The Role of Nurse-Midwives and Why It Matters

January 4, 2024 By Frontier Nursing University

For decades, Frontier Nursing University has excelled at preparing nurse-midwifery and nurse practitioner students to become ethical, compassionate, innovative, and entrepreneurial leaders. FNU has long understood the vital roles that nurse-midwives and nurse practitioners play in the nation’s healthcare system. To the general public, however, the different terms and titles can be confusing, yet understanding them grows more important as the U.S. combats significant healthcare shortages and crises across the country.

Even before the start of the COVID-19 Pandemic, it was well-known that the U.S. was facing a healthcare provider shortage. This trend was verified in a June 2021 report by the Association of American Medical Colleges, which estimated the U.S. faces a shortage of primary care physicians of between 17,800 and 48,000 and a shortage across the non-primary care specialties of between 21,000 and 77,100 physicians. (Source: https://www.aamc.org/media/54681/download?attachment)

Perhaps even more disconcerting is the maternal mortality crisis. A maternal death is defined by the World Health Organization as “the death of a woman while pregnant or within 42 days of termination of pregnancy, irrespective of the duration and the site of the pregnancy, from any cause related to or aggravated by the pregnancy or its management, but not from accidental or incidental causes.” According to the Centers for Disease Control (CDC), in 2021, the maternal mortality rate in the United States was 32.9 deaths per 100,000 live births, a dramatic increase from rates of 23.8 in 2020 and 20.1 in 2019. The rate for non-Hispanic Black women is even more alarming, at 69.9 deaths per 100,000 births in 2021. (Source: https://www.cdc.gov/nchs/data/hestat/maternal-mortality/2021/maternal-mortality-rates-2021.pdf)

Answers to systemic problems are complex and involve multiple components, but data suggests that nurse-midwives could help dramatically to improve the nation’s maternal mortality crisis. The Lancet Series on Midwifery found that midwives are linked to higher rates of physiologic birth and fewer adverse neonatal outcomes. The report noted that approximately 10 percent of U.S. births are attended by nurse-midwives, compared to 50-75 percent in other high-resource countries. (Source: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5821332/#sec004title)

In addition to educating and preparing more nurse-midwives, part of the solution is also an increased awareness of exactly what nurse-midwives do. Taking note of the many myths about nurse-midwives, FNU has made it a strategic priority to be a source of information and education about the vital role of nurse-midwives.

“Nurse-midwives contribute significantly to better care for women and families,” said FNU President Dr. Susan Stone, DNSc, CNM, FACNM, FAAN. “This is why a number of healthcare organizations across the country are embracing collaborative models and adding nurse-midwives to healthcare teams. With their unique skill sets, nurse-midwives help improve quality and decrease costs. They also serve as excellent advocates for patients, which is particularly important as more and more women are seeking out-of-hospital care.”

Certified nurse-midwives (CNMs) are educated in two disciplines: midwifery and nursing. They earn graduate degrees, complete a midwifery education program accredited by the Accreditation Commission for Midwifery Education (ACME), and pass a national certification examination administered by the American Midwifery Certification Board (AMCB).

“An important objective for Frontier Nursing University is to define the role of the certified nurse-midwife so the public understands the broad scope of services these professionals provide,” Dr. Stone said.

FNU’s strategy to educate the public about the difference between nurse-midwives has included sharing informational messages across multiple platforms, including FNU’s publications and communications, including the FNU website, blog, Quarterly Bulletin, e-newsletters, press releases, and myth-busting fact sheets.

Nurse-midwives have a core focus on promoting optimal health, not only caring for the sick but also providing guidance to assist in long-term health. This model of care forms a partnership between nurse and patient with a focus on promoting ongoing health in addition to treating illness. The focus on health maintenance is a core characteristic of the practice of nurse-midwives and nurse practitioners. Midwifery care, as defined by the American College of Nurse-Midwives, includes health promotion, disease prevention, wellness education and counseling, and full-scope primary care services, including maternity care. A 2023 study found that midwifery-led care has many positive effects on improving several key maternal and neonatal outcomes, including fewer emergency Caesarean sections, higher rates of vaginal births, lower rates of episiotomies, and shorter neonatal stays in intensive care units. (Source: https://www.ncbi.nlm.nih.gov )

“Nurse-midwives serve as excellent advocates for patients, which is particularly important as more women seek out-of-hospital care,” Dr. Stone said. “Frontier Nursing University’s goal is to educate more certified nurse-midwives so that midwifery care is available to all women who seek it, and to educate the public about the care that these nurse-midwives can provide.”

Related Content: Why Should I Become a Nurse-Midwife?

Learn more about advanced nursing degrees and specialties at Frontier Nursing University. Subscribe to our blog for the latest news and events at FNU and to get inspired with stories featuring our alumni, students, faculty, preceptors and staff!

