Creating a More Diverse Midwifery Workforce in the United States: A Historical Reflection.

INTRODUCTION: As nurse-midwifery practice expanded beyond areas surrounding early nurse-midwifery education programs, leaders in the profession wanted to establish a strong diverse, inclusive professional organization, a necessary step in creating a diverse workforce (defined here as open to nurse-midwives of all colors, ethnicities, and national origins) that would maintain standards, provide continuing education, and facilitate communication among nurse-midwives. This research presents historical context and organizational factors supporting and limiting development of a workforce reflective of communities served by nurse-midwives. METHODS: Searches in the National Library of Medicine Historical Collection, American College of Nurse-Midwives (ACNM) Collections, and the Rockefeller Archives Center, as well as recorded interview data, provided primary sources for analysis. Secondary sources include research and opinions in scholarly publications including journals and books released from 1930 to the present. RESULTS: Nurse-midwifery leaders developed relationships with well-respected philanthropists, as well as maternal and child health administrators in state departments of health and the US Children's Bureau, to implement initiatives to recruit and retain midwives of color. Continued interest in the goal of inclusion, work of midwives of color, and commitment to creating a diverse workforce led to the creation of the standing ACNM Midwives of Color Committee in 1990 and the Diversity and Inclusion Task Force, which released its report, "Shifting the Frame: A Report on Diversity and Inclusion in the American College of Nurse-Midwives,"1 in June 2015. DISCUSSION: Over the past 60 years, ACNM leadership and midwives of color have continued to explore new and effective means to create a workforce that reflects the communities in which nurse-midwives practice.

Historical reflection on health promotion within midwifery care in the United States.

Heath promotion has become recognized as a vital component of health care delivery. It is well known that the traditional model of medical care delivery is limited by its focus on diagnosis of illness and treatment. The integration of public health concepts of prevention and health promotion offers depth and breadth of care that is associated with attaining optimal health status. This review offers a historical reflection on the early and continued integration of health promotion activities in midwifery care in the United States.

Beliefs and rituals in traditional birth attendant practice in Guatemala.

Childbearing women and infants in developing countries continue to experience unacceptably high rates of mortality and morbidity in spite of targeted initiatives to address the problem. The aim of this study was to identify the beliefs and rituals of traditional birth attendants (TBAs) in one indigenous Guatemalan community to better understand the cultural influences on perinatal care practices. Ethnographic methods were used to increase understanding of the practice of 10 Mayan TBAs. Three themes were constructed: sacred calling, sacred knowledge and sacred ritual.

International service learning in midwifery and nursing education.

The health of women and childbearing families is a global concern that must be addressed if we are to be successful in ensuring healthy families. Numerous strategies have been suggested to increase appreciation for the global factors that influence maternal and child health and the overall health status of a community. Inclusion of cultural content in courses offered in educational programs and provision of clinical learning experiences in diverse communities have commonly been used in midwifery and nursing education. This article reviews the concept of service learning and its application in a course that provides an opportunity for students to participate in an international immersion program. Evaluation of the course found that participants increased their knowledge and skills in providing reproductive health care, developed appreciation for the knowledge and skills of traditional birth attendants, and expanded their world view of women and families in communities.

"I saw it in a different light": international learning experiences in baccalaureate nursing education.

Health care providers in the United States are faced with delivering care to an increasingly diverse population. Nursing leaders and their respective organizations long have recognized the need to prepare nurses who understand the effects of the growing global community. Inclusion of cultural content in theory courses and clinical assignments in diverse settings are two ways to increase student nurses' cultural competency. This study explored the experiences of nursing students and faculty mentors who sought to increase their cultural competence through participation in a short-term immersion learning project in Central America. Analysis of data gathered through interviews and journal entries identified three themes--being "other," "I was already a nurse," and expanding my worldview.