The 65th ACNM Annual Meeting & Exhibition will bring together the largest concentration of nurse-midwives (CNMs) and certified midwives (CMs) in the nation, and other women’s health practitioners, allied health professionals, researchers, faculty, community leaders, policymakers, self-advocates, and midwifery students in support of common goals to advance women’s health.

The Annual Meeting offers a variety of session types, including: Education Sessions, Panel Discussions, Extended Sessions, Round Table Sessions, Fast Track Sessions, DOR Global Health Research Forums and Symposium Sessions. Each 1-hour time block attended qualifies attendees for 1 CEU credit.

ACNM is Offering Over 75 Sessions with CEUs This Year at the J.W. Marriott Austin, TX!

Jump to each day’s schedule:
Friday, May 29
Saturday, May 30
Sunday, May 31
Monday, June 1
Tuesday, June 2

Friday, May 29, 3:00 – 4:00 PM

Co-Sleeping Confusion: Are Families Best Served by Current Practice?
Michelle Collins
Education Session – Clinical – 1 CEU

In the recent past, there has been an intentional movement on the part of some maternal-child health stakeholders, to aggressively “warn” parents as to the “dangers” of co-sleeping. Despite sound evidence to prove the benefits of, and lack of harm, when practiced in the absence of all known hazards especially by breastfeeding mothers, and with likely over 2 million USA mothers at least intermittently bedsharing with their infants, the US government NICHD has launched a nationwide educational campaigns to inform the public as to the inherent “danger” of co-sleeping. This session will discuss the current climate of support (and lack thereof) for co-sleeping (in various forms) between infants and their parents. The biologic imperatives that underlie the practice and which support the co-sleeping relationship will be presented, as well as diverse lines evidence that justifies and legitimizes co-sleeping. Finally, directives on how to best counsel clients amidst a sea of conflicting information on the topic will be presented.

First Year Cleveland: Implementation of a Bias Training Program to Address Racism in Healthcare
Celina Cunanan, Margaret Larkins-Pettigrew
Education Session – Racism and Health Disparities – 1 CEU

For more than five decades, the City of Cleveland in Cuyahoga County has had one of the highest infant death rates in the country. With a history rich in segregation, red-lining and racism, black Americans in Cleveland continued to struggle in health outcomes despite living among several of the largest and best health care systems in the country. First Year Cleveland’s mission is to mobilize the community through partnerships and a unified strategy to reduce the number of babies dying in the community. This presentation will discuss the process and challenges of the movement’s initiatives along with their outcomes and plans for system-wide bias trainings moving forward.

Probiotic Interventions to Prevent Antenatal Group B Streptococcus Colonization: A Systematic Review and Meta-Analysis
Lisa Hanson
Education Session – Clinical – 1 CEU

This systematic review will provide midwives with the available evidence concerning the efficacy of antenatal probiotics to reduce GBS colonization. Implications for practice and future research will be discussed. The scientific evidence concerning probiotic interventions to reduce antepartum GBS colonization will be systematically reviewed and meta-analyzed. Probiotic species, strains, dosage, route and intervention onset and duration shown effective against GBS in available clinical trials will be presented.

DOR Global Health Forum – 1 CEU

This forum combines similar presentations within a 60-minute education session time frame. The time is divided between the presentations with a 10-minute period for questions at the end.

‘Chimwemwe Mu’bereki’ (Joyful Motherhood): Closing the Gap in Unmet Need for Home Based Nurse Midwifery Care in High Risk Infants and Postpartum Women in Malawi
Joanne Chiwaula, Marcianna Nosek
DOR Global Health Forum – Research

This session will discuss a mixed methods descriptive study conducted to evaluate the home visit nurse midwife programs of Joyful Motherhood (JM), or Chimwemwe mu’bereki. JM is a Malawian nonprofit organization, founded by a US midwife in 2008, and provides care to high risk, critically ill postpartum women and infants in rural villages of Lilongwe, Malawi. JM employs three nurse-midwives who perform all community visits. Women served include, but are not limited to, those who experienced postpartum complications such as severe anemia, sepsis, eclampsia or ruptured uterus. Infant clients include premature, low birth weight, multiples, and orphans who lost their mother in childbirth. All are enrolled for up to two years. JM’s success for over 10 years demonstrates it is a viable model for unmet home care for high risk infants and postpartum women in Malawi. Financial challenges prevent scaling up of services and expansion of clientele. Efforts to improve data collection are ongoing.

Nurse/Midwife-Led HIV Services in East and Southern Africa: Challenges and Opportunities For Health Facilities
Sydney Spangler
DOR Global Health Forum – Research

This session will discuss the results of a study conducted to identify perceived challenges and opportunities for nurse/midwife-initiated and managed antiretroviral therapy (NIMART) in high volume, high HIV-burden health facilities. Almost 20 million people are currently living with HIV/AIDS in east and southern Africa, about 40% of whom are not consistently getting antiretroviral therapy (ART). In response to this persistent problem, many countries are authorizing and training nurses and midwives to routinely provide first-line ART and other HIV services. However, much remains unknown about the extent to which this form of task sharing is being used, its effectiveness, and implementation issues it presents for health facilities. Despite structural challenges related to infrastructure, staffing, and pre-service education, health facilities have important opportunities to strengthen NIMART through providing standardized in-service trainings, developing formalized clinical mentorship programs, and crafting specific protocols for supportive supervision.

San Raymundo: Methods for Teaching Guatemalan Lay Midwives about Obstetrical Emergencies
Kimberly Garcia
DOR Global Health Forum – Research

This session will discuss the results of a study conducted to evaluate methods for teaching Guatemalan Lay Midwives (LMs) about obstetrical emergencies. The study had two objectives. First was to examine the effect of a culturally sensitive training on LMs’ knowledge of obstetrical emergencies. The second was to evaluate LMs’ interpretation of drawings of obstetrical emergencies used in the training. Government programs have not changed LM knowledge about obstetrical emergencies, primary because the programs are in Spanish with written material even though most LMs are illiterate and speak Mayan dialects. Recent studies revealed oral training in the primary language of LMs changed knowledge about obstetrical emergencies, and LMs understand simple color drawings better than complex, black and white drawings about obstetrical emergencies. This study concluded that future culturally sensitive trainings should be oral in the native language of TBAs and use simple color drawings to reinforce the training.

Friday, May 29, 4:15 – 5:15 PM

Bylaws, Privileges, & Protocols: How to Change Your Hospital So Your Midwifery Practice Can Flourish
Elizabeth Cook
Education Session – Midwifery Matters – Business – 1 CEU

Midwifery practices are largely dependent upon institutional bylaws, privileges, and protocols. Yet these are usually written by administrators and physicians who may not be fully aware of progressive midwifery practices and scope of care. Furthermore, the foundational training of most midwives almost exclusively revolves around direct patient care. So for those who find themselves in positions of influence, leadership, and program development, navigating the necessary political and business complexities can seem daunting. Being poised for success requires that such midwives comprehend the political process, the framework by which administrators and physicians function, and tactical mechanisms to effect change and collaboration. From there a dovetailing of the unique perspectives that midwives, physicians, and administrators bring to a practice will provide the edge that every midwifery team needs to achieve autonomy and great success.

Correlation is Not Causation! Addressing Vaccine Hesitancy in the Age of Measles
Carol Hayes
Education Session – Clinical – 1 CEU

This presentation will present data on the most effective communication tools to address patient’s hesitancy to accept data on the safety of vaccines and other medications in pregnancy. The risks and dangers of infectious diseases will be discussed, and our moral imperative to engage patients with data in the age of social media.

Hard Hat Needed? Promoting a Culture of Psychological Safety
Tonya Nicholson
Education Session – Leadership – 1 CEU

Psychological safety in the workplace is characterized by all constituents of an organization feeling valued and safe. This safety extends to feeling that they can verbalize concerns, share differing ideas, and stand in disagreement without fear of repercussions. An environment that reflects these ideals can increase its efficacy as well as the satisfaction of its members. Learn how to assess your workplace’s level of safety and how to nurture a culture of psychological safety in your practice.

Helping People Conceive: Fertility Counseling & Evaluation, An Important Component of Reproductive Primary Care
Elizabeth Smith
Education Session – Clinical – 1 CEU

Multiple studies show that patients of all types posses minimal awareness regarding natural fertility rates, age-effects on reproduction, & fertility risk factors. Frequently, people overestimate the chances of spontaneous conception and the effectiveness of assisted reproductive technologies. At the same time, other studies demonstrate the failure of providers to address issues of fertility in routine health encounters, and when addressed, studies find their advice to be out-dated, non-specific, & untimely. People of color and LGBTQIA clients experience greater inequity and inaccuracy in their family expansion efforts. In this presentation, we will discuss fertility counseling and evaluation from a reproductive justice framework and why it should be a component of routine, midwifery-led, health promotion. We will review the basic anatomy & physiology of conception, discuss the influence of racism & gender bias on fertility. We will explore the 4 pillars of a thorough, evidenced-based fertility evaluation, discuss lifestyle factors that influence conception, dispel myths regarding getting pregnant, and review evidence-based behaviors that improve fertility. Finally, we will present evidence-based guidelines for incorporating intrauterine inseminations into midwifery practice.