Frontier Nursing University offers four specialty tracks for nurses

December 6, 2023 By Frontier Nursing University

In the field of healthcare, everyone has their own unique passions and interests. That’s why at Frontier Nursing University (FNU) we offer four specialty tracks with paths for a Master of Science in Nursing (MSN) or Post-Graduate Certificate (PGC), depending on the student’s educational background and career goals. A Post-Master’s Doctor of Nursing Practice (DNP) is also offered as a degree option for those who have completed the MSN. Our specialty tracks are Nurse-Midwife, Family Nurse Practitioner, Women’s Health Care Nurse Practitioner and Psychiatric-Mental Health Nurse Practitioner. All of our specialties share an emphasis on rural and underserved communities.

What sets FNU apart?

Students can attend full or part-time, while completing 100 percent of coursework online and a clinical practicum in their home community. Students also enjoy one or two brief on-campus immersion experiences where they meet and connect with the FNU community, including faculty, alumni, staff and peers. FNU students earning an MSN can continue on to complete their DNP with 30 additional credit hours.

Four Specialty Tracks for Advanced Nursing Degrees

Let’s take a look at each specialty offered at FNU.

Certified Nurse-Midwife (CNM)

As the university with the oldest and largest continually operating nurse-midwifery education program in the U.S., FNU's alumni population is made up of many passionate Certified Nurse-Midwives (CNM). In fact, FNU graduates more than 40 percent of the nation's nurse-midwives, and more than half of FNU's faculty members are CNMs.

CNMs are advanced practice registered nurses who specialize in the care of women throughout their lives including pregnancy and childbirth. They offer primary care for women throughout their lifespan, including routine gynecological exams, family planning services, and menopause management.

At Frontier Nursing University, our goal is to educate more certified nurse-midwives so that midwifery care is available to all women who seek it. To learn more, visit frontier.edu/nurse-midwife.

Family Nurse Practitioner (FNP)

Home of the nation’s first Family Nurse Practitioner (FNP) program, FNU has been an innovator in family nursing education for over 50 years. With a strong academic and clinical basis, FNU strives to equip students with the tools to be a successful FNP and a leader in healthcare.

An FNP is an advanced practice nurse who manages the healthcare of individuals and their families by providing preventive and primary care, promoting health and wellbeing, and helping their patients manage chronic conditions. FNPs conduct routine checkups and assessments, order and interpret tests, make diagnoses, prescribe medications, and initiate and manage treatment plans for their patients.

To learn more, visit frontier.edu/family-nurse-practitioner.

Women's Health Care Nurse Practitioner (WHNP)

For nurses seeking advanced education in women's health, FNU offers a Women's Health Care Nurse Practitioner (WHNP) program. The program provides students with the tools to holistically address the unique needs of women across their lifespans.

A WHNP is an advanced practice nurse who specializes in continuing and comprehensive health care for women throughout their lives. WHNPs provide well-woman care, reproductive and gynecological care, and prenatal and postpartum care. Additionally, WHNPs focus on health promotion, disease prevention, health education, and helping patients make smart lifestyle choices.

To learn more, visit frontier.edu/womens-health-care-nurse-practitioner.

Psychiatric-Mental Health Nurse Practitioner (PMHNP)

FNU added a Psychiatric-Mental Health Nurse Practitioner (PMHNP) specialty track and began accepting students in 2017 for nurses who wish to serve the mental health needs of their communities. According to the Centers for Disease Control, mental illnesses are among the most common health conditions in the United States.

A PMHNP is an advanced practice nurse who seeks to improve mental health care and the overall health status of communities. With a focus on lifetime care for individuals, PMHNPs are committed to promoting mental health through assessment, diagnosis and treatment of behavioral problems, mental disorders and comorbid conditions.

To learn more, visit frontier.edu/psych-mental-health-nurse-practitioner.

A leader in distance education

FNU has been a leader in distance education since 1989. We have thousands of alumni who have completed advanced nursing degrees from their home communities. If this sounds like the right path for you, trust that we will be here to support you every step of the way.

Learn more about advanced nursing degrees and specialties at Frontier Nursing University. Subscribe to our blog for the latest news, events and inspiring stories from our alumni, students, faculty, preceptors and staff! If you’re ready to apply, click here.

Featured Preceptors: CNMs Frances Sahrphillips and Tricia Heinrich work together to precept FNU students

December 4, 2023 By Frontier Nursing University

At the heart of Frontier Nursing University is a talented and diverse community of students, alumni, faculty, staff, couriers and preceptors. Spotlight blogs feature members of our FNU community that are focused on the mission of educating nurse-midwives and nurse practitioners to deliver quality healthcare to underserved and rural populations.

