We know midwifery care works. So why isn't it everywhere?

In this episode, host Dr. Melissa Avery sits down with Brie Thumm, CNM, PhD, midwife and assistant professor at the University of Colorado Anschutz College of Nursing, to explore this game-changing question: not whether midwifery care improves outcomes, but how to get it adopted, sustained, and equitably integrated across every setting in the U.S?

Dr. Thumm breaks down implementation science, which is the study of how to translate proven interventions into everyday practice. She reframes the midwifery model of care itself as an evidence-based intervention ready for rigorous, systematic adoption.

In this episode, you'll learn:
-What implementation science is (and why it's different from effectiveness research)
-How theories, models, and frameworks create shared language for studying midwifery across wildly different settings
-Why "positive deviance" studying practices already succeeding may be the key to spreading what works
-The four levels of barriers and facilitators to integration: patient, provider, organization, and system
-Practical steps any clinician can take today to identify and share what's working in their own practice

Whether you're a clinician, researcher, or midwifery advocate, this conversation offers a roadmap for moving midwifery care from proven to prevalent!

Listen now and subscribe to Speaking of Midwives, brought to you by the Journal of Midwifery & Women's Health.

Credentials: Brie Thumm, PhD, CNM, RN, MBA, FACNM

Article: A Synthesis of Principles and Approaches From the Field of Implementation Science for Studying Midwifery Integration in the United States - Thumm - Journal of Midwifery & Women's Health - Wiley Online Library

Related article mentioned during the episode 
Curran, G. M. (2020). Implementation science made too simple: a teaching tool. Implementation science communications, 1(1), 27. 

Social Media: LinkedIn: www.linkedin.com/in/e-brie-thumm-b5580249

#Midwifery #ImplementationScience #MaternalHealthEquity #MidwiferyIntegration #JMWH #WomensHealth #NurseMidwife #HealthEquity #MaternalHealth

The U.S. lags behind other developed nations in maternal and infant health outcomes; and Dr. Cynthia Nypaver, midwife, associate professor, and program director at the University of Cincinnati College of Nursing, believes preconception care is a missing piece of the puzzle.In this episode, Dr. Nypaver joins us to unpack her latest article synthesizing the research on preconception health innovations. We explore why care before pregnancy matters as much as care during it, the individual, provider, and structural barriers keeping people from accessing it, and the exciting new tools changing the landscape. F-rom AI-powered conversational agents like "Gabby" to mobile apps, chatbots, and electronic health record prompts that make preconception screening part of routine care.We also dig into policy-level solutions for closing gaps in maternity care deserts, the role of telehealth in reaching rural communities, and practical, ways clinicians can start normalizing preconception care starting tomorrow.

Whether you're a midwife, OB, family medicine provider, or nurse practitioner, this conversation offers a roadmap for treating preconception care as what it truly is: primary care for people of reproductive age.In this episode:-Why preconception care affects outcomes across generations-Screening tools every provider should know (reproductive life plan, PHQ-9, IPV screening)-New digital health innovations, from apps to virtual conversational agents-Community and population-level interventions that have worked

Guest Credentials: Cindy Nypaver PhD, APRN-CNM, WHNP-BC, FACNM

Article: Innovations in Preconception Care: Optimizing Health for AllIndividuals - Nypaver - 2024 - Journal of Midwifery & Women's Health -Wiley Online Library

Website of interest: https://beforeandbeyond.org/

In this episode of Speaking of Midwives, our host talks with Dr. Nikia Grayson, midwife, chief clinical officer at CHOICES Center for Reproductive Health in Memphis and Carbondale, and associate professor at UCSF, about her article, "The Choices Black Midwifery Fellowship: An Innovative Model for Training Midwives in Reproductive Justice and Community-Centered Care."Dr. Grayson describes how CHOICES, a nonprofit reproductive healthcare organization serving Memphis for over 50 years, and now Carbondale, Illinois as well, built a fellowship grounded in Black feminist thought and reproductive justice to address a gap she experienced firsthand: what happens after graduation, when new midwives need support translating clinical knowledge into confident practice.She walks through the fellowship's five pillars: full-scope reproductive health education, Black feminist thought, leadership and mentorship, neonatal/postnatal care, and community-centered care. She shares candid insights on funding a program that pays fellows a real, livable salary; embedding policy engagement into clinical training; and building an intentionally Black-led midwifery workforce in the South.The conversation also touches on lessons for midwifery faculty and preceptors everywhere: the need for structured mentorship, training beyond hospital-based medicalized settings, and reframing midwifery as inseparable from advocacy and social change.Tune in for a compelling look at what it takes to build a training model designed for midwives to not just enter the profession, but stay, lead, and transform it.CHOICESWebsite: www.yourchoices.orgInstagram: @yourchoicesclinicsFacebook: www.facebook.com/yourchoicesclinicsLinkedIn: linkedin.com/company/your-choicesDr. Grayson's Social Media: Instagram: @nikiagrayson_midwifeLinkedIn: www.linkedin.com/in/nikiagraysonFacebook: www.facebook.com/nikiagraysonArticles:Grayson N, Quinones N, Oseguera T. A Model of True CHOICES: Learnings from a Comprehensive Sexual and Reproductive Health Clinic in Tennessee that Provides Abortions and Opened the City's First Birth Center. J Midwifery Womens Health. 2022;67(6): 689-695. https://doi.org/10.1111/jmwh.13448The CHOICES Black Midwifery Fellowship: An Innovative Model for Training Midwives in Reproductive Justice and Community‐Centered Care - Grayson - 2026 - Journal of Midwifery & Women's Health - Wiley Online Library

