Georgetown Midwifery Students Storm Capitol Hill: Experiential Learning of Advocacy Skills in Washington, DC

Sunday, 29 October 2017: 4:35 PM

Cindy L. Farley, PhD
School of Nursing and Health Studies, Nurse-Midwifery/WHNP Programs, Georgetown University, Yellow Springs, OH, USA

The professional responsibilities of Certified Nurse-Midwives (CNMs) and Certified Midwives (CMs) include knowledge of the legal basis for practice, support of legislation and policy initiatives that promote quality health care, and knowledge of issues and trends in health care policy and systems (ACNM, 2012). New midwives need to have basic skills in political advocacy in addition to beginning skills in midwifery care in order to make significant positive change in the health policy arena. Limited research suggests that supportive practice laws are associated with larger midwifery work forces and more midwifery-led births (Yang et al., 2016).

Midwives, nurses, and nurse practitioners can make a difference in the health policy arena for midwifery and women’s health by advocating for social justice and the common good. Although health policy content is addressed in basic midwifery education, it is not the educational focus for students and faculty who are prioritizing acquisition and application of foundational midwifery knowledge and skills to become safe novice clinicians. However, once new graduates enter into practice, they begin to realize the impact legislation and regulation have on their ability to practice to the full extent of their training and expertise. Restrictive legislation and regulation are legislative barriers to practice requiring redress. Thus, midwives need to acquire both basic skills in political advocacy and beginning skills in midwifery care in order to make significant positive change in legislation and regulation.

Georgetown University, with its geographic location in Washington, DC, and its history of proactive engagement in federal relations in the United States, is ideally situated to provide powerful experiential learning for their midwifery students. Georgetown University’s midwifery education program transitioned to an on-line hybrid format in 2011, with an increase in student numbers and geographic diversity. Students in each cohort come to campus three separate times for on campus intensive learning via simulations, skill development, and seminars. This provided an opportunity to develop a learning activity that focused on currently supported federal legislation by the American College of Nurse-Midwives (ACNM), the professional organization of CNMs and CMs, congruent with the values-based education of Georgetown University, a Jesuit institution. Beginning in 2016, students in their Integration Term of the Nurse-Midwifery/Women’s Health Nurse Practitioner program scheduled appointments with their United States Senators and Representatives on Capitol Hill. Walking among the iconic buildings of Capitol Hill inspires a sense of history and awe that strengthens the influence of this learning activity.

ACNM staff and volunteers in the Midwives Political Action Committee (PAC) and Governmental Affairs Committee (GAC) were engaged in the development of this learning activity. Cohorts of Georgetown students prepared for their visits through webcasts, lecture/discussions with ACNM policy leaders, and review of materials on ACNM’s Grassroots Advocacy web page. Students, ACNM staff and volunteers and Georgetown faculty gathered on the day of the visits and were briefed on the latest updates of legislative activity on the bills of interest by ACNM’s lobbyist in Washington DC near the Capitol. Delegations of students, staff, and faculty were formed, written materials to leave with the legislators were reviewed, and visits were conducted. Delegations gathered at the end of the day to share experiences and to complete follow-up tasks.

There is a paucity of reported research describing the political knowledge base, attitudes, and activities of midwives practicing in the United States (US). Only one published study specifically explored this topic and it is more than 25 years old (Gesse, 1991). Other studies focusing on midwifery and politics have described midwifery’s early struggles to professionalize (Tjaden, 1987) or the political will of countries to incorporate midwifery into services to women (Wilder-Smith, 2003) or the symbolism of midwifery traditions being leveraged for political persuasion (MacDonald, 2004). Much has changed in the 25 years since Dr. Theresa Gesse’s work was completed, including, but not limited to, the emerging emphasis placed on political activities in midwifery educational programs (ACNM, 2011) and new ways to engage in the political process through social media. Additionally, the presidential campaign of 2016 illustrated a shift in the general electorate that may be reflected in the midwife population. Political activity may become more important in the coming years.

This presentation will describe the experiences and learning of Georgetown University faculty, ACNM health policy staff and volunteers, and midwifery students participating in this learning activity. The influence of these visits on ACNM grassroots legislative efforts will be discussed. This information will be useful to midwifery and nursing faculty interested in planning in person visits to local, state, or federal legislators to create a powerful learning experience on health politics and policy for their students.