Health reform is underway in the United States and new systems for the provision and payment of services are in development. This presents many opportunities as well as some threats to midwives and the women who choose their care.

This session highlights how maternity care reform fits within the larger context and what midwifery advocates can do to support the recognition, integration and expansion of midwifery services.

In January 2010, Childbirth Connection released the Blueprint for Action: Steps Toward a High-Quality, High-Value Maternity Care System that answered the question: Who needs to do what, to, for, and with whom to improve maternity care quality within the next 5 years? More than 100 leading experts set out to answer this question, reaching unprecedented consensus on the steps and actions needed to reform this critical and costly segment of the U.S. health care system. Five stakeholder workgroups collaborated to develop concrete solutions to the most pressing issues facing the U.S. maternity care system. The result is a detailed list of actionable strategies to improve maternity care quality and value. Amy Romano, CNM, MSN, Director of Childbirth Connection's Transforming Maternity Care Partnership, provided symposium participants with an update on the project.

Federal legislation, including the Affordable Care Act, includes provisions that will lead over the next several years to significant changes in how health care is paid for in the U.S. As CPMs gain ground as primary maternity care providers, it is essential to understand the new payment reforms and the reformed health care system they will help to create. Christopher Dawe, Director, Health Reform Delivery System, U.S. Department of Health and Human Services, speaks to the National Quality Strategy and an array of options through which providers can engage in health care delivery system reform.

As a health policy analyst and former Congressional staff supporting the work of the Senate Finance Committee, Billy Wynne of Health Policy Source, Inc., has a deep understanding of federal policy and health care reform. He has particular expertise in drafting legislation regarding Medicaid. Since 2009, he has been a lobbyist and health policy advisor to the Midwives and Mothers in Action Campaign, becoming an ever more dedicated and effective advocate for CPMs. With his colleagues at Health Policy Source, he has identified opportunities and opened doors to leading officials for the MAMA Campaign.

The Center for Medicare and Medicaid Services (CMS) is seeking ways to improve perinatal outcomes in the U.S. The majority of childbearing women in the U.S. are of low-risk health status, and yet they are typically treated with care more appropriate to high-risk status. When midwives and low-risk birth settings are provided for childbearing women, significant cost reduction and quality improvements result. Jeffrey Thompson, MD, MPH, describes Washington State Medicaid's commitment to improving consultation and referral relationships, support for the integration of midwives, and increasing women's access to midwifery care and home/birth center birth to improve the quality of care for women and to reduce health care costs.

WOW! What a truly educational and informative newsletter...the CPM Symposium e newsletter continues to link public policy AND the midwifery model of care in a way that I continue to learn from and get inspired by! Thanks.
~Jill Wodnick, MA, LCCE


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