Frontier Nursing University preceptors Frances Sahrphillips and Tricia Heinrich not only work toward preparing the dedicated healthcare professionals of tomorrow, but they also join forces to make a positive impact on the lives of patients today. Both serving as Certified Nurse- Midwives (CNMs), Sahrphillips and Heinrich contribute their expertise with the Southeast Georgia Health System while collaborating on precepting students.

In their role as CNMs, Sahrphillips and Heinrich work with women from adolescence to menopause. Their practice serves a high percentage of active duty military members and dependents due to its proximity to a nearby Naval base. They also serve residents of surrounding rural counties where obstetrical services are unavailable. Many of their patients are on Medicaid.

: Frances Sahrphillips, CNM with student Karen Howell

: Tricia Heinrich, CNM with student Karen Howell

In addition to her work with the Southeast Georgia Health System, Sahrphillips also serves as a CNM with the Georgia Health Department Coastal Health District Camden County. She is a published author in the Journal of Midwifery & Women’s Health and has provided webinars for the Healthy Mothers, Healthy Babies Coalition of Georgia. She was inducted into the American College of Nurse-Midwives Fellows earlier this year and has been a board member of the Georgia Perinatal Association.

“Her patients feel heard and can expect their concerns to be addressed,” said FNU student Elijah Paradee. “If a patient lacks resources or is in need, Frances is adept at guiding them to the proper resource or aid. The high comfort level I see between Frances and her patients is indicative of this.”

Sahrphillips and Heinrich have jointly precepted numerous FNU students. For Heinrich, an FNU alum, working with FNU students is particularly rewarding.

“I love watching everything come together and the confidence build,” she said. “It’s so rewarding giving back and shaping the future. I absolutely love being able to be a part of this process and giving back, especially to Frontier being a former student.”

FNU student Karen Howell, who is earning her Doctor of Nursing Practice (DNP), said she is the first DNP student Sahrphillips and Heinrich have precepted together. She said throughout the process, they have done everything necessary to make sure she can succeed and have been encouraging in her professional growth.

“They are a dynamic duo who are always concerned with providing quality care with a patient-centered focus and in a timely manner in a collaborative practice,” she said.

Thank you, Frances and Tricia, for your dedication to precepting FNU students and for your unwavering commitment to patients through your roles as CNMs.

To read about previously recognized preceptors or to nominate a preceptor, click here.

Are you interested in becoming a Frontier preceptor? Learn more here.

Learn more about nurse-midwifery and advanced nursing degrees and specialties at Frontier Nursing University. Subscribe to our blog for the latest news and events at FNU and to get inspired with stories featuring our alumni, students, preceptors, faculty and staff!

Jessica Bacon Answers the Call … From the White House

May 17, 2023 By Frontier Nursing University

When the White House calls seeking your expertise, it is a pretty good indication that you are doing something right. That is exactly what happened to Jessica Bacon, CNM, APRN, MSN, and her colleagues at Wentworth-Douglas Hospital in Dover, New Hampshire.

Among her duties in the hospital’s Women and Children’s Unit, Bacon is part of Seacoast STRENGTH, the multidisciplinary care team for pregnant people with substance use disorder. She and her colleagues, Katie White, RN, and Lindsay Ginter, Case Manager, met with Federal officials via Zoom to answer their questions about their approach to caring for pregnant people who have substance use disorder.

“As they were getting ready to roll out their recommendations for programming, they reached out to different hospitals that have programs for substance use and pregnancy just to talk about the barriers and what has been working well,” Bacon said of the hour-long meeting with the White House representatives. “They were just trying to gather ideas from different people. We discussed where we currently are at with our program and what our hopes are going forward.”

Their goals are ambitious but attainable, much like Bacon’s were growing up in Ludlow, Massachusetts. By the time she was in high school, she already knew she wanted to work in women’s healthcare. She went to nursing school and worked as a nurse for 12 years before graduating from Frontier Nursing University as a nurse-midwife in 2012.

Like the rest of the country, substance use is prevalent in New Hampshire, Bacon says. A sad fact that led to the creation of the Substance Use Disorder Team.

“It’s an example of something that is being developed out of need, unfortunately,” Bacon said. “In New Hampshire, we have a high rate of opioid use disorder. It’s especially concentrated in the area that we live and work in. The New Hampshire Maternal Mortality Review Committee recently cited that 62 percent of our maternal mortality is related to a drug overdose. In our area, it’s not really the postpartum hemorrhages and untreated hypertension that’s killing people. It’s a drug overdose, particularly seven to 12 months postpartum.”

The overwhelming data demonstrated the need, and Bacon and her colleagues began to develop a plan. With the support of the hospital administration, Seacoast STRENGTH became reality. The learning curve was steep, however.