Management of Menopause Symptomatology
Desiree Clement
Education Session – Clinical – 1 CEU

Midwives may devote only a small percentage of their clinical practice to the management of menopausal symptoms and complaints. This may lead to discomfort in the care management for menopausal women with further potential to necessitate a referral instead to another provider. Although the research shows evidence that midwives remain knowledgeable and updated in traditional areas of women’s health including the management of menopausal complaints and health screenings for women transitioning from childbearing into menopause can be complex (i.e. non-hormonal or hormonal management for menopause symptoms). This all affords an opportunity for potential practice improvement within midwifery, along with the ability to increase one’s comfort level with managing menopause which remains a necessary part of being a full-scope midwife. The purpose of this educational session is to assist with increasing the midwifery comfort level with when caring for menopausal women supported by the research. The methods planned are evaluating and applying clinical knowledge gained through evidence-based lecture and integrative discussion. The clinical implications are the hopeful stated increase in midwifery comfort level and plan for the utilization of various safe options for managing menopausal symptoms. The ability for evaluation derives from the perceived intent to change practice and active participation within this educational session.

Friday, May 29, 5:30 – 6:30 PM

Brief Behavioral Therapy for Insomnia: All Midwives Can Help Women Sleep and Improve Mood
Jennifer Hensley
Education Session – Clinical – 1 CEU

Insomnia is the leading sleep disorder in developed countries. Inadequate sleep has adverse consequences in the physical, psychological, and relational realms. Lack of sleep can precipitate or worsen a mood disorder. For chronic insomnia, the proven treatment is cognitive behavioral therapy (CBTi). CBTi requires multiple sessions with extended visits with a paucity of qualified providers. An alternative to CBTi is brief behavioral therapy for insomnia (BBTi). BBTi can be learned by all professionals and woven into short clinic visits such as annual or problem GYN and return OB visits. BBTi is a useful tool that every midwife should have in her back pocket. Come and learn!

Essential Knowledge and Resources for Midwives Teaching Globally: Taking the ACNM Global Health Competencies from Theory to Practice for Global Teaching and Learning
Emma Clark
Education Session – Global Health/Refugee Care – 1 CEU

American midwives are increasingly interested in working globally. Teaching is one of the most common and sustainable ways that they can do so. The recently released ACNM Global Health Competencies highlight the skills necessary for midwives who want to work globally, including a specific sub-set of competencies for midwives who plan to engage in global teaching and/or learning activities. Familiarity with these competencies can help guide midwives who are planning or preparing to teach globally. This session provides information on tools that these midwives can take to translate the competencies from theory into practice and basic information and rationale on why these teaching/learning competencies are critical to successfully, ethically, and respectfully working in a global setting.

Material discussed includes a brief discussion of critical contextual knowledge around the cultural and regulatory environment a midwife should gather to assist with teaching/material preparation before departure; differences in pre- and in-service education and an overview of current evidence and best practices for each; and a demonstration of a selection of the many evidence-based tools available to help a midwife review and master relevant clinical skills in low-resource settings prior to departure and to adapt and provide training or training materials in essential midwifery competency areas (e.g., family planning provision, neonatal resuscitation, management of postpartum hemorrhage). The session will conclude with adequate time for discussion and all participants will leave with a printed list of resources for future reference.

How to Say What They Need to Hear: Providing Effective Student Feedback
Tonya Nicholson
Education Session – Education – 1 CEU

This session will provide practical skills that will help midwifery faculty and preceptors to provide effective feedback to students. The cornerstones of kindness, honesty, and grace are explored and built upon to equip the learner to guide students as they apply their knowledge in their coursework and clinical experiences. Feedback is meant to bring about improvement for the student and the skilled educator/preceptor can nurture this change.

It’s Not Just Postpartum Depression Anymore: The Role of the Midwife in Treating Maternal Mental Health Disorders
Bridget F. Hutchens, Julie Paul, Tanya Tanner
Education Session – Clinical – 1 CEU

Midwives are responsible for the delivery of “integrated, accessible health care services” while “addressing the majority of health care needs, developing a sustained partnership with patients, and practicing within the context of family and community” (ACNM, Core Competencies, 2012). Maternal mental health disorders are regularly encountered during perinatal care and provide an opportunity for midwives to engage in shared decision-making to provide evidence-based care to women. Essential midwifery knowledge to ensure optimal outcomes for women with maternal mental health disorders that will be addressed in this presentation includes an understanding of the incidence, risk factors, diagnostic criteria, and first-line treatments of these disorders. Creating midwifery management plans to safely address emergent mental health conditions will also be discussed. Strategies for engaging women in conversations about treating maternal mental health disorders using effective shared decision-making techniques will be presented. Caring for women with maternal mental health disorders can be a positive experience for both midwives and women, resulting in a successful midwife-woman partnership, inclusion of family and community values in treatment planning, and improved treatment adherence.

Friday, May 29, 5:30 – 7:30 PM

Expecting Sunshine: A Journey of Grief, Healing, and Pregnancy After Loss, the Documentary Film, and Q&A with Filmmaker Alexis Marie Chute
Extended Session – Education – 2 CEUs

Join us for a screening of Expecting Sunshine: A Journey of Grief, Healing, and Pregnancy After Loss, the award-winning documentary film based on the best-selling memoir by author/filmmaker Alexis Marie Chute. By producing this film, Chute seeks to break the taboo around pregnancy loss. The film brings viewers along on real-life medical appointments, introduces them to other bereaved parents and medical professionals through thought-provoking interviews, right through to the delivery room where Chute welcomes her “rainbow baby,” her child born after the death of her son Zachary.

The film investigates different perspectives on traumatic birth, how loss affects personal identity and faith, and the ways families change, thrive, and cope through grief. Also highlighted is the decision-making process around family planning after loss and the unique stresses of subsequent pregnancies. With poignant narration about grief and the healing journey, Expecting Sunshine documentary casts fresh light on a private and isolating experience.

There will be a Q&A discussion after the film presentation.

Saturday, May 30, 8:30 – 9:30 AM

Fast Track Sessions – Education – 1 CEU

A Fast Track session is a 30-minute session that is shared with another 30-minute session in a 1-hour time block to qualify for CE credit.

Building Professional Resilience Plans: A Primer for Midwifery Students and Their Faculty
Erin Wright
Fast Track Session – Education – 0.5 CEU

Work-related tension and stress have been shown in multiple studies to alter the trajectory of midwifery careers. Students face a unique set of challenges as they try to successfully navigate the rigors of midwifery training and subsequently as new graduate midwives. This session is designed to enlighten midwifery students, their faculty, and new graduate midwives about the benefits of building a resilience plan to help lay the foundation for a robust and life long career. By exploring sample plans and available evidence based modalities for the reduction of student and professional stress, students and their educators may experiment with building resilience plans which are tailored to their specific needs. Multiple studies have shown the positive impacts of midwifery care on their clients. By providing future midwives with tools for career longevity we have the opportunity to improve outcomes for birthing parents and their infants.

Making More Midwives: Midwifery Education in an Academic Medical Center
Susan DeJoy, Susan Krause
Fast Track Session – Education – 0.5 CEU

The present education of new CNMs/CMs is not robust enough to meet the growing demand, with a stagnant number of CNM/CM education programs. There is an existing but underutilized model for CNM/CM education: programs based in academic medical centers. Numerous academic medical centers with robust midwifery practices exist and midwives are involved in the education of residents and medical students throughout the nation. It is possible to develop midwifery education programs within such academic medical centers. Using Baystate Midwifery Education Program as a model, this presentation will explain how a clinical service can expand to include a midwifery education program, adding CNM/CM positions while improving job satisfaction and CNM/CM retention. Opportunities for interprofessional education will be discussed. Discussion will also include the possibility that this program design may provide the opportunity to increase the diversity of the midwifery workforce.

Disparities in Access to Reproductive Health Care: A Presentation by the ACNM Ethics Committee
Kimberly Allard, Ira Kantrowitz-Gordon
Panel Discussion – Racism and Health Disparities – 1 CEU

Disparities in access to reproductive health care in the United States exist along multiple dimensions, including race, citizenship, gender diversity, geographic location, and disability. The scope of access disparities ranges across the continuum of care offered by midwives, including infertility treatment, perinatal care, and family planning. Differences in access to health care and services may be an important mechanism for disparities in health outcomes. This presentation will provide an overview of the scope of the problem and the clinical and ethical challenges of combatting systems that directly and indirectly restrict access to care. An ethical and social justice lens will be used to analyze the health care access disparities across racial, ethnic, and cultural differences. A panel discussion of representative clinical cases will present diverse perspectives to guide ethical strategies to increase health care access at the individual and population level.

Transgender Persons Contemplating Gestation: Midwifery Considerations for Care
Tanya Vaughn-Deneen
Education Session – Racism and Health Disparities – 1 CEU

Research is lacking for reproductive care of transgender individuals considering gestation. It is important for midwives to have a general understanding of the reproductive options and necessary counseling of preconception care for the transgender community. Transgender individuals may desire to have children while undergoing gender affirming hormonal or surgical therapy that can complicate fertility. Assisted reproductive technologies can offer options for this population, however, it is imperative to discuss issues that can arise associated with hormonal or surgical gender affirming interventions. Midwives should be able to understand and navigate the barriers and disparities of care that transgender people may endure. Information offered at this presentation will help the midwife provide culturally competent, sensitive reproductive healthcare for the transgender individual considering gestation.

