Speaking of Midwives

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 practiceWhether 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, FACNMArticle: 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 LibraryRelated 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 workedGuest Credentials: Cindy Nypaver PhD, APRN-CNM, WHNP-BC, FACNMArticle: Innovations in Preconception Care: Optimizing Health for AllIndividuals - Nypaver - 2024 - Journal of Midwifery & Women's Health -Wiley Online LibraryWebsite 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