The tools we use to counsel patients aren't always keeping pace with reality. In this episode, midwife-researcher Ann Ledbetter joins us to discuss her study, Observed versus Predicted Vaginal Birth After Cesarean for Patients of a Community Health Center, published in the Journal of Midwifery & Women's Health.Ann shares findings from 507 labors after cesarean at a Milwaukee community health center serving a predominantly Latina population. The numbers challenge assumptions baked into the widely used VBAC calculator. Her team found actual VBAC success rates outpaced predictions across the board, with the calculator proving especially inaccurate for patients with higher BMIs and no prior vaginal birth.We dig into what these findings mean for clinical counseling, the risks of discouraging TOLAC based on probability scores alone, and why Ann believes the conversation needs to shift from "fixing the calculator" to examining hospital-level practices driving cesarean variability. She also makes the case for continued midwifery support as a driver of improved VBAC rates, and outlines the research she'd like to see next.A thoughtful, data-driven conversation about equity, autonomy, and trusting birthing people's bodies.Articles:Considering Labor After Cesarean in a Woman with Class 3 Obesity - Ledbetter - 2020 - Journal of Midwifery & Women's Health - Wiley Online LibraryObserved Versus Predicted Vaginal Birth After Cesarean for Patients of a Community Health Center - Ledbetter - 2025 - Journal of Midwifery & Women's Health - Wiley Online LibraryAnn's Substack: A Moderate Midwife | Ann Ledbetter | SubstackAnn is featured on Emily Oster's newsletter Parent DataVBAC: Risks, Benefits, & How to Prepare

Adapting Group Prenatal Care for Telehealth: Lessons from a Federally Qualified Health CenterWhen COVID-19 made in-person group prenatal care impossible, the midwifery team at Mary's Center, a federally qualified health center serving a predominantly a Spanish-speaking community in Washington, DC, didn't just adapt they innovated.In this episode of Speaking of Midwives, our host Dr. Melissa Avery talks with Dr. Katherine Daly and Dr. Christina Marea (both of Georgetown University) about their two companion articles on rebuilding Mary's Center's group prenatal care program for telehealth. This model included Zoom-based sessions, at-home blood pressure monitoring, bilingual facilitators, and preserved in-person touch points for essential care.The results were striking: the telehealth group care clients completed significantly more prenatal visits than those in individual telehealth care (15.6 vs. 10.3) and were far more likely to receive adequate care. Qualitative findings added the rest of the story. The participants felt genuinely connected, supported, and seen.Dr. Daly and Dr. Marea also discuss what it takes to sustain this kind of model, from funding and digital literacy support to the policy changes needed to reimburse group and telehealth care fairly, especially as Medicaid and DC Alliance cuts threaten access. Tune in to hear how a team of midwives turned a crisis into a model of care worth replicating.The articles:Daily C, Gresh A, Hamilton ER, and Marea CX. Adapting Group Prenatal Care for Telehealth: A COVID-Era Innovation to Address Barriers to Care for Latinx Clients. J Midwifery Womens Health. 2024: 69(6); 945-951. https://doi.org/10.1111/jmwh.13701Daily C, Gresh A, Hamilton, E.R., Crowell, N.A., Martinez, G.G.A. and Marea, C.X. (2026), Evaluating the Impact of Telehealth Prenatal Care at a Federally Qualified Health Center. J Midwifery Womens Health. Published online May 21, 2026. https://doi.org/10.1111/jmwh.70107Catherine (Katie) Daily DNP, CNM, FACNMwww.maryscenter.orghttps://gufaculty360.georgetown.edu/s/contact/00336000014Ry8mAAC/catherine-daily-dnp-cnm-facnm?asPublic=truehttps://www.linkedin.com/in/katie-daily-a15036351/Christina Marea PhD, CNM, MA, MSN, FACNM https://www.linkedin.com/in/christina-marea-95a978239https://gufaculty360.georgetown.edu/s/contact/00336000014Tp5cAAC/christina-x-marea-phd-ma-msn-facnm