Birth in Eight Cultures
Melissa Cheyney, Robbie Davis-Floyd
Education Session – Education – 1 CEU

This presentation, based on Birth in Eight Cultures, edited by Robbie Davis-Floyd and Melissa Cheyney (2019), takes a comparative cross-cultural approach to birth in the US, the Netherlands, Japan, Brazil, Greece, New Zealand, Mexico and Tanzania. It describes how the core values of each culture are reflected in their birthways, an important part of the process of turning young women into mothers. Each chapter in the book this presentation describes is based on intensive and lengthy ethnographic fieldwork conducted by the chapter authors on the maternity care systems of their respective countries. This presentation clearly shows that obstetric systems in most countries are not founded on science but on cultural belief and tradition, yet evidence-based systems such as those of the Netherlands, Japan, and New Zealand are possible to achieve and can offer valuable lessons to midwives in the US regarding how to transform maternity care in this country. It concludes with a global overview of key issues in childbirth, midwifery, obstetrics, and maternity care.

Saturday, May 30, 8:30 – 10:30 AM

OB Triage: Beyond Labor Evaluation
Carol Griffin, Meghan Hendrickson, MaryLou Smith, Angela Wilson-Liverman
Extended Session – Clinical – 2 CEUs

Obstetric triage for non-labor related conditions can be safely done by CNMs/CMs with additional training. Many institutions are utilizing CNMs/CMs more robustly in areas such as triage. The primary objective of this workshop is to provide up-to-date clinical information on the evaluation and treatment of several common 2nd and 3rd trimester non-labor complaints in order to increase the comfort level of the CNM/CM evaluating the pregnant non-laboring woman.

Saturday, May 30, 9:45 – 10:45 AM

DOR Research Forum I – Research – 1 CEU

This forum combines similar presentations within a 60-minute education session time frame. The time is divided between the presentations with a 10-minute period for questions at the end.

Duration of the Latent Phase of Labor: Characterization and Outcomes Associated with Longer Latent Phase Among Low-Risk Women in Spontaneous Labor
Mia Ahlberg, Nicole Carlson, Aaron Caughey, Mekhala Dissanayake, Julia Phillips, Jonathan Snowden, Ellen Tilden
DOR Research Forum I – Research

This session will discuss the results of a study conducted to characterize entire latent phase duration and evaluate the association between latent phase duration at five points of distribution (mean, median, 80th, 90th, and 95th percentiles) and perinatal processes/outcomes. Little is known about the full duration of the latent phase of labor or if duration of the latent phase predicts labor processes or outcomes. The study found that the duration of the latent phase of labor was longer than described in previous U.S. studies. Longer latent labor duration may signal longer total labor processes, increasing dystocia, interventions to manage dystocia, and epidural use. Women’s hospital admission during the latent phase may be a result of longer latent labor duration rather than a true causal risk factor for intervention use. Longer latent labor in multiparous women may signal underlying complications that lead to NICU admission.

Exploring Experiences of Structural Racism and Its Influence on Maternal and Child Health
Kamila A. Alexander, Kelly Bower Joffe, Keyona Hough, Kelley Robinson, Amber Summers, Brielle Weber
DOR Research Forum I – Research

This session will discuss the results of a study conducted to explore the ways in which structural racism influences the health of pregnant and postpartum people and their infants in Baltimore, Maryland. Systematic racism and discrimination has been proposed as a significant risk factor that contributes to health disparities in maternal and child health outcomes for African American families. There is evidence to suggest that racism is associated with poor birth outcomes and limited evidence to suggest a link between racism and maternal health outcomes. However, most studies examine the role of interpersonal racism, whereas fewer explore the role of systemic racism, and few have examined the mechanisms by which systemic racism impacts health from the perspective of those affected. Preliminary results have identified a variety of systems that play a role in the health of pregnant and postpartum people and infants including: medical, justice, government, neighborhood environment, schools, and commercial/retail. For most systems, racism acts by way of the quality and availability of goods and services; bias, stereotyping, and racial profiling; and power imbalance. For example, participants commonly reported experiencing disrespectful medical care and described the ways in which it impacts their health. Other specific examples will be provided.

Group Counseling for Shared Decision Making (GCSDM) about Birth after Cesarean for Haitian Speaking Women: A Mixed Methods Study
Somphit Chinkam, Allison Shorten, Courtney Steer-Massaro
DOR Research Forum I – Research

This session will discuss the results of a study conducted to develop culturally appropriate group counseling sessions about the mode of birth after cesarean for Haitian Creole-speaking women. Haitian women in Massachusetts have high rates of cesarean and low rates of vaginal birth after cesarean (VBAC), despite evidence suggesting many are eligible for labor after cesarean (LAC). Limited English and Haitian Creole reading comprehension coupled with cultural norms, including limiting questions of providers, challenges the traditional approach of written educational material and clinic prenatal visits. The study found that the Group Counseling and Shared Decision Making (GCSDM) session was acceptable to Haitian Creole-speaking women and was feasible to implement in practice. Evaluation of ongoing program effectiveness is planned for continuous quality improvement. The GCSDM session could be adapted to improve shared decision making discussions for other non-English speaking women.

Human Trafficking: Opening our Eyes to a Hidden Health Care Crisis in Plain Sight
Kelly Dore, Wendy Smith
Education Session – Clinical – 1 CEU

Whether enslaved by strangers or trafficked by acquaintances, sex trafficking victims went unrecognized by health care providers almost universally according to a 2017 and 2019 survey of former victims. In this session, we will explore patterns of abuse and assist midwives in identification of trafficked persons. We will provide practical strategies for recognition, and resources for development of safe, trauma informed intervention. We will also provide a framework for implementation of policy and midwifery practice for practical survivor support.

Maternal Mental Health Disorders: The Lived Experience
Bridget F. Hutchens, Julie Paul, Tanya Tanner
Education Session – Clinical – 1 CEU

Mental health disorders affect up to 25% of new mothers and 10% of new fathers. These disorders negatively impact parental role acquisition, infant development, and family adjustment. This session will feature a moderated panel discussion with women who have a history of maternal mood disorders, a therapist specializing in maternal mood disorder treatment, and midwives who are perinatal psychiatric mental health specialists currently researching or caring for women with maternal mood disorders. Discussion about current research, interventions helpful to women and families, personal experience, and clinical case involvement will provide a rich tapestry of information to ehance clinical midwifery practice. Attendees’ knowledge of maternal mood disorders and their sequelae will be enhanced, and their understanding of the impact of these disorders on all involved in the experience will be deepened.

The New ASCCP Risk-Based Management Consensus Guidelines for Abnormal Cervical Cancer Screening Tests and Cancer Precursors: Understanding and Using the New App
Sally Hersh, Jeanne Murphy
Education Session – Clinical – 1.0 CEU

Cervical cancer prevention strategies in the United States are complicated and, at times, controversial. HPV vaccination will eventually prevent most cervical precancer and cancer. However, cervical cancer screening will remain important as efforts to increase vaccination rates in the U.S. continue. This session will review the new ASCCP Risk-Management Consensus Guidelines for Abnormal Cervical Cancer Screening Tests and Cancer Precursors. ACNM, along with other women’s health organizations and advocacy groups, has participated in development of the consensus guidelines. Controversies around setting of risk benchmarks and other challenges will be reviewed. Explanation and a walk-through of the new app will be provided.

Saturday, May 30, 11:00 AM – 12:00 PM

Fast Track Sessions – Clinical – 1 CEU

A Fast Track session is a 30-minute session that is shared with another 30-minute session in a 1-hour time block to qualify for 1 CE credit.

A Mixed Methods Study of Posttraumatic Growth in Military Nurses who Served in Iraq and Afghanistan
Mary Ellen Doherty, Elizabeth Scannell-Desch
Fast Track Session – Clinical – 0.5 CEU

This session will discuss the results of a studying that examined posttraumatic growth in U.S. military nurses who served in Iraq and Afghanistan wars. This phenomenon can be identified in some trauma survivors and in their caregivers. Nurses preparing to serve in a war zone, as well as those returning, need special attention in regard to physical, psychological, emotional, and spiritual health. Our profession needs to guard against anyone ‘falling through the cracks’ and not receiving the high quality, comprehensive healthcare they so deserve.

Caring for the Female Veteran
Robin Neumeier
Fast Track Session – Clinical – 0.5 CEU

Female veterans are the fastest-growing population of veterans today. Learn about the unique challenges female veterans face as they transition from military to civilian workforce. Additionally, learn how midwives can provide holistic, compassionate and gender-specific care to women warriors.

ACNM Maternal Mental Health Task Force Recommendations
Jacqueline Clark, Barbara Hackley, Lucia Jenkusky, Sara Mertz, Julie Paul
Panel Discussion – Clinical – 1 CEU

Perinatal mood and anxiety disorders affect approximately twenty percent of childbearing women. They include depression, anxiety, panic disorder, PTSD, bipolar mood disorder and psychosis. Adverse outcomes associated with these disorders include preeclampsia, substance abuse, poor adherence to health care, higher divorce rates, loss of financial resources and employment, preterm delivery, low birth weight, lower Apgar scores, and delayed cognitive development, suicide and infanticide. Postpartum depression is the leading cause of death during the first postpartum year.