“From precepting different students, I think that there is now some integration of substance use disorder into the midwifery programs, but it wasn’t a thing when I was in school, and the same was true for most of the providers here,” Bacon said. “We just kind of jumped in and learned everything that we could about it because we were having people present to us in withdrawal. Unfortunately, even though we had local prescribers of buprenorphine, a lot of them wouldn’t prescribe to people that were pregnant because they were concerned about the effect on the pregnancy. There is, in recent years, lots of data establishing that both methadone and buprenorphine are appropriate medications for opioid use disorder in pregnancy.”

The care provided is free of judgment and infused with compassion and a simple desire to help someone who is ill. Treating the immediate threat and establishing a level of trust are essential first steps toward long-term positive outcomes.

“We try our best to normalize it like any other chronic condition – just like people with diabetes need extra care or extra medications,” Bacon said. “This is a chronic disease.”

All patients are screened verbally when they present for alcohol or opioid use. With consent, they may also be drug tested. Bacon says those tests almost always indicate that the street drugs are being laced with any number of other drugs, such as meth, cocaine, fentanyl, and heroin.

“When we get these test results, it reveals that the drugs are contaminated,” Bacon said. “That’s what is contributing to a lot of the overdoses because you don’t know what you’re getting. It’s no longer a single substance in most cases. So, we have to keep in mind the model of risk or harm reduction, where anything we can do for them is better than them getting opioids off the street and having these lethal overdoses.”

There are many hurdles to keeping these patients off the street, starting with getting them to ask for help in the first place. Transportation, insurance, finances, and lack of trust are imposing hurdles. Bacon said the Unit treats between 40 and 50 patients with opioid disorder per year, dating back to 2017.

“Pregnancy seems to be a pretty motivating time for people,” Bacon said. “It’s a time when people want to make changes in their life, but it’s really hard. So it’s not uncommon to make contact with people three or four times before they are even willing to attempt medications. We are in the process of developing a program where people can come to us, and we will support them with initiation for either buprenorphine or methadone. With help of the hospital’s Substance Use Response Team, we have done a lot of training with our providers and nurses for trauma-informed care, motivational interviewing, and all things substance abuse related. With time, the staff has gotten really comfortable with the process.”

As one process is perfected, the next looms on the horizon. Transportation and childcare remain the most significant hurdles for most patients. The thought of having to go to obstetric appointments, recovery services, and their buprenorphine prescriber can be overwhelming.

“Our goal this year is to integrate that recovery care with prenatal care as well,” Bacon said, noting that they have applied for grants to support this goal. “We have a small team of us that are going to provide continuity of care for the prenatal care. They will be able to get their prenatal care and recovery services all at the same time. They are going to come once a week for a two-hour session. An hour of that will be group work with a curriculum where we discuss safety planning, relapse prevention, emotional regulation, and other similar topics. They also will attend classes such as childbirth education and breastfeeding. Included an hour where they can meet individually with me for prenatal care or their case manager to work on the social determinants of health and get the resources that they need.”

These types of projects and planning come naturally to Bacon, who is also the nursing practice specialist at Wentworth Douglas. She is responsible for being up to date on current evidence-based practice and working with her team to implement policies, procedures and programs as needed to fill gaps in care. Because of those responsibilities, Bacon came back to Frontier and is currently enrolled in the DNP program (Class 48).

“In this role as the nursing practice specialist, I’m doing a lot of quality improvement work, and I want to do it right,” Bacon said of her decision to pursue her DNP.

The decision to return to Frontier was just as easy as her initial choice to attend Frontier to become a certified nurse-midwife.

“The initial draw (to Frontier) was the ability to do the courses in my own community,” she said. “I had young kids, and I had a job here. Picking up and moving and going to a brick-and-mortar school was not feasible for me because there are none in my area. Frontier has been doing distance learning for a very long time, and they’ve worked out a lot of the kinks. I think now you’re seeing more and more institutions offer that as an option; they’re still having to work through a lot of those issues, whereas Frontier had done that work long before I got there. My experience there was great.”

Student Spotlight: Advocacy is essential to nurse-midwifery for FNU student Chantel Haynes

March 2, 2023 By Frontier Nursing University

At the heart of Frontier Nursing University is a talented and diverse community of students, alumni, faculty, staff, couriers and preceptors. Spotlight blogs feature members of our FNU community who are focused on the mission of educating nurse-midwives and nurse practitioners to deliver quality healthcare to underserved and rural populations.

For Frontier Nursing University (FNU) student Chantel Haynes, advocacy has always been a critical part of her journey and career in healthcare. A resident of Sedalia, Missouri, Haynes has been a staunch advocate for informed choice and autonomy among birthing people, Vaginal Birth After Cesarean (VBAC), and for acceptable working conditions among nurses and healthcare providers.

“I have found that advocacy is an essential part of birth work and nursing care,” she said.