Every midwife knows the tension. How long is too long in second stage, and what does the evidence actually say about letting someone labor down? In this episode of Speaking of Midwives, our host Dr. Melissa Avery sits down with Dr. Elise Erickson, midwife, PhD, and associate professor at the University of Arizona, to discuss her research published in the Journal of Midwifery & Women's Health examining the role of passive descent and epidural analgesia in outcomes associated with prolonged pushing among nulliparous midwifery patients.

Drawing from a prospectively collected dataset of nearly 1,500 births across a midwifery practice in the Pacific Northwest, Dr. Erickson unpacks what the data reveals about prolonged pushing, cesarean risk, obstetric anal sphincter injury, and the nuanced, and often underdocumented time between full dilation and active pushing. Elise issues a compelling call to action for midwives everywhere who are benchmarking their outcomes: your data matters, and the profession needs it. This is exactly the kind of midwifery-led, practice-informed research that is building the evidence base one dataset at a time.Article: Erickson EN, Hersh SR, Wharton MR, Bovbjerg ML, Tilden EL. The Role of Passive Descent and Epidural Analgesia in Outcomes Associated With Prolonged Pushing Among Nulliparous Individuals in Midwifery Care. J Midwifery Womens Health. 2024; 69(4): 499-513. https://doi.org/10.1111/jmwh.13624Citations for two other articles Elise mentions in this episode:Cahill AG, Srinivas SK, Tita ATN, et al. Effect of Immediate vs Delayed Pushing on Rates of Spontaneous Vaginal Delivery Among Nulliparous Women Receiving Neuraxial Analgesia: A Randomized Clinical Trial. JAMA. 2018;320(14):1444–1454. Doi:10.1001/jama.2018.13986Montfort E, Nallet C, Cot S ...Active second-stage duration under 15 minutes in spontaneous vaginal deliveries with delayed pushingAmerican Journal of Obstetrics & Gynecology, 2025; 234, 1470-1477Dr. Erickson's Links:website is www.mumhlab.com Instagram at @mumhlab

In this episode of Speaking of Midwives, host Melissa Avery, PhD CNM sits down with Dr. Julie Blumenfeld, Associate Professor and Midwifery Program Director at Rutgers University, to tackle one of the most critical challenges facing the profession today: the clinical preceptor shortage.

Despite the growing demand for midwifery care in the United States, securing clinical sites remains a complex hurdle for students and program directors alike. Dr. Blumenfeld shares insights from her recent study, "Identifying Drivers and Barriers to Precepting Midwifery Students," using a socio-ecological lens to understand why midwives say "yes" (or "no") to teaching the next generation.

The "Time vs. Teaching" Tug-of-War: How to balance high-volume patient panels with the responsibility of clinical instruction without burnout.

The Support System: Why institutional backing and workload reduction are essential to making precepting sustainable, rather than a "series of personal favors."

Recharge and Renewal: How seasoned midwives find renewed energy and stay current with their skills through the infectious enthusiasm of students.

Policy and Funding: The urgent need for federal support—including the Midwives for MOMS Act—to modernize clinical education and provide parity with medical residency funding.

Equity in Education: A look into the SIMPL study and the importance of addressing the unique barriers faced by sexual and gender minority students.

Precepting isn't just an "extra" task; it is a core professional competency and the heartbeat of the midwifery pipeline. Whether you are an early-career midwife or a veteran practitioner, discover how you can advocate for teaching rights in your contracts and help ensure the profession continues to thrive.

Credentials: Julie Blumenfeld, DNP, CNM, FACNM, FAAN

Blumenfeld J, Alspaugh A, Wright L, Lindberg L. Identifying Drivers and Barriers to Precepting Midwifery Students: “A Little Part of Me Lives on in Each Student Midwife”. J Midwifery Womens Health. 2024;69(5):727-734. https://doi.org/10.1111/jmwh.13654

Resources:

• The New Jersey Midwifery Education Project: Access the Preceptor Learning Platform for asynchronous CEs and clinical teaching strategies.
• Midwives for MOMS Act: Learn more about pending federal legislation to support midwifery workforce development.

Connect with Us:
If you enjoyed this episode, please subscribe and leave a review. Your support helps us bring midwifery-led research to the forefront of maternal health.

