Our Acknowledgement

Midwifery practice, education, and advocacy in the United States have long been shaped by divisions–between Indigenous, Black, Traditional, Community-based midwives, Certified Professional Midwives, Certified Nurse-Midwives, and Certified Midwives. These divisions often occur at the expense of one another’s expertise and proximity to medical systems. We operate within separate advocacy groups, governing bodies, and educational frameworks, each with distinct scopes of practice. This fragmentation contributes to public confusion and enables regulatory systems to uphold reproductive policies that harm our communities.

We know that midwifery is a powerful answer to the crisis in perinatal care. We know that we are stronger together. We know that the obstetrical model continues to harm birthing people and deepen racial disparities. These truths are widely recognized—and yet, the midwifery profession remains fractured.

Historically, midwifery has been dominated by white nurses who actively marginalized and discredited out-of-hospital midwifery, including Indigenous, Black, Traditional, and all community-based practitioners. This intentional rupture has never been meaningfully addressed, yet it has shaped where and how we practice, how we are educated, and who we are able to advocate for. Hospital-based midwifery, often aligned with patriarchal and medicalized institutions, has had to conform to systems that prioritize obstetric authority and frequently disregard normal physiologic birth. As a result, such births are rarely seen in hospitals and are underrepresented in nurse-midwifery education.

Meanwhile, out-of-hospital midwifery continues to thrive in homes, communities, and birth centers—despite systemic barriers that limit its growth and legitimacy. These barriers have led to reduced access to care and restricted autonomy for midwives serving marginalized communities.

Midwifery education reflects these divides. Hospital-based programs often serve the medical model, while out-of-hospital midwifery—especially as practiced by Indigenous, Black, Traditional, and community-based midwives—seeks to revive and sustain time-honored models of care. Despite these differences, we are learning many of the same skills and holding many of the same values: that pregnancy, birth, menstruation, and aging are normal processes; that birthing people deserve autonomy and respect; and that midwifery, when fully supported, can save lives and reduce disparities.

We share a belief that we need more midwives—midwives who reflect and serve their own communities, in more places, in more ways than we currently do. This shared belief is the driving force behind our work. It is the foundation for H.E.A.L.I.N.G. Midwifery together.

– HMT Team 2025