Maternal Mortality in the U.S. – What is Being Done to Decrease the Problem
Katrina Nardini
Education Session – Racism and Health Disparities – 1 CEU

The goal of this session is for participants to understand the importance of maternal mortality reviews as a means of identifying underlying causes of maternal death and examining disparities to inform prevention strategies. It is important for midwives to understand what is being done at a national level as well as on their own state level, including the coordinated efforts of the CDC to bring together state entities to try to optimize solutions to this problem. Midwives/participants will leave the session with an understanding of the recommendations that have come out of state data sharing, in order to better understand the strategies and solutions to decreasing maternal mortality and improving health inequities.

Saturday, May 30, 12:15 – 1:15 PM

“They Tried to Bury Us, They Didn’t Know We Were Seeds”: Inspiring Tales of Midwifery-Led Teams
Kimberly Couch, Samantha Evans, Jackie Griggs, Diana R. Jolles, Victoria Meinhardt, Sister Angela Murdaugh, Paula Pelletier-Butler
Panel Discussion – Midwifery Matters – Business – 1 CEU

It is not a coincidence that states with the most restrictive barriers to midwifery practice are also host to the worst disparities and outcomes for childbearing families. This panel brings together service directors from 5 practice models to explore the forces of resilience and resistance. Attendees will hear stories and lessons from Sister Angela Murdaugh, one of Texas’ mothers of midwifery as well as case studies from birth centers, hospital based practices including tribal health. Participants will leave inspired to form partnerships for the protection of communities, for the promotion of midwifery and for the transformation of the healthcare delivery system.

Buprenorphine for Opioid Use Disorder: Understanding the Pharmacology
Angela Mitchell
Education Session – Clinical – 1 CEU

Buprenorphine has been noted to be an effective treatment in caring for those with opioid use disorder (OUD). In 2018, the Support for Communities and Patient Act further expanded the OUD treatment workforce to include certified nurse-midwives (CNMs). CNMs are now able to apply for the SAMSHA DATA 2000 waiver, which would allow them to prescribe buprenorphine. Buprenorphine has multiple pharmacological benefits such as suppressing opioid withdrawal symptoms, blocking effects of illicit opioid use, reducing cravings, reducing or stopping illicit use of opioids, and facilitating patient engagement in recovery activities. It has been shown to significantly reduce the illicit opioid use, maintain patients in treatment, and reduce HIV risk behaviors. This is a great opportunity for CNMs to meet the unmet needs of so many of their patients.

Hypoxic Ischemic Encephalopathy: An Unexpected Event
Maribel Morgan
Education Session – Clinical – 1 CEU

Hypoxic ischemic encephalopathy is a common cause of neonatal morbidity and mortality. We will discuss the epidemiology, risk factors, presentation and available management strategies for this disease. It is typically an unexpected tragic event, we will also discuss how to discuss findings with involved families in a sensitive and comprehensive manner.

Improving Care for Women with Urinary Incontinence
Bailee Burningham, Samantha Lawson
Education Session – Education – 1 CEU

A significant evidence-practice gap exists in the diagnosis and management of urinary incontinence (UI). There are many effective treatment options and there are several practice guidelines from professional organizations outlining the management of UI; however, providers do not screen for or treat this condition and many women live with the burden of UI unnecessarily. This session will describe the barriers, facilitators and strategies for implementation, as well as the role of the midwife, to improve care for women with urinary incontinence .

Subclinical Thyroid Abnormalities and Preterm Birth
Janelle Komorowski
Education Session – Clinical – 1 CEU

Maternal hyper and hypo-thyroid are known risk factors for preterm birth, but current evidence suggests that subclinical hypothyroidism and thyroid autoimmunity may also be risk factors for preterm birth. This session will review current clinical guidelines for management of thyroid function test abnormalities and evidence for consideration of treatment subclinical levels. Midwives should be aware of the association between subclinical thyroid function and preterm birth, and be able to competently discuss with the client the risks and benefits of pharmacotherapy, incorporating shared decision-making.

Saturday, May 30, 5:30 – 6:30 PM

Let’s Talk About Post-Menopausal Sex
MaryJane Lewitt
Education Session – Clinical – 1 CEU

As women mature, many factors influence their ability to form caring, intimate relationships with others. We know these relationships influence all aspects of women’s lives. Menopause creates physiologic and psychologic changes that directly impact a woman’s sexual relationships in the second half of their lives. This presentation will review these changes and provide concrete examples of how we can work with women to address their sexual concerns as they enter and navigate menopause. With the average US life expectancy now almost 80 years, women will live over 1/3rd of their lives with the physiological and psychological changes associated with menopause. Sexuality in older people is often overlooked by current health care providers, yet it is critical to an individual’s overall health. The presenter will discuss these physical and psychological changes and offer solutions that you can bring to your care of women in this part of their life.

Midwives and Reproductive Justice: Beyond the Hashtag
Ana Delgado
Education Session – Racism and Health Disparities – 1 CEU

Some midwives use the term reproductive justice (RJ) to describe their work, in some cases accurately applying the framework as it was intended and in many cases missing the intention of the founding mothers of RJ. By reminding us of the roots of RJ, and citing current examples of midwives embodying RJ, this talk will give midwives a way to incorporate RJ into their work without co-opting or narrowing the scope of this human rights framework. A local case study of Mama Sana/Vibrant Woman located here in Austin will be presented.

Prevention of Childbirth Trauma Through Postpartum Debriefing
Jacqueline Clark, Sara Mertz
Education Session – Clinical – 1 CEU

It is estimated that post-traumatic stress disorder (PTSD) affects 3-4% of all women after birth, and increases to 15-19% of women who experience pregnancy or labor complications, or preterm birth. Birth trauma can lead to complications for future pregnancy and maternal health, including poor bonding with child and negative impact on partner relationship, negative cognition and mood, hyperarousal, and situational triggers causing panic attacks or severe anxiety. Postpartum debriefing prior to discharge is one intervention proposed to prevent development of birth trauma. Midwives should be rehearsed in this intervention as the midwifery model of care includes “monitoring the physical, psychological, and social well-being of the mother throughout the childbearing cycle.” Methods of debriefing range from listening while a woman tells her birth story to the use of cognitive behavior therapy techniques and motivational interviewing. While debriefing methods may vary, nearly all women in studies related to this intervention have reported finding it helpful.

Providing Culturally-Competent Midwifery Care for Patients Who Have Experienced Female Genital Mutilation
Christa Sanford
Education Session – Clinical – 1 CEU

Female genital mutilation (FGM) is a procedure that negatively impacts psychological and physical well-being, including immediate and long-term complications. While there is a perception that this is a “third-world” problem, 513,000 females in the United States are at risk to undergo this procedure. Multiple social determinants of health —including education, childhood experience, gender, and culture — are often under-addressed or mismanaged in primary and obstetric care. Midwives have a unique opportunity to individualize their care in a culturally sensitive way to meet the needs of this growing subgroup. In this session, we will address prevalence, types, specific health disparities, complications and management, and additional tools on how to provide comprehensive care to survivors of FGM. This session will be presented jointly by a Certified Nurse-Midwife and a survivor (patient) with FGM Type-3 and is willing to speak to health care workers about her experience to improve understanding. She believes that by telling her story, she can improve care for other women who have experienced FGM.

What’s That Rash and How Do I Get Rid of It? A Dermatology Review for Midwives and Primary Care Providers
Melissa Davis, Stephanie Devane-Johnson, Julia Phillipi
Education Session – Clinical – 1 CEU

Dermatology can be an intimidating topic for midwives. Rashes and skin lesions are common complaints in clinical practice, yet diagnosis and treatment can be difficult. This session will review common dermatology terminology, the most common types of rashes/lesions, methods of skin cancer prevention, and the most recent information regarding skin cancer screenings. Methods of instruction include PowerPoint presentation as well as audience interaction with a “guess that lesion” question/answer session. Many common complaints can be addressed easily by midwives, while others need referral. This presentation will increase provider comfort in identifying which complaint is which.

Sunday, May 31, 10:45 – 11:45 AM

“Arrival” of a Big Problem: Interpreting the Evidence on 39 Week Elective Inductions
Rebecca Dekker
Education Session – Clinical – 1 CEU

New findings from the highly publicized ARRIVE trial (A Randomized Trial of Induction Versus Expectant Management) have led to an upsurge in elective induction across the U.S. In some practices, providers are informing all of their clients that they must be electively induced at 39 weeks! Many midwives are finding themselves caught between collaborating physician desires, hospital administration pressures, client preferences, and ACNM guidelines. This session will provide clarity on the ARRIVE trial and help you develop an action plan for facing clinical challenges related to 39-week inductions in your community. It will examine the methods of the ARRIVE study, as well as its outcomes, strengths, and limitations, and discuss the evidence from other randomized trials on this topic. Following this examination of the evidence, attendees will discuss whether or not these research findings can be generalized to clients in their communities. Midwives will leave this session with confidence in their ability to face the clinical challenges created by the publication of this influential study.

Assessing the Consistency of Carrier Screening Guidelines Across Seven Populations and 408,000 Individuals
Summer Pierson
Education Session – Clinical – 1 CEU

Current guidelines recommend carrier screening for several genetic conditions only in certain ethnicities. A recent study analyzed carrier rates of 176 serious conditions to determine whether current guidelines support consistent care across all ethnicities. Many conditions have population-specific incidence comparable to CF in the Southeast Asian population—the rarest population-condition pair currently recommended for carrier screening by both ACMG and ACOG. Expanding guidelines to include additional conditions with comparable or higher incidence in select populations would improve equitability of medical care across populations. Simultaneously, however, it would further complicate ethnicity-specific testing by inflating the panel of conditions—in excess of four-fold—for each ethnicity. This added complexity could be mitigated by adopting pan-ethnic expanded carrier screening as the recommended approach to carrier screening.