Since the landmark ARRIVE trial reshaped labor induction practices across the country, midwives have been asking, what do these findings actually mean in the hands of midwifery-led care? In this episode of Speaking of Midwives, host Melissa Avery sits down with Dr. Denise Smith, midwife, researcher, and assistant professor at the University of Colorado, to discuss her recently published study in the Journal of Midwifery & Women's Health examining outcomes for labor induction compared with expectant management across four diverse midwifery practice groups serving more than 7,000 births.Dr. Smith and her team at the Midwifery Reach research lab set out to answer what clinicians were already asking in practice, does induction of labor increase cesarean birth rates in midwifery-managed settings? The findings are both reassuring and revealing, with important implications for how midwives counsel patients, manage labor, and advocate for resource equity.This is midwife-led research, answering questions that matter most to midwifery practice. These conversations are exactly what Speaking of Midwives is here for.Smith DC, Gemkow JW, Shiferaw BA, Anderson J, Bulinski D, Brody MG, Carrington S, Cherry C, Pirrie SM, Williams A, Smyth HL, Kissler KJ. (2026), Outcomes for labor induction compared with expectant management among women receiving hospital-based, midwifery-led care. J Midwifery Womens Health. Published in EarlyView April 2026.

What does the research tell us about how pregnant people of color experience communication with their care providers? What can midwives do about it right now?

In this episode, we sit down with Amy Goh, CNM, PhD, whose integrative review published in the Journal of Midwifery & Women's Health examined communication dynamics between pregnant people of color and their prenatal care providers across the United States. Dr. Goh unpacks the overarching themes her team uncovered — racism, discrimination, and critical unmet educational needs — and translates that evidence into actionable strategies for building stronger, more trusting patient-provider relationships.

We have a candid conversation about confronting the historical roots of midwifery and obstetrics, and what it truly means to provide care grounded in respect, safety, and bodily autonomy for every birthing person. Dr. Goh also shares the Beloved Birth 50 by 50 bold vision, which is a national call to action to have 50% of all U.S. births attended by midwives by the year 2050.

Key Takeaway:Systemic change begins with local action. When we center the leadership of midwives of color and expand equitable access to birth centers, we move closer to a future where every birthing person feels genuinely safe, respected, and heard.

Featured Research:Goh AH, Altman MR, Canty L, Edmonds JK. Communication between pregnant people of color and prenatal care providers in the United States: An integrative review. J Midwifery Womens Health. 2024;69(2):202–223. https://doi.org/10.1111/jmwh.13580

Behind every breakthrough in reproductive healthcare, a researcher is asking the right questions. More often than you think, that researcher is a midwife.

Welcome to Speaking of Midwives, we are the official podcast of the Journal of Midwifery & Women's Health where our host, Melissa Avery, PhD, CNM, FACNM, FAAN leads conversations about evidence, innovations, and the future of midwifery science.

Today, in our debut episode Melissa interviews Heather Bradford, PhD, CNM, FACNM, about weight bias in midwifery. Heather shares how she became interested in this topic and how weight bias affects the way we deliver care. The episode introduces our commitment to honest, unfiltered discussions about birth, reproductive justice, and the future of maternal health.

Whether you are an expectant parent, a birth professional, or simply a believer in better care for all, this episode is your invitation to join the conversation as we begin Speaking of Midwives.

More about Heather Bradford, PhD, CNM, FACNM

• Linkedin - @hmbmidwife
• Bradford HM, Puhl RM, Phillippi JC, Dietrich MS, & Neal JL. Weight bias in the perinatal period: An integrative review. Birth. 2025;52(2):189-206. Doi:10.1111/birt.12870
• Bradford HM, Puhl RM, Phillippi JC, Dietrich MS, & Neal JL. Weight bias among certified nurse-midwives and certified midwives: Findings from a national sample. J Midwifery Womens Health. 2024;69(3):333-341. Doi:10.1111/jmwh.13608
• Bradford HM, Puhl RM, Phillippi JC, Dietrich MS, & Neal JL. Implicit and explicit weight bias among midwives: Variations across demographic characteristics. J Midwifery Womens Health. 2024;69(3):342-352. Doi:10.1111/jmwh.13616Olson SM, Muñoz EG, Solis EC,
• Bradford HM. Mitigating weight bias in the clinical setting: A new approach to care. J Midwifery Womens Health. 2024;69(2):180-190. doi:10.1111/jmwh.13578

Clip mentioned by Heather during the interview. James Cordon clip ⁠   • James Corden Responds to Bill Maher's Fat ...  ⁠