Haynes is currently pursuing her Master of Science in Nursing in Nurse-Midwifery and is on track to graduate in 2024. She also works as a PRN nurse with a freestanding birth center in Kansas and a substance abuse clinic in Missouri. Throughout her career in nursing, Haynes has worked as a doula, LDRPN nurse and birth center nurse.

Advocating for Nurses and Better Care

Before becoming a PRN nurse, Haynes served as an acute bedside nurse in a hospital setting for 12 years. After she left this position in March 2022, she heightened her advocacy work for better acute care through safe staffing ratios, safe work environments, and adequate pay for hospital-based and long-term care nurses. She was one the speakers at the Missouri Chapter of the National Nurse March in May 2022. She also advocates through social media, letters to newspapers, and by engaging with government representatives.

“Short staffing has created a dangerous patient care environment,” she said. “This is leading to increased provider workload and stress, which is leading to a lack of access to healthcare, especially for the underserved.”

Haynes also expresses concern for dangerous practice environments for nurses and providers.

“Nurses are being subjected to high patient ratios, unsafe patient care environments, and increased abuse from patients and family members,” she said. “The number of assaults on hospital staff has risen drastically with the degrading environment. Currently, I advocate for change by using my voice and resources to call attention to these horrendous conditions and support others who don’t feel like they have a voice.”

Haynes said she has wanted to earn her MSN in Nurse-Midwifery since becoming a doula in 2001. She decided to pursue her dream through FNU after discussing the program with a co-worker who earned her MSN at FNU.

A Year of Challenges

Haynes’ path to earning her degree has not been without challenges. In August 2021, she experienced severe complications from COVID-19. She was hospitalized for four days and was on oxygen for a total of four weeks. In November of that year, she tore her ACL and gastrocnemius muscle due to decompensation from the virus. These complications set her back two terms from her initial Clinical Bound date.

Amid these struggles, Haynes said staff at FNU have helped her navigate these obstacles in her course work every step of the way.

“My RCF and advisors have been available when I need them, and we have been able to find solutions,” she said. “2021 was a year of frustration between being a bedside nurse caring for COVID patients to becoming one myself. I have found patience at Frontier.”

Haynes is a wife of 30 years, mother of four adult children and has two grandchildren. Outside of her work, studies, and advocacy, she enjoys tending to her garden, taking care of her backyard flock of chickens and ducks, crafting, crocheting, participating in church activities and volunteering in her community.

Thank you, Chantel, for choosing FNU in your path toward earning your MSN in Nurse-Midwifery and for your devotion to healthcare advocacy.

FNU Featured Preceptor: Megan Ferguson Instills Love of Profession in Graduate Nursing Students

August 30, 2022 By Frontier Nursing University

At the heart of Frontier Nursing University is a talented and diverse community of students, alumni, faculty, staff, Couriers and preceptors. Spotlight blogs feature members of our FNU community who are focused on the mission of educating nurse-midwives and nurse practitioners to deliver quality healthcare to underserved and rural populations.

Frontier Nursing University is proud to announce FNU alumni, Megan Ferguson, CNM, as the 2022 Spring Term Featured Preceptor! Ferguson was nominated by FNU nurse-midwifery student Megan Webb for always going above and beyond.

Before becoming Webb’s preceptor in Wasilla, Alaska, Ferguson was Webb’s provider for Women’s Health at Alpenglow Women’s Health. Ferguson is the co-owner of Alpenglow Women’s Health, where she serves the women and families of her community, supporting them through their prenatal journey, women’s health issues, and deliveries at the community hospital.

“I was hoping that I would be able to have her as my preceptor,” Webb said. “And when I asked her at my appointment, she had zero hesitation.”

Ferguson had her own difficulties finding a preceptor in Alaska when she was going to school. She had to travel into Anchorage for clinical as there are only a few hospitals in Alaska.

During this time, Ferguson has given Webb exactly what she needed: to be consistently challenged and encouraged to step outside her comfort zone.

“She has instilled confidence, encouraged education, and nurtured growth in me as I transition from nurse to nurse-midwife,” Webb said.

“Watching students grow as they start to make the transition from an RN to an APRN. It’s like watching the synapses form as they link their knowledge, differentials, and decisions,” Ferguson said.

“We need to raise these next generations of practitioners to love and grow their practice so that we can continue to listen to women and provide the care all women deserve.”
– Megan Ferguson, CNM, FNU Preceptor

Ferguson, who precepts nurse-midwifery and family nurse practitioner (FNP) students, hopes to make students comfortable with the learning process and instill a deep love for this profession, which is what drives her.

Ferguson encourages other Advanced Practice Registered Nurses (APRNs) to precept students.

