FNU Presidential Transition

FNU has been very fortunate to have the outstanding services of Susan Stone, DNSc, CNM, FACNM, FAAN as the President since 2001. Dr. Stone has skillfully guided the organization over 20 years from a small, certificate awarding education program for nurse-midwives to the current Frontier Nursing University; a fully accredited MSN and DNP degree granting organization of national prominence. Over 1,000 degrees were awarded by FNU in 2022 highlighting the tremendous growth of the educational programs. This growth in graduates was accompanied by the solidification of FNU’s financial resources, substantial proliferation of faculty and staff positions, the relocation of the entire operations to a single location in Versailles, KY, continued recognition as one of the United States’ Best Universities to work for, and outstanding achievements in Diversity, Equity, and Inclusion. Dr. Stone’s work over the past 22 years provides a very strong foundation for the next President.

The education of certified nurse-midwives (CNMs) and nurse practitioners (NPs) includes some important characteristics but also some considerable differences. The country has had the opportunity to embrace CNMs for over a century, however the uptake has been slow in most areas. There are many reasons for this and not the least of these is the profoundly unique education these individuals need to enter practice as fully competent clinicians. Most nursing schools in the U.S. have shied away from attempting to provide this education. This is often tied to the concern of some universities about the conflict between powerful political forces in the medical community who do not understand the necessity for CNMs. Rather they believe that OB/GYNs are the standard of practice in maternity care and some believe that CNMs are a threat to OB/GYNs and therefore a threat to all physicians. There seem to be some challenges to that perspective but there is not universal acceptance for CNMs in the larger medical community.

Today, FNU stands as the nation’s premier CNM preparation organization in both numbers and quality of our graduates. The achievement of our mission is strengthened by the addition of nurse practitioner programs reflecting our contribution to meeting the needs of the health care communities our students serve. Providing nurse-midwifery education would likely be much easier if we only educated CNMs in large communities and at large hospitals. Yet, this is not our mission. We believe CNMs are desperately needed in rural, underserved communities that often are disproportionately communities of color in which the worst health outcomes exist for new mothers and their babies. We believe that more CNMs are an essential part of the solution to many of the challenges faced by these mothers, their babies, and their communities.

There are over 400 programs that prepare nurse practitioners in the U.S. yet there are only 39 CNM programs. This means that the mission of FNU to prepare CNMs must always rise to the top of our work if we are to serve people in need of our graduates’ services. Also, very few of the CNM educational programs are set to deliver a high-quality community-based program which is the hallmark of FNU.

There are political, financial, and myriad other challenges facing CNM education and practice that do not impact NP education or practice. Some of these are subtle and difficult to fully appreciate for the non-CNM. The leader of FNU must be able to take hold of our banner and lead to a new tomorrow for both the CNM and NP programs. CNMs face challenges daily, and they develop a unique lens through which they see problems and solutions in their attempt to provide care to mothers, babies, and their communities. A President who is not a CNM could administer a nurse-midwifery education program, but the question remains whether they would be able to authentically advocate for and represent the practice of nurse-midwifery at the highest levels of policy setting. The Board of Directors believes that the practice of nurse-midwifery must be integrated into the health care systems in our nation in order to improve maternity care outcomes. For these and other reasons, the FNU Board of Directors adopted a policy in 2018 confirming the President of FNU must be a CNM.