2020 Susan Marie Hanafin Memorial Lecture
Grit, Resilience, and Our Context of Care: Preventing Burnout in Midwifery
Diana R. Jolles, Sister Angela Murdaugh, Peter Nielsen, Jessica Schwartz, Brie Thumm
Panel Discussion – Midwifery Matters – Business – 1 CEU

On January 22, 2019, Susan Marie Hanafin lost her battle with chronic depression. Susan made innumerable contributions to the field of public health nursing and midwifery over the past 34 years. She was a quintessential clinician, mentor, and preceptor. By no coincidence, she was the attending midwife to many of her practice partners: midwives, physicians and colleagues. This panel joins in Susan’s honor and memory to explore the state of the science on burnout in public health and midwifery. The panelists share heartfelt stories related to burnout mitigation including actionable things midwives can do for themselves, for their practices, at the affiliate and national level. We will explore programs that have been implemented around electronic health record workflow and training, healing from secondary trauma and interprofessional teamwork.

Words Matter: Avoiding Bias in Health Care Communications and Scholarly Writing
Frances Likis, Kathryn Osborne
Education Session – Racism and Health Disparities – 1 CEU

The language used in health care communications and scholarly writing has the power to influence readers’ perception of the individuals and populations described therein. It is critical that health professionals avoid the use of biased language, which can be inaccurate, harmful, and disempower people. This session, led by editors of the Journal of Midwifery & Women’s Health, provides best practices for avoiding the use of biased language and is intended for health professionals and students with a wide range of writing interests and skills. From e-mail messages to clinical practice documents and course materials to published manuscripts, this session will provide content you can use to make a positive difference with your words.

Sunday, May 31, 4:00 – 5:00 PM

Breast Cancer Survivor Care for Midwives and Advance Practice Nurses
Dwynn Golden, Dawn Lovelace, Linda McDaniel
Education Session – Clinical – 1 CEU

Women are increasingly surviving breast cancer but the majority (up to 90%) experience unexpected long-term sequelae as a result of treatment. Symptoms can include physical, functional, emotional and psychosocial changes that can dramatically alter the quality of life for breast cancer survivors. Midwives and nurse practitioners are likely to care for these women, and should be familiar with common symptoms, treatment and best practices to avoid permanent dysfunction. A holistic approach to assessment and treatment as needed is an effective strategy and falls within the philosophy and the scope of practice of midwives and nurse practitioners.

From Lovers to Parents and Back Again: What Midwives Need to Know About Perinatal Sexuality
Amy Gilliland
Education Session – Clinical – 1 CEU

All parents expect sexual adjustments during the postpartum period, however few report feeling prepared for the massive changes that occur. The birth experience may also have a psychological impact that shows up in an individual’s sexual identity and relationships with others. Midwives are uniquely situated to adjust their clinical practices in ways that support the pleasure functions of the female body and the primary mate relationship(s) of their patient. This session seeks to mend the knowledge gap about the impact of birth practices on sex and sexuality and normative postpartum sexual experience. The presenter has reviewed over 270 research articles on this topic and utilizes a variety of small group learning strategies sprinkled through lecture and discussion. Through a deeper understanding of the importance of pleasure in our bodies, especially our sexual bodies, midwives can have a lifelong positive impact on their patients and their relationships.

Maximizing Midwifery!
Ginger Breedlove, Wendy Gordon, Karen Jefferson, Elle Schnetzler
Midwifery Matters – Public Perception – 1 CEU

This session will bring together thought leaders from all nationally certified midwives for a panel discussion regarding the barriers that we face as a profession in meeting the reproductive healthcare needs of the US. We will discuss various perspectives on the barriers that exist to scaling up and integrating midwifery in the US and what changes are needed in order to establish midwifery care in all settings as the new norm.

Physiologic Latent Labor – What is Known, Unknown, and Mis-Known: A Critical Collaboration of Midwife Scientists
Nicole Carlson, Elise Erickson, Katherine Kissler, Julia Phillipi, Ellen Tilden
Education Session – Clinical – 1 CEU

Professional organizations recommend women in spontaneous labor complete latent phase at home based on evidence linking early hospital admission to increased intervention, including augmentation and cesarean birth. However, current guidelines do not discuss how to care for women who present to the hospital in latent labor. Five midwife-scientists from universities across the country will present a latest research on latent labor and labor onset from a physiologic and symptoms-based approach. We will critically analyze the physiologic and symptoms literature to describe what is known, not known, and misunderstood about latent labor and labor onset in women with healthy, term pregnancies. We will explore best evidence for caring for women in latent labor, strategies for future innovation, and recommendations for research.

Sunday, May 31, 4:00 – 6:00 PM

What Just Happened Here?: Interactive Simulation Session to Heal Cultural Ruptures and Practice Calling-In for Microaggressions in the Workplace
Jami Baayd, Susanna Cohen, Karen Tao
Extended Session – Racism and Health Disparities – 2 CEUs

This interactive session will guide participants on the use of simulation to help healthcare teams understand and address implicit bias and microaggressions, particularly those having to do with race, gender, sexual orientation, weight, socio-economic status and religion. Implicit bias and its manifestation as microaggressions can impact the patient-provider interaction, the quality of patient care, and may cause patients to delay or avoid seeking care. Simulation explicitly provides participants opportunities to identify when they have received, committed, and/or witnessed microaggressions, to engage in self-reflection about those experiences, and to practice the communication skills necessary to address microaggressions within clinical and team settings in-the-moment.

Sunday, May 31, 5:15 – 6:15 PM

DOR Research Forum II – Research 1 CEU

This forum combines similar presentations within a 60-minute education session time frame. The time is divided between the presentations with a 10-minute period for questions at the end.

Exogenous Oxytocin in Labor: Postpartum Hemorrhage and Third Stage Labor Duration Following Term Vaginal Birth
Elise Erickson
DOR Research Forum II – Research

This session will discuss the results of a study conducted to determine the level of risk for postpartum hemorrhage and prolonged third-stage labor associated with varying duration and peak dosage of oxytocin used during labor among women having a vaginal birth. Both oxytocin use during labor and postpartum hemorrhage are increasing in the United States. Oxytocin use may contribute to postpartum uterine atony as the oxytocin receptors available for postpartum uterine contraction have been down-regulated or desensitized during an oxytocin-stimulated labor. Oxytocin is also the first-line recommended uterotonic for postpartum hemorrhage prophylaxis and immediate treatment of postpartum blood loss after birth. The specific dose or duration of oxytocin that contributes to adverse postpartum outcomes is not known. The study found that both oxytocin duration and peak dose influenced the risk for postpartum hemorrhage. The definition of prolonged oxytocin use may need to be shortened to increase vigilance around postpartum hemorrhage prediction.

Friedman and Zhang Might Both Be Right: A Group-Based Trajectory Analysis of Progress in the First Stage of Labor
Nancy Niemczyk
DOR Research Forum II – Research

This session will discuss the results of a study conducted to identify distinct trajectories of progress in first stage spontaneous labor. Abnormal progress of first stage labor is the indication for 15–30% of US cesareans, but the normal course is poorly understood. Studies (Friedman, linear progress; Zhang, exponential progress) conflict, and guidelines based on Zhang’s research have not consistently resulted in better outcomes. The presenters believe understanding labor progress is limited by assuming a single normal course, and they explored modeling multiple labor trajectories. They found that distinct trajectories exist among spontaneous labors, and are associated with neonatal/parturient characteristics and labor management. If replicated in national datasets, this research could expand the definition of normal labor progress, leading to more individualized and evidence-based guidelines for labor management.

Metabolic Predictors of High- vs. Low-Oxytocin Requirements During Labor Induction
Nicole Carlson
DOR Research Forum II – Research

This session will discuss the results of a study conducted to identify metabolic profiles activated in serum collected during late pregnancy from African-American women who experienced difficult labor induction (e.g. high dose of synthetic oxytocin infusion following cervical ripening). During the past few decades, the use of labor induction has increased substantially. However, wide variations in labor induction success by hospital and maternal factors have been demonstrated. Little is known regarding the mechanism by which maternal variations cause labor inductions to require higher doses of synthetic oxytocin. The findings suggest that a prolonged, high-oxytocin induction phenotype may be predicted in part by a pro-inflammatory state characterized by low levels of circulating omega-3 fatty acids during pregnancy. Moreover, high levels of omega-6 fatty acids may have caused the cases in this study to be less likely to respond to cervical ripening medications, thereby leading to synthetic oxytocin infusions being initiated before effective cervical ripening was complete.5

Midwifery Legislation In Action
Zoe Gutterman, Emily Hart, Amy Kohl
Education Session – Midwifery Matters – Public Perception – 1 CEU

This session will help give midwives up-to-date information and effective techniques to bring about policy change at local, state and federal levels. The presentation will review and discuss legislative successes and challenges since the 2019 ACNM Annual Meeting, and will look at upcoming legislation of importance to ACNM members. Additionally it will offer practical advice will be included on how midwives can influence health policy.

