The 2021 State of the World Midwifery Report is a call to action for investment to grow the midwifery workforce in populations that need it most. Additionally, growing the CPM workforce aligns with JHPIEGO’s work on task shifting that “has been adopted extensively around the world in an effort to expand the reach of lifesaving services to the women, newborns, and families who need them.” According to JHPIEGO, task shifting is ideally “considered as a part of the larger health system that needs to be designed to equitably meet the needs of mothers, newborns, children, and families.” With the recent Momnibus and the White’s House’s newly released Blueprint for Addressing the Maternal Health Crisis there is no better time in the US for task shifting utilizing CPMs.

Black midwives and Black midwifery students report racism in schools, apprenticeships, accreditation systems, and conferences, and have said that the CPM community is unsafe and unwelcoming for them. This has been documented in writings by BIPOC midwifery students, such as “Owning the Shadow: White Patriarchal Culture in the Preceptor and Student Relationship,” the Black Student Midwives Speak series, and many others. Keisha La’Nesha Goode’s dissertation “Birthing, Blackness and the Body” also highlights several of these dynamics. Our program aims to build a cadre of BIPOC midwives with shared lived experience to reduce the racist harm BIPOC midwifery students face and to create a space of learning where BIPOC midwifery students feel a sense of belonging and thereby thrive.

Dill and Duffy (2022) examine health care work as “a critical arena in which Black women are located at the intersection of racism and sexism” and wherein the career trajectory of Black women in the US is determined by structural racsim tracing back to slavery. They show that Black women are overrepresented in healthcare jobs in the US workforce when compared to women of other races. Within health care jobs and when controlling for education, marital status, age, or immigration status, Black women are disproportionately more likely to be in low paying, high risk and labor intensive occupational health care categories such as licensed practical nurse or aide as opposed to higher paying categories such as RN, physician, advanced practitioners, therapists or technical health workers. Our CPM Licensed Certified Professional Midwifery Program will build career ladders and address racism in the healthcare pipeline by building career ladders for Black and other BIPOC professionals currently mired in low paying healthcare jobs.

The long term impact we seek is higher racial, cultural and social concurrence of care resulting in improved outcomes for Black birthing people. Many studies show Black healthcare providers increase access to healthcare for Black communities, reduce race-based health disparities, spend more time with Black patients, and earn the trust of Black patients more effectively than White providers. One study found a 50% reduction in perinatal mortality when Black babies are cared for by Black doctors. Many Black healthcare providers have named how midwives specifically have been crucial to Black community health throughout US history. Jennie Joseph has data showing dramatic reduction of health disparities in Black families using her model of care. HBC’s CPM program will address racism in the system that perpetuates poor outcomes. Only about 2% of all contemporary midwives in the United States are Black (Vedam et al, 2019).Our community birth worker to CPM pipeline program will increase the number of racially, culturally and socially concurrent CPMs working in their communities and inturn will improve outcomes for BIPOC people seeking care.