“If we do not help grow our own, who will be left when our bodies give out and it’s time to move on?” Ferguson said. “We need to raise these next generations of practitioners to love and grow their practice so that we can continue to listen to women and provide the care all women deserve.”

Thank you, Megan Ferguson, for your dedication to serving your community and helping educate the next generation of nurse-midwives and nurse practitioners.

Are you interested in becoming an FNU Preceptor? Fill out the form on this page to learn more!

Boston Midwife Prepares to Open Alabama’s First Birth Center

June 14, 2022 By Frontier Nursing University

To the casual observer, opening Birth Sanctuary Gainesville might not make a lot of sense. First, Gainesville is a rural town in Alabama with a population of less than 200. Second, because of state regulations that severely restrict the scope of care nurse-midwives can provide, there are no birth centers in the entire state. That is about to change because FNU alumni Dr. Stephanie Mitchell, DNP, CNM, CPM, plans to open Birth Sanctuary Gainesville later this year. While the uncertainties are many, Mitchell insists, “It will get done.”

Mitchell is the sort of person who finds ways to get things done. Barriers represent an opportunity rather than a permanent roadblock. Even her road to becoming a nurse-midwife was a circuitous one. Where others might have given up and changed course, Mitchell never wavered from her plan.

Growing up in urban Boston, Massachusetts, in the 1980s, Mitchell’s first thoughts of pursuing a medical career began by watching The Cosby Show.

“My very first exposure to childbirth was on television,” Mitchell said of The Cosby Show. “It was very shocking to me because the family would have mirrored my family, except that they were completely different echelons of human society. We were struggling along in the hood, the ghetto, dealing with all the things that 1980s Boston brought for a low-income black family. It was the opposite on TV. The father was an obstetrician, and the mother was a lawyer. That was my first exposure to pregnancy, and the healthy dynamic of that family really appealed to me and stuck with me.”

Her second exposure to pregnancy and her first to obstetrics came a few years later when she was 16 and pregnant. She had collaborative care with an obstetrician and a midwife.

“The way my body was honored during that process of pregnancy is really cemented into my mind,” she said. “I figured out that the word wasn’t ‘obstetrician’ or ‘obstetrics’ – it was ‘midwife’. I thought, ‘How do I do that?’”

She did that by having her baby, finishing high school, attending community college, and going on to earn her BSN from Curry College. She knew she wanted to be a midwife and wanted to attend Frontier Nursing University. She also knew that she needed to gain experience, preferably in labor and delivery. She worked in pediatrics for about six years before getting into a labor and delivery unit, where she worked for six years before applying to Frontier. She continued working in labor and delivery while she earned her MSN and DNP from FNU, the latter in 2019.

“The hospital I worked at was a lovely place in the backdrop of my neighborhood in Boston. I learned so much and have deep respect for my colleagues there,” Mitchell said. “But it was shocking to me to get to the labor and delivery unit and realize that the medical staff was not reflective of the community. I had come from the Boston Children’s Hospital, and we had a very diverse staff. I got to the labor and delivery unit, and it was shocking to be one of three black nurses on a staff of 120 in that unit. That was difficult because there are so many stark cultural differences between the care providers and those that they are caring for.”

Mitchell had learned the importance of diversity at an early age when she was part of a busing program aimed at addressing segregation in the city. She attended school in a predominantly white school system.

“You learn to interact with people who are definitely not from your community,” she said. “To have experience with individuals that don’t look like you, don’t talk like you, don’t have the same cultural norms as you, provides exposure that’s valuable in life. Midwives and advanced nurse practitioners are not always going to be black or people of color or LGBTQ, but you have to have people in place who are truly antiracist and empathetic.”

Mitchell was also concerned about what she termed “the conveyor belt of care” that sometimes persists in hospitals with high volumes of patients. She wanted to practice in a different setting, where more time could be spent with the patients in a less frantic environment. She wanted to open a birth center and started looking into the prospects in Boston. She soon realized that funding would be a problem, as would the significant amount of competition. She shelved the idea temporarily until she and her husband Jamie moved to Gainesville, Alabama, where Jamie had family.

Jamie is a successful pitmaster who got into the catering business. When the catering business became overwhelming, the Mitchells realized that a restaurant would be the better option. Starting a restaurant in Boston would not only be expensive but also involve a great deal of competition.

“He wanted to get rid of the landlord and the competition, so we came down here to Gainesville and built a restaurant,” Mitchell said. The Alabama Rib Shack is open Friday through Sunday, with the capacity to cater as needed.

As they prepared to move, Mitchell began researching places where she might be able to work. She soon found that there are no birth centers in the state. Further, in Gainesville and the surrounding area, there is no access to family planning services, midwifery care, or obstetric care.

“If you’re pregnant, it’s a desert,” Mitchell said. The nearest options are approximately 45 miles away in Tuscaloosa or across the state line into Mississippi.

