Monday, May 6, 2013

MEAC - How to Make Accreditation Matter in Midwifery Education

The Midwifery Education Accreditation Council - also known as MEAC - is the organization that accredits programs that train midwives to become eligible to take the NARM exam and become CPMs.  (Note: The MEAC accredited route represents only one path to becoming a CPM.

Believe it or not, we have had numerous discussions regarding MEAC-accredited midwifery programs and creating a requirement of graduation from a MEAC-accredited program as a provision for CPM licensure in Michigan.  Florida and California already do this, and it beefs up the educational background for certified professional midwives licensed by these states. The American College of Nurse-Midwives has a position statement regarding midwifery certification in the US, and supports licensure of CPMs who have completed a formal education program. Requiring formal midwifery education goes above and beyond the paltry educational requirements set forth by NARM and perhaps even fulfills the education requirements set forth by the International Confederation of Midwives.

In our discussions we've come to the conclusion that MEAC does not do enough to ensure high-quality midwifery education, and though it is an improvement over NARM's rudimentary standards, it is not sufficient for licensing independent midwives.

Why doesn't Safer Midwifery for Michigan endorse the MEAC-graduate CPM as holding the minimum requirement for Michigan licensure?
  • MEAC does not assure uniformity in education between accredited programs (some graduates hold master's degrees, others have a 'certificate' in midwifery)
  • MEAC does not assure more thorough academic preparation than apprenticeship-only education
  • MEAC does not strive to provide an education that is an improvement over the infamous portfolio evaluation process (PEP), but takes care to make certain there is no advantage of MEAC-graduates over apprenticeship-only trained midwives
  • MEAC bows to the lowest common denominator, citing that "all pathways" to becoming a CPM are equal,  
  • MEAC does not require integration into post-secondary education institutions to assure consistency with American standards for general education requirements. This means if a CPM graduates from a MEAC-accredited program, none of the credits earned will transfer to any real university or college in the US.
  • MEAC programs do not require evaluation of the preceptor's teaching methods or efficacy in training student midwives.
  • MEAC does not require any hospital-based clinical experience midwifery

What would it take for SMM to endorse the MEAC route to becoming a CPM?
  • Regional accreditation as well as specialty accreditation.
  • Requiring preceptors to have training and guidance in teaching students.
  • Oversight in determining how successful completion/competence is determined by preceptor
  • Require clinical experience in a US hospital setting
  • Require at a minimum a Bachelor's degree
  • Require specific coursework related to health care and midwifery in biology, chemistry, anatomy and physiology, microbiology, pharmacology, statistics, risk screening, assessment, the midwifery scope of practice, ethics, embryology, primary care for women's health, and prenatal, postnatal and intrapartum theory courses.
  • Commit to ensuring superior education and training of midwives who are educated through MEAC accredited programs. 
  • MEAC should not be branded as a 'separate but equal' pathway to becoming a CPM, but a more rigorous, more thorough, more comprehensive pathway that produces higher-quality midwives.
  • MEAC must advocate for accredited programs to be the only valid route to attaining a CPM credential.

Currently, the bottom line for CPMs is that ACCREDITATION DOESN'T MATTER - because graduation from an accredited educational program is purely optional for becoming a CPM. A student midwife could drop out, not graduate or fail every single one of her classes, and as long as her 'skills were signed off on' the student midwife could still take the NARM exam and become a CPM.

A quote from Via Vita Midwifery Midwifery illustrates this point:

Though this is just one example of the attitude toward accreditation of midwifery programs, we have found it to be common among CPMs. Here's another sentiment expressed in a 2011 newsletter from the National Association of Certified Professional Midwives. (Notice the glaring lack of any statement regarding assuring quality of education):

Why does accreditation matter? It remains the first accomplishment in the midwifery movement where we have fully achieved federal recognition. It is that part of the movement that dips its feet into the mainstream waters. It is the portion of our educational fabric that is easily understood by the mainstream,and easily accessed by students who are looking for an educational experience that they can finance in the mainstream and defend in the mainstream. It is a portal where the radical can slip into the mainstream and stir up a change! ~ Ellie Daniels, CPM, Past President of MEAC
So the rationale for MEAC-accreditation - from the words of a past-president of MEAC - is not to assure competent and highly-skilled midwives, but merely to gain some acceptance in mainstream America?

We believe Michigan families deserve better than this, and this is why SMM cannot support MEAC-graduates as qualified for licensure as midwives in our state.

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