Second Victim: Impact of an Adverse Outcome
Linda McDaniel, Charlotte Morris
Education Session – Midwifery Matters – Public Perception – 1 CEU

Health care providers may experience multiple adverse events during their professional career. As a result of being directly or indirectly involved in the adverse event, health care providers are considered second victims. The second victim phenomenon leads to significant physical, psychological, and psychosocial sequelae that negatively impacts their personal and professional lives for either a short or long period of time. It is imperative for second victims to incorporate self-care behaviors and that health care organizations implement an efficacious support program to assist second victims during the recovery process. The literature shows midwives may be equally if not more affected by adverse events because of the intimate nature of their care. Since health care providers have a high probability to encounter adverse events they should be aware of this phenomenon, associated symptoms, appropriate treatment, and peer support options to avoid consequential negative outcomes.

Sunday, May 31, 5:15 – 7:15 PM

Assessing Your Current Readiness and Learning Needs to Engage Effectively in Global Health Work
Robyn Churchill, Emma Clark, Jane Dyer, Debra Price
Extended Session – Global Health/Refugee Care – 2 CEUs

Midwives are increasingly interested in global health, yet many do not know what applicable knowledge, experience, and skills they already possess and what else they may need for this area of work. In 2019, ACNM established the ACNM Global Health Competencies and Skills for Midwives to response to requests from ACNM members who are considering global work. Now, members will benefit from guidance on how to best use these competencies for self-assessment and to develop their personal learning pathway for engaging in global midwifery work.

The purpose of this session is to provide participants with a structured approach to assess their current global health abilities and identify areas for further personal and professional development for productive engagement in global health work.

Sunday, May 31, 6:30 – 7:30 PM

Midwives Leading Quality Improvement Teams to Improve Quality and Outcomes for First Time Births
Cathy Emeis, Susan DeJoy, Lisa Kane Low, Katie Page
Panel Discussion – Leadership – 2 CEUs

Midwives are increasingly called upon to lead and participate in interdisciplinary quality improvement teams. These may be part of institutional initiatives, regional collaboratives, or statewide improvement initiatives, such as AIM. In this panel discussion, midwife leaders will share their leadership techniques used to engage interdisciplinary teams. These skills will be helpful for midwives participating in any quality improvement or change initiative. Presenters for this session are RPC coaches and nurse midwives who led improvement teams in their hospitals as part of ACNM’s Reducing Primary Cesareans (RPC) national quality improvement collaborative and their state’s AIM initiatives.

Persistent Occiput Posterior Position 20/20
Elizabeth Arnold-Leahy, Barbara Reale
Education Session – Clinical – 1 CEU

This session will discuss the results of a survey conducted to analyze occiput posterior position, the most common malposition in labor. While up to 90% of fetuses rotate to a more favorable position before birth, those fetuses remaining posterior result in an operative (vaginal or cesarean) birth rate of up to 73% and multiple sequalae for mothers and infants regardless of mode of birth. Persistent occiput posterior has been attributed to up to 12% of cesarean birth. The study found that No identifiable characteristic accurately predicts OP position at delivery before the onset labor or in early labor. Factors that appear to be associated with fetal position include nulliparity, short maternal stature, narrow supra pubic angle, posterior fetal spine position, anterior placental location, and increased epidural rates and oxytocin use in labor. Midwives can use these characteristics to increase awareness of posterior fetal in laboring women, allocate resources, and initiate corrective measures as needed. The fetal spine was identified as a better predictor of fetal position and outcome compared with the fetal occiput position. Additionally, the fetal spine may be more amenable to correction via position and manipulation. This may be a more beneficial area of research for pursuit.

Screening for Human Trafficking in the Health Care Setting
Pamela Glenn
Education Session – Clinical – 1 CEU

The health care team is a vital partner in addressing the human trafficking situation in the U.S. and around the world. This session takes on the extraordinarily hidden and complex challenge of screening for human trafficking in the health care system. One study notes that approximately 88% of sex trafficking victims had contact with a health care professional. Each of these contacts is an opportunity for identifying and assisting a victim. It is a goal of this talk to provide an increased awareness of the trafficking situation to all members of the health care team. Included in this presentation is the identification of the multiple trafficking types, behaviors and dynamics which play out in these situations, as well as “red flag” warning signs. Stereotypes surrounding this issue, barriers to screening, and the unique challenges faced when trying to identify trafficked victims are also discussed. Most importantly, techniques for effectively screening victims, as well as follow-up recommendations and resources, are provided. As a result, it is hoped that all members of the health care team are empowered to incorporate effective screening techniques into their every day practice, along with strategies for identifying and assisting trafficking victims.

Team-Based Learning Online: The New Frontier in Midwifery Education
Laura Kim Baraona
Education Session – Education – 1 CEU

Team-based learning (TBL) is an exciting, powerful form of small-group learning that actively engages students in critical thinking, supporting deeper long-term learning. While team-based learning has been successfully implemented in face-to-face national and international professional healthcare educational programs, its use in online programs is just beginning to emerge. This presentation will describe TBL’s essential elements, advantages and disadvantages, address barriers to integrating TBL to an online format, and describe a course design used for successfully adapting TBL to an online program with students from a variety of geographic locations.

Monday, June 1, 8:30 – 9:30 AM

From Formative Research to Programmatic Realities: A Mental Health Adaptation of Group Antenatal Care in Bamako, Mali
Nicole Warren, Molly Lasater, Sarah Murray, Aissata Ba
Panel Discussion – Global Health/Refugee Care – 1 CEU

Women in low-resource settings experience a high burden of perinatal mood disorders, however there are few examples of how to address these challenges given the stigma, lack of mental health providers, and highly constrained health care systems. Although group antenatal care has been associated with positive health outcomes, including mental health, explicit mental health components have not previously been integrated into group care in low-resource settings. This presentation will describe a partnership between Group Care Global, Johns Hopkins University, Mothers & Babies program, and the University of Bamako in Mali, West Africa. Our team developed a group antenatal care program focused on perinatal mental mood disorders. We will describe how early, formative work clarified local conceptualizations of mood disorders and principles of cognitive behavioral therapy were infused into group care sessions. Programmatic challenges from this experience may be useful to other CNMs/CMs working to integrate mental health into maternal services in similarly low resource settings.

Nonprofit Industry Response to Inequalities in Use and Donation of Donor Human Milk – A Call to Action
Kimberly Updegrove
Education Session – Racism and Health Disparities – 1 CEU

For some babies, human milk feedings make a life and death difference. According to the American Academy of Pediatrics, this includes Very Low Birthweight infants, and many agree that it also applies to those infants with significant cardiac and GI complications. No population is free from experiencing these issues, and African American infants have the greatest risk for prematurity. They are also least likely to have their mothers’ own milk. This suggests that African American babies are most likely to receive donor human milk, yet, statistics from the Mothers’ Milk Banks of Austin and San Jose show that they are least likely as outpatients to be prescribed donor human milk. They are also least likely to be milk donors. Breastfeeding is the gold standard for babies and mothers. Breastfeeding rates in the US are far below ideal, and most especially for the preterm and medically vulnerable infants. Donor human milk fills a gap for medically fragile babies who need human milk from a source other than their biological mother. Medical outcome disparities cannot change until reasons for these differences across populations are addressed. Milk banks are in the perfect positions to positively affect breastfeeding rates and access to donor human milk. Likewise, midwives play a critical role in advocacy and support for all aspects of breastfeeding, milk donation, and hospital policies that incorporate door milk for ill — and well — babies. Disparities in breastfeeding rates begin with our messaging, and midwives have an opportunity and an ethical responsibility to advocate for donor human milk for everyone with a goal to breastfeed. Donor demographics and case studies of hospital well baby units using supplemental donor human milk in support of maternal breastfeeding shed light on how we collectively can ensure that all human babies have human milk feedings as an option.

Transform Nursing Students into Professional Allies, Clients, and Future Midwives
Barbara McAlister
Education Session – Midwifery Matters – Public Perception – 1 CEU

Although vast pregnancy and childbirth resources are available digitally, lack of understanding of the midwifery model of care persists. For midwives interested in enhancing the public’s perception of midwifery while potentially cultivating the future midwifery workforce, student nurses are a pragmatic choice for focusing efforts. The purpose of this presentation is to share approaches for midwives to educate student nurses about midwifery and normal birth. Maternity nursing faculty are sometimes hesitant to explore normal birth topics with students when medicalized birth experiences are exclusively witnessed in their clinical setting. Midwives can fill that crucial gap. Topics such as the midwifery model of care, physiologic vs. medicalized birth, research evidence for maternity care practices, and birth as a transformative process, can heighten nursing students’ awareness and ignite their curiosity.

Monday, June 1, 8:30 – 9:30 AM

Round Table Sessions – 1 CEU

Each Round Table Session will be 30 minutes long. Participants attending Round Table Sessions will rotate between two presentations at the 30-minute mark to qualify for CE credit.