It didn’t take long for Mitchell to think about opening her own birth center in Alabama. Not only did she need it as a source of income, but the community needed it as well.

“I’ve always valued the low volume, slower-paced care that can be offered through midwifery,” Mitchell said. “I had a good amount of surface information to build on what it would mean to build a birth center in Alabama. It was important to me to work in the black and not be in a situation where I am over my head and sink myself before I get started. Kitty Ernst wisely once reminded me to follow the money. I followed the business model that my husband has followed for years – eliminate the competition and eliminate the landlord. There is no competition in Alabama, and people deserve to have options. To not have it as an option is unconscionable.”

While many would agree with that, few have been as determined as Mitchell to bring about the necessary changes. One of the primary barriers created by the state’s legislation and regulation of midwives is the prevention of independent practice. Mitchell sought out physicians with whom she could partner to provide collaborative care but found none.

Midwives who attended out-of-hospital births in Alabama were jailed until 2019 when the state began issuing midwifery licenses for Certified Professional Midwives (CPM) for the first time since 1976. Contrary to Certified Nurse-Midwives (CNM), who have nursing degrees, CPMs are not required to have a nursing degree. Despite being a CNM, Mitchell had to get a CPM license so she could practice in Alabama.

“I was annoyed that I had to be a CPM because it prevents me from offering those full range of comprehensive health services,” Mitchell said. “ I see the value in being a Certified Nurse-Midwife. I see the value of being able to provide that umbrella of comprehensive care. Why would anyone ever specifically go the path of CNM only to be boxed in a corner to be a CPM? Prescriptive authority, billing insurance, access medications, full-scope care – it’s all gone. Especially in a healthcare desert like Alabama, it doesn’t make any sense. I’m still fighting that battle. It will take a while. But it’s not, ‘we can’t do it,’ it’s ‘we haven’t done it yet.’”

Mitchell says that the Alabama Birth Center Coalition, Alabama Midwife’s Association, the Alabama Board of Midwifery, and the Alabama chapter of the American College of Nurse-Midwives are all lobbying for change. In the meantime, she is pressing forward with Birth Sanctuary Gainesville. For years on their visits to Alabama, Mitchell had admired an old two-story home in Gainesville. Built in 1835, it is a registered historic landmark. It sat empty for years until, shortly after they moved, Mitchell saw that it was for sale. The Mitchells bought it and began renovation and construction to convert it into a birth center.

The roof, soffits, plumbing, electrical, and HVAC all had to be replaced or updated, but the structure was good, and the price and location were right. An exam room and a bathroom have been added, and the work continues with hopes of opening later this year.

“My first goal is to get this birth center opened this year and have our first birth here this year,” Mitchell said.

Grassroots efforts have provided the majority of the funding for the construction of the birth center. One fundraiser is a legacy walkway campaign in which people can purchase bricks and inscribe their own messages. Another fundraiser included the creation of three $5,000 scholarships that will go to BIPOC (Black, Indigenous, and people of color) midwifery students.

“This grassroots effort is a constant return back into the systems we’re working in,” Mitchell said. “It’s been overwhelming. I’ve been filled with gratitude, and I remain so humble about this project, reminding myself that this isn’t a ‘me project.’ This is a project that will impact so many families just to be able to have that access to care.”

Mitchell hopes to continue to give back to the nurse-midwifery profession by precepting students. She knows drawing them to rural Alabama might be difficult so that the birth center will include a special space for students. Mitchell describes it as a calm room where students will be able to rest or sleep in their own private space.

Until the birth center is ready to open, Mitchell is operating as an LLC and providing home birth services as a CPM. She plans to continue to offer home births even after Birth Sanctuary Gainesville is fully operational. She is also working with the University of Alabama-Birmingham’s midwifery program, assisting with course development and serving as an adjunct professor.

“I have been delighted to take part in that program,” she said. “I believe that’s the solution. UAB is a stronghold for the state. They are highly influential, and what better investment into the future of maternal healthcare and pregnancy healthcare than having a school that is going to be educating the midwives? That will lay the groundwork for accessibility in ways that we haven’t even thought about in this state.”

Mitchell has successfully managed to fund the birth center to this point and continues to advocate for more access to nurse-midwifery care in the state. She has overcome many obstacles and knows many more loom ahead, not the least of which is the potential patient population.

“It doesn’t make any sense to build a birth center here,” she said. “The same thing about my husband having a restaurant here. It seems highly unlikely and improbable. But what he has learned is that people will travel for quality. They will do it in Alabama for barbecue in a minute. There is the same sort of model in terms of accessibility. We’re talking zero freestanding birth centers in the state. It becomes a question of, ‘Do you want to travel to get care?’”

