, but the proportion has been decreasing slightly over time. Salaries for midwives continue to rise, but the reasons for this are unclear.

INTRODUCTION:In partnership with the American College of Nurse-Midwives (ACNM), the authors conducted a survey of ACNM members to examine the incidence of lawsuit involvement, the outcomes of the litigation in which they were involved, and coping mechanisms among midwives who had been involved in a lawsuit. METHODS:In the spring of 2009, a nationwide Web-based survey was completed by ACNM members. In addition to using chi-square tests and nonparametric testing in data analysis, a logistic regression model was used to evaluate predictors of lawsuit involvement. RESULTS:Among 1340 midwives responding to the survey, 32% had been named in a lawsuit at least once. The median number of years in practice when the event leading to lawsuit occurred was 6. The majority of midwifery lawsuits involved hospital births and were settled prior to going to court. Three variables were statistically significant for involvement with litigation: the midwife's age, the number of births attended, and the ACNM region of practice in the United States. DISCUSSION:Lawsuits among midwives were significantly related to exposure to births over time. Practice patterns and job security were not greatly affected by the experience of a lawsuit. Future cyclic surveys are needed to track the frequency of litigation and the outcomes that lead to lawsuits and to better define the relationships between midwifery practice and medical malpractice litigation.

Journal of Midwifery & Women's HealthVolume 53, Issue 5 p. e49-e49 Essential Midwifery Practice: Public Health; By Grace Edwards and Sheena Byrom, editors. United Kingdom: Wiley-Blackwell, 2007. 256 pages. $49.99, paperback Kerri D. Schuiling CNM, WHNP-BC, PhD., Kerri D. Schuiling CNM, WHNP-BC, PhD.Search for more papers by this author Kerri D. Schuiling CNM, WHNP-BC, PhD., Kerri D. Schuiling CNM, WHNP-BC, PhD.Search for more papers by this author First published: 24 December 2010 https://doi.org/10.1016/j.jmwh.2008.05.005Read the full textAboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Share a linkShare onFacebookTwitterLinked InRedditWechat No abstract is available for this article. Volume53, Issue5September‐October 2008Pages e49-e49 ACNM Members ACNM Members: Click here to log in RelatedInformation

Journal of Midwifery & Women's HealthVolume 52, Issue 4 p. 422-423 Disease Priorities in Developing Countries, 2nd Edition First published: 24 December 2010 https://doi.org/10.1016/j.jmwh.2007.03.026Read the full textAboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Share a linkShare onFacebookTwitterLinked InRedditWechat No abstract is available for this article. Volume52, Issue4July‐August 2007Pages 422-423 ACNM Members ACNM Members: Click here to log in RelatedInformation