Advocating for Change to NRP Policy

The American College of Nurse-Midwives (ACNM) recently issued a call for applications from midwives who are NRP instructors to serve as a representative to the Neonatal Resuscitation Program (NRP) Steering Committee.  This is a big step forward towards the integration of care and the inclusion of midwifery in NRP policy.  The American Association of Birth Centers (AABC) and the Commission for the Accreditation of Birth Centers (CABC) played a pivotal role in getting to this moment. 

In the fall of 2022, AABC and CABC joined the leadership of the North American Registry of Midwives (NARM) to compose a letter to the NRP Steering Committee.  In that letter we addressed several challenges in the implementation of the Neonatal Resuscitation Program in the community birth setting:

• Access to Instructor Led training (as exacerbated during the pandemic)
• The need for relevant training and tools for Community Birth providers
• Gaps in training and communication between Community Birth providers, Emergency Management Systems (EMS), and critical access hospitals

 We recommended several priorities, including

• Inclusion of a community based midwife on the NRP steering committee
• A change in policy that new instructor candidates must be from a hospital setting
• Increased scientific attention to the needs of learners in settings besides tertiary care hospitals

The letter was circulated to agencies who were stakeholders in community birth work.  In addition to AABC, CABC and NARM, the letter was signed by ACNM, the National Association of Certified Professional Midwives (NACPM), Birth Center Equity, and Elephant Circle., and sent to the NRP Steering Committee in November of 2022. (View letter)

In January of 2024 we received a response from the NRP steering committee (View letter). The letter:

• Acknowledged the need for a midwife representative to the steering committee and said the Committee would seek a nomination from ACNM.
• Announced a policy change that an “accredited birth center” would be recognized as a setting from which clinicians can apply for instructor candidacy, and that the “CNM/CM” credential would be added to the list of qualified clinicians who may become instructors. 

All these changes signify enormous steps in a positive direction toward integration of care and the inclusion of midwifery in NRP policy.  

However, the NRP Steering Committee's response excluded the important role of Certified Professional Midwives (CPMs) and failed to acknowledge that their organizations, NACPM and NARM, are involved in midwifery policy and education in the United States. 

We have sent a response from all of the original signing organizations to the NRP Steering Committee to thank them for these important changes, but also to affirm that CPMs (and their organizations) safeguard newborns and provide neonatal resuscitation.  We emphasized that CPMs work in, lead and own CABC accredited Birth Centers.  (View the letter)  

Our gratitude is expressed to all of these groups for their advocacy and commitment to midwives and the families we serve, and to AABC and CABC for their leadership with the NRP Steering Committee.