Everyone deserves a midwife

Integrating midwife-led care into existing practice settings – such as clinics and hospitals – and amplifying and expanding the capacity of community-birth midwives, are key strategies for improving reproductive health care access and outcomes in California.

Midwifery Access California (MACa) is a multi-stakeholder collaboration between midwifery practices, Medi-Cal health plans, community advocacy organizations, and state and local agencies.  

Our goal is to integrate midwife-led care into existing practice settings – such as clinics and hospitals – and to amplify and expand community midwifery (birth care in homes and freestanding birth centers), as a key strategy for improving reproductive health care access and outcomes in California

Our project is specifically focused on communities existing on the margins – those most impacted by social, economic, geographic, and health inequities and racism-based disparities.

MACa was born from the California Midwifery Learning Collaborative. The members of this group envisioned a continued collaboration of diverse health care and community-based experts to carry on the work of midwifery integration in California. Click the spotlight tab for stories about coalition members and the work they do.

Our Work

 We are working to increase access to midwife-led care through the following endeavors 

Educate Stakeholders About Midwifery

There is so much misunderstanding about what midwives do. To learn more about what midwives do and their model of care, click here. 

Improve the Contracting Process between Midwives and Health Plans

The current process for midwives to contract with health plans is cumbersome, lengthy, and sometimes includes unnecessary requirements.  Consumers often find it difficult to find an in-network midwife through the health plan’s public-facing materials. To address this, we have created a go-to resource.

Click here for Best Practices in Contracting, Reimbursement, and Advancing Midwifery Care in Medi-Cal.

Click here for a short video on the 5 key principles for health plans that contract with California midwives.

Advocate for Updated Laws, Policies and Regulations for Midwifery

We work with community advocacy organizations and others to improve laws and regulations to ensure midwives can provide the care they’ve been trained to deliver. We educate policymakers on midwifery so they can make informed decisions about maternity and reproductive health care. Click here for the Midwifery Stakeholder Checklist to learn how you or your organization can help.

Create Midwifery Payment Models and Improve Reimbursement

Insurance companies often reimburse care provided during the child-bearing year through outdated payment models that prioritize patient volume and productivity. Midwives are required to use billing and coding systems that were designed by and for physicians within the dominant model of maternity care. These systems don’t account for the significant care coordination, patient education, and time with the patient – all of which are central to the midwifery philsophy of care, but are not reimbursed. Payment redesign is necessary to improve access to midwives. Click here for the California Midwifery Payment Model

Expand In-Network Access to Midwives

Access to midwifery care should be an in-network benefit in everyone’s health plan. Many health plan networks include only the minimum number of midwives required by state law. Yet, midwives improve maternal outcomes and are available and eager to work in areas with limited physician providers. 

Grow the Midwifery Workforce and Education