Mitchell said that, in order to help with that, they are even considering providing space for families who make the journey with their loved ones. It’s true that travel is a potential hurdle, but true to her nature, Mitchell sees not only the barrier but also the potential solution. In the end, it all makes perfect sense.

Are you interested in learning more about Certified Nurse-Midwives? Learn about the care they provide.

Editor’s Note:
Dr. Mitchell wishes to acknowledge her husband, Jamie. “Making the journey into midwifery with a family could have been my insurmountable obstacle. He’s been my stronghold for the last 20-plus years.” She also expressed her gratitude for the support of her children, Jasmyn, Jaymie, Jayar, and Jesse, and wished to acknowledge former FNU Academic Advisor and current Clinical Advisor Carisa Lipp. “I loved so many of the faculty, but none so much as Carisa. She was the constant person of contact at FNU as I made my way through each term. I can’t say how much her guidance meant. Funny that it wasn’t a midwife who I’d describe as most impactful, but that just goes to show that one’s biggest support can come from unexpected places if you keep your eyes peeled and your heart open!”

FNU Students Earn Honor Society Scholarships

April 11, 2022 By Frontier Nursing University

Each fall, Frontier Nursing University’s (FNU) Chi Pi Chapter of the Sigma Theta Tau International Honor Society of Nursing (STTI) awards several students with financial scholarships. To qualify for STTI membership, students must have completed at least a quarter of their degree program, hold a 3.5 or higher grade point average and demonstrate academic excellence.

This year, three nurse practitioner students received the scholarship, including Jazmin Townes, Joanna Wilder, and Sarah Logan. Congratulations to FNU’s Fall 2021 Chi Pi scholarship recipients! The FNU community is proud of your dedication to hard work.

Meet Our Scholarship Recipients:

Jazmin Townes, from South Carolina

Jazmin Townes is in FNU’s Nurse-Midwifery program. In her scholarship essay, Townes detailed her goals for after graduation of opening a birth center on the island of St. Thomas, allowing women to have more choices regarding their birthing and overall health needs.

“I give all glory and honor to the Most High for allowing this blessing to fall upon myself and my family. As a new mother of a sweet baby boy, this scholarship will aid in the completion of my master’s degree as clinical rotations are on the horizon. Becoming a Certified Nurse-Midwife has been a dream of mine as I admired many women who were midwives and doctors growing up in the Caribbean. My grandmother was a midwife on the island of Anguilla. When she migrated to the United States Virgin Islands she gave up her passion to care for her 4 children by working in a jewelry store. Her story motivates me to excel in Frontier’s Midwifery program. With clinical rotations approaching I will be 192 miles away from my 5 month old baby boy. Not only is this heartbreaking but nerve-racking. I want to make my husband and son proud of this accomplishment and receiving this award is just the beginning of that. The funds from the scholarship will pay for the preparation of my Clinical Bound and travel expenses to my clinical site. I am humbled and honored to be a Chi Pi recipient. “ – Jazmin Townes

Joanna Wilder, from Tigard, Oregon

Joanna Wilder has been a nurse since 1990, working in a hospital setting and at a birth center, and is now working towards becoming a Certified Nurse-Midwife. After graduating, Wilder plans to continue her education and get her DNP, focusing on the role of pregnancy and birth in the healing of childhood trauma. She would ultimately like to teach future midwives the sacred work of holding healing spaces during pregnancy and birth.

“I want to express my heartfelt gratitude for the Chi Pi scholarship, which I have been awarded twice during my master’s program. I am a Certified Professional Midwife, and had to close my practice when I started the Frontier nurse-midwifery program. I worked as a nurse educator during the didactic terms, and then made the hard choice to stop working to give my full attention to clinicals. We have been carefully budgeting my husband’s disability/social security income. The scholarship money came exactly when the need was the highest. It was incredibly humbling; and reminded me that this journey is to be made with open hands. Holding a space of curiosity, I can wonder how our needs will be provided; rather than try to figure it out by the strength of my will. Watching our needs be met has led to deep conversations with my 3 teens at home, and with my adult kids who are intimidated by grad school costs. If I can graduate with my MSN at 55, and move into the Companion DNP, then they can too! Frontier truly embodies the culture of caring. So grateful for this community.” – Joanna Wilder

Sarah Logan

Sarah Logan is an FNU Certified Nurse-Midwife graduate and is currently pursuing her Doctor of Nursing Practice (DNP). Logan has been involved in nursing education for several years now and has taken on many leadership roles. With the help of a colleague, she is working towards opening an outpatient mobile clinic to serve the migrant population in her city with prenatal and well-visit care. With the scholarship, Logan plans to continue working on projects that make a lasting impact in her community.

To find out more about Chi Pi and apply for the 2022 scholarship, please visit our Honor Society Page. We encourage all students and prospective students to check out the various scholarships offered at FNU.