Tips for Getting Published: Turning Your Presentation into a Publication
Patricia Murphy
Education – 0.5 CEU

The Effects of Oral Contraceptive Pills on Sexual Pain and Dysfunction
Kathy Herron
Clinical – 0.5 CEU

Stress, Acculturation, and Preterm Birth in Mexican-Origin Women
Robin Page
Racism and Health Disparities – 0.5 CEU

You Eat What? Clinical Implications of Dietary Recommendations for Women Across the Lifespan
Megan Arbour, Kelly Walker, Judith Wika
Clinical – 0.5 CEU

Changes in Reimbursement and Why Every Midwife Should Be Excited
Iain Holmes
Midwifery Matters – Business – 0.5 CEU

Nutrition Basics for Busy Providers
Melissa Davis, Stephanie Devane-Johnson, Tonia Moore-Davis
Clinical – 0.5 CEU

Tools to Implement Shared Decision Making and Personalized Care Planning in Prenatal, Intrapartum, and Postpartum Care
Amy Romano
Clinical – 0.5 CEU

Antepartum and Postpartum Hand Pain: When It Isn’t Carpal Tunnel
Courtney Pitts
Clinical – 0.5 CEU

Socioeconomic Disparities as Root Causes of Obesity and Midwifery Interventions to Support Those With Obesity
Cecilia Jevitt
Racism and Health Disparities – 0.5 CEU

Who’s Minding the Midwife? Compassion and Caregiver Fatigue
Michelle Collins, Diane Folk
Clinical – 0.5 CEU

Implementation of Preeclampsia Prevention Guidelines in a Birth Center Setting
Lana Giles
Clinical – 0.5 CEU

Bridging the Gap: Innovative Approaches to Increasing Access to Holistic Midwifery Care for Populations Vulnerable to Health Disparities in a Culturally Diverse Environment
Erica Corbett, Sunday Smith
Midwifery Matters – Business – 0.5 CEU

The International Childbirth Initiative (ICI): 12 Steps to Safe and Respectful Mother-Baby-Family Maternity Care
Robbie Davis-Floyd
Education – 0.5 CEU

Vaginal Birth After Two Cesarean Sections
Christina Shutters, Rebecca Winnike
Clinical – 0.5 CEU

Curandera-Parteras, Midwives, and Nurse-Midwives: A Legacy of Caring for Mind, Body, and Soul in Texas
Eileen Thrower
Midwifery Matters – Public Perception – 0.5 CEU

Black Infant and Maternal Mortality – How Sharing Stories Promotes Healing and Reduces Rates!
Erica McAfee
Racism and Health Disparities – 0.5 CEU

Navigating Turbulent Waters: Implementing a Waterbirth Program at a Regional Hospital
Ellen Solis
Clinical – 0.5 CEU

High Fidelity Clinical Simulations to Improve Maternal and Fetal Outcomes in the Birth Center Setting
Margaret Buxton, Heather Sevcik
Clinical – 0.5 CEU

Recognizing and Supporting the Laboring Patient with Previous Trauma Experience
Amy Gilliland
Education – 0.5 CEU

Women’s Mental Health Across the Lifespan
Julie Paul, Tanya Tanner
Clinical – 0.5 CEU

Transfer Simulations: Connecting Community Birth Professionals with EMS and Hospital Providers Through Teamwork, Communication and Obstetric Emergency Simulation Training
Jami Baayd, Susanna Cohen
Education – 0.5 CEU

Implementation of a Perinatal Telemedicine Program to Address Health Disparities in an Urban Federally Qualified Health Center
Catherine Daily
Clinical – 0.5 CEU

Midwifery and HIV Prevention: Increasing Prep Access and Addressing Underutilization
Noelene Jeffers
Racism and Health Disparities – 0.5 CEU

Triple Oppression: A Primer for Midwives. Understanding the Confounding Effects of Structural, Institutional and Interpersonal Racism, Classism, and Transphobic Attitudes Affecting the Health of Black Gender Nonconforming and Transgender Men
Theresa Coley-Kouadio, Michelle Drew
Racism and Health Disparities – 0.5 CEU

The Inclusion of Reproductive Justice in the Education and Health Care System
Lodz Joseph
Clinical – 0.5 CEU

“Saging Midwives”: One Practice’s Solution to Meeting the Needs of Aging Midwives
Margaret Hutchison
Midwifery Matters – Business – 0.5 CEU

Midwifery Burnout: What Midwives Have to Say
Brie Thumm
Leadership – 0.5 CEU

Maternity Care for Pregnant Women with Opioid Use Disorder
Abigail Rizk
Education Session – Clinical – 0.5 CEU

Monday, June 1, 12:30 – 1:30 PM

Building Maternity Care Teams via Distance Online Simulation
Tia Andrighetti, Dominic Cammarano, Robin Grant, Audrey Perry
Education Session – Education – 1 CEU

The U.S. healthcare system often fails to meet the needs of women and their families. Providers are rushed and responsibilities are often fragmented. The projected deficit of maternity care providers, current poor maternal-child outcomes and uncoordinated care compounds the care crisis. Simulation is an effective teaching method to expose students to clinical situations prior to real-life encounters. Distance online interprofessional simulations may be an effective, cost-efficient and convenient intervention to bring student nurse-midwives and OB/GYN residents across the country together to lay a foundation for future collaborative practice. This session discusses the results of a project demonstrating how to accomplish interprofessional education when all students are not in the same physical location, and provides strategies to overcome challenges.

Evidence-Based Practice and Waterbirth: A Three-Pronged Approach
Elizabeth Nutter
Education Session – Clinical – 1 CEU

The goal of evidence-based practice is to improve patient outcomes, quality of care, and to provide standardization of treatment. This session will present a framework to help midwives articulate how waterbirth is an evidence-based practice through discussion of research findings, clinical expertise, and consideration of patient preferences and values.

Liability and Social Media
Kathleen Page, Michelle Palmer
Education Session – Clinical – 1 CEU

Risk of liability for midwives caring for pregnant people, non-pregnant people, and newborns is significant. This risk has increased over the last twenty years in both numbers of lawsuits and categories of liability risk. Social media is an emerging area of risk in terms of use by the midwife and impact of consumer use of social media in health care. This presentation will look at the characteristics and influences of liability for midwives in the United States related to the use of social media, present basic principles of liability involved in use of social networking as a midwife, and review potential areas of vulnerability due to patient use of social media in health care. An interactive discussion of strategies and risk management plan development will follow the initial presentation.

Sexual Health in All the Right Places: Improving Effective Extragenital STI Testing
Daniel Stec
Education Session – Clinical – 1 CEU

Gonorrhea and chlamydia continue to be a public health concern, with most infections found via urogenital testing. There is a large reservoir of extragenital (oral or anal) infections missed in all populations with only urogenital testing. This session discusses the results of a project that aimed to increase effective care for STIs by screening, testing, and managing those at risk for extragenital gonorrheal and chlamydial infections to 60% in 8 weeks. This project enhanced the organization’s sexual healthcare and created a more robust environment of communication and awareness of needs. The tools could be spread to other departments and in other settings with similar gaps.

The National Academy of Sciences, Engineering, and Medicine Consensus Study: Assessing Health Outcomes by Birth Settings
Jilli Alliman, Melissa Cheyney, Michelle Collins, Wendy Gordon, Debbie Jessup, Lori Trego
Panel Discussion – Racism and Health Disparities – 1 CEU

In 2019, the National Academies of Sciences, Engineering, and Medicine (NASEM) formed an ad hoc committee to examine and synthesize the available research on birth settings, focusing particularly on health outcomes experienced by sub-populations of women. This panel session will bring together representatives from the NASEM consensus study committee, staff, and sponsor for a discussion of the findings as presented in a forthcoming NASEM report, Assessing Health Outcomes by Birth Settings (anticipated for public release in January 2020).

Monday, June 1, 3:00 – 4:00 PM

Preserving Our Profession: Don’t Let the 5% Crowd Out the 95%
Elizabeth Cook
Education Session – Leadership – 1 CEU

Midwifery is a profession inherently built on a fundamental belief that we are to provide what is best for moms and babies. What makes midwifery great is the variance in perspectives and experiences we all bring to the table, centered around a core commitment that never wavers. The greatest threats to our profession are not the perennial conversations about scope of practice, privileging, and community acceptance. We’ve got those in the bag! Our greatest threat is unraveling from within our own ranks. Clinically, philosophically, socially, and politically we agree on 95% of the issues. We differ on 5% of the issues – midwifery education, addressing disparities, demographics and communities we serve, risk level of patients, and reproductive rights — and that’s good. But while open and respectful conversation about that 5% is healthy, it should never crowd out the 95% that glues us together as a profession and makes us assuredly successful.

Designing an Effective Anti-Racism Workshop for Midwives and Other Clinicians
Jatolloa Davis, Melicia Escobar, Mari-Carmen Farmer
Education Session – Racism and Health Disparities – 1 CEU

Are workshops and trainings that address implicit bias, racism, and health disparities an effective strategy for change? What ingredients are essential to make educational approaches to these topics relevant and effective? How can facilitators prepare for leading trainings and workshops focused on a topic fraught with challenging historical narratives and a wide spectrum of participant experience and belief? Are there skills that midwives have that lend themselves to designing and facilitating a workshop of this kind? Finally, and most importantly, are these trainings being implemented primarily to reduce harm, to prevent the loss of lives occurring as a result of racism, or are mixed motivations impairing outcomes? Participants will leave this session with a toolkit of strategies designed to help create an individual workshop or training to their own healthcare settings, and will be given the opportunity to ask questions and address scenarios that may have challenged participants when facilitating workshops in the past. The content that will be presented will be based in the evidence found in literature from various disciplines that has examined what is most effective in creating change, particularly among healthcare providers and in healthcare institutions.

DOR Research Symposium – Research – 1 CEU

This forum combines similar presentations within a 60-minute education session time frame. The time is divided between the presentations with a 10-minute period for questions at the end.

Correlates of Reproductive Coercion among College Women in Abusive Relationships
Karen Trister Grace
DOR Research Symposium – Research

This session will discuss the results of a study conducted to examine correlates of reproductive coercion (RC) among a sample of college women in abusive relationships. RC describes coercive and controlling behaviors that interfere with a woman’s autonomous reproductive health decision-making. College age (18-24 years) women are known to experience the highest prevalence of intimate partner violence and sexual violence and reproductive coercion may be an important facet of such violence exposure, with significant impact on reproductive health and well-being. RC may be an indicator that a young woman is experiencing more severe violence and is at risk for severe sequelae such as Traumatic Brain Injury. RC remained a significant predictor of depression after adjusting for severity of IPV, which indicates that RC is independently associated with depression. This finding has important implications for midwives working with college-aged women, regarding the need for depression screening and referral to mental health services concurrent with providing services related to IPV and RC. A larger proportion of women who experienced RC sought help from a healthcare provider for contraception, which indicates an important opportunity for midwives to intervene when women are experiencing RC.

Reproductive Coercion Among Latina Women and Strategies for Minimizing Harm
Karen Trister Grace
DOR Research Symposium – Research

This session will discuss the results of a study conducted to explore risk factors for reproductive coercion (RC), association with pregnancy intention and intimate partner violence (IPV), and the use of RC safety strategies among Latina women attending an urban clinic. The study articulates the risk of RC in abusive relationships for Latina women. Results are contextualized with qualitative interview data from Latina women who have experienced RC. Midwives working with racially and ethnically diverse women have an important role in screening and support for safety/harm reduction strategies that include informing women about less detectable methods of contraception.

Millennial Women are Having Postpartum Sex Before They are Ready. What is the Midwifery Response?
Diana Spalding
DOR Research Symposium – Research

This session will discuss the results of a study conducted to examine the sexual practices of millennial women (defined as women born between 1981 and 1996) following birth to better understand where support is needed during this vulnerable time. Additional qualitative research is needed regarding why a significant portion of women are having postpartum sex before they feel ready. Regarding implications for practice, there are both individual clinical and societal investigations and improvements needed. Midwives are in an excellent position to work with women to understand the potential physical and emotional consequences of reengaging in sexual activity before they feel ready. And, as advocates for women, midwives can be instrumental in influencing cultural shifts that are more supportive of all aspects of the postpartum experience.

Monday, June 1, 4:15 – 5:15 PM

2020 Global Health: Hot Topics for Midwives
Robyn Churchill
Panel Discussion – Global Health/Refugee Care – 1 CEU

Up-to-date information about the most recent issues affecting perinatal health around the world or for women recently resettled to the U.S. is often not easily available to practicing midwives. The purpose of the 2020 Global Health Hot Topics for Midwives Panel is to provide midwives interested in global health with the latest information in four areas. In the global setting, midwives provide clinical care within a variety of cultural contexts, educate a variety of professionals, and participate in healthcare systems change and management. As midwives increasingly engage in global work, including care of refugee women, they need the most recent information about critical reproductive and maternal health issues of the global arena.

Collaborative Model of Care Between Midwives and MFMs for Substance Use Disorders in Pregnancy
Adi Lazary-Dagan, Erin Wright
Education Session – Clinical – 1 CEU

The challenge of caring for pregnant patients who live with substance use disorders increases daily along with the opioid epidemic in the US. The Center for Addiction and Pregnancy in Baltimore is a uniquely collaborative model of care between midwives, maternal fetal medicine physicians, psychiatrists, substance use counselors, pediatricians, and social workers who provide holistic care during pregnancy, intrapartum, and postpartum for the birthing parent-infant dyad. In this session, we will discuss the model of care, its outcomes for patients, and pharmacologic management of the substance using pregnant client. We will also discuss implication for implementation of such a program in different settings.

Data Collection and Reporting for Midwives: Making Your Numbers Work for You
Cathy Emeis, Molly MacMorris-Adix, Karen Perdion
Education Session – Midwifery Matters – Business – 1 CEU

Collecting and reporting data is critical to promoting midwifery practice and improving outcomes. But where to start? This session will help you determine what information to collect, which tools are available, and how to create and effectively use reports to benefit your practice. We will also discuss using your data for quality improvement and Benchmarking Project participation, as well as leveraging it when working with administrators. Whether you are just getting started or are looking for new ideas, there will be something for you in this session.

The Fellows’ Panel: Midwives Mentoring Midwives
Heather Bradford, Ginger Breedlove, Heather Findletar Hines, Deborah Walker
Panel Discussion – Leadership – 1 CEU

Many challenges in midwifery advancement exist within the practice and professional environment, such as bullying in the workplace, barriers to autonomous practice, lack of diversity in leadership, and uncertainty as to how to attain leadership positions within ACNM. Although one to one mentoring in professional leadership development is different than mentoring midwives’ entrée into practice, principles that lead to successful mentoring are similar. The Fellows of ACNM recently initiated a formal mentorship program in conjunction with the Students and New Midwives Committee, offering a mentorship program between Fellows and midwifery students and new midwives. Panel members will discuss successful mentoring strategies that play an important role in meeting mentee goals, developing mentee leadership skills and encouraging aspiration to leadership roles in the professional organization. Mentors will receive guidance on establishing and maintaining a satisfying mentor-mentee relationship. The focus of this session will be on providing skills for a successful relationship for both the mentor and mentee and is designed for all conference attendees, not just those seeking a mentor.

Tuesday, June 2, 10:45 – 11:45 AM

Exercise in the Perinatal Period: Myths Explored and Debunked
Tanya Tringali
Education Session – Clinical – 1 CEU

Education and encouragement regarding exercise is a critical component of midwifery care, yet it is commonly overlooked or minimized by busy clinicians. Additionally, this subject is riddled with outdated information and myths, especially when applied to women in the perinatal period. Considering the positive perinatal outcomes associated with regular exercise including fewer newborn and maternal complications, improved birth outcomes, overall improved health throughout the lifespan and no association between complications such as miscarriage, preterm labor and stillbirth, it is important that midwives provide accurate, up to date and evidence-based care regarding exercise to their clients as a routine part of prenatal and postpartum care. An interdisciplinary approach to exercise in the perinatal period with a special emphasis on the postpartum period is warranted. Examples of individual exercise counseling and group exercise programs will be described.

Identifying Destructive Communication with Student Midwives
Rebecca Burpo
Education Session – Education – 1 CEU

A mounting number of studies over the past decade have identified the prevalence of destructive communication with students in a variety of academic and clinical settings. Several publications focus on developing student resilience or coping strategies; yet, few address the perpetrators of this communication, which can create career-long trauma in our developing midwives. As a profession with an ethical code of respectful behavior to all and a position statement against incivility and bullying, we must look inward to acknowledge how we treat the youngest members of our profession. We must learn the difference between “high standards” and “abusive behavior”. This session will describe the various forms of destructive communication (incivility, bullying, and rude,dismissive, or aggressive [RDA] communication), recognize that these are classified as a form of violence, and explore more respectful strategies for interacting with student midwives.

Use of Tranexamic Acid for Postpartum Hemorrhage (PPH)
Ruth Mielke, Sarah Obermeyer
Education Session – Clinical – 1 CEU

Tranexamic acid (TXA) is an anti-fibrolytic pharmacologic agent with demonstrated use in reducing death resulting from blood loss due to trauma and major surgery. World Health Organization (WHO) recently updated its treatment recommendations for PPH to include TXA as part of the standard care for women with PPH following vaginal or cesarean birth regardless of etiology. Midwives should be aware that TXA is part of the standard of care for women with PPH in low resource settings and an adjunct treatment to PPH protocols in high resource settings. Research supports TXA use in prevention of PPH in cesarean and emerging research suggests that TXA is useful to prevent PPH in women having vaginal birth.

Violence Update for Midwives: Emerging Topics and Promising Interventions
Karen Trister Grace
Education Session – Clinical – 1 CEU

Midwives frequently encounter patients who have experienced violence and coercion. Understanding the wide variety of forms of violence and coercion is critical to providing sound, compassionate care. Best practices for screening, documentation and management will be discussed. Recent phenomena such as “stealthing” will also be covered, as well as emerging technological interventions to aid survivors of violence. Attendees will develop an understanding of the barriers to disclosing violence, and what to do if violence is disclosed.

Working With The Laboring Brain
Amy Gilliland
Education Session – Clinical – 1 CEU

This session will discuss the allegories between release of the social peptide oxytocin during normal human interaction, and the purpose of the hormone during human labor and birth. The speaker argues that the social purposes of human labor and birth are designed to strengthen attachment relationships and caregiving templates in parents and children. These processes are intertwined with the limbic system’s encoding of potent long lasting memories, and the release of oxytocin and catecholamines in labor. These processes explain the effectiveness of the professional birth doula (and sometimes midwife) rather than family member in obtaining positive obstetric, neonatal and postpartum outcomes. In laboring adults, receiving contingent and sensitive labor support may provide an opportunity to strengthen secure attachment orientations or create a potent memory of receiving appropriate care for those with insecure attachment orientations. Clinical application of working with the laboring brain include increased spontaneous oxytocin, lower perception of pain, increased feelings of safety, increased bonding and heightened sensitivity of parent to child, and more loving feelings and behaviors between the laboring and supportive parents in the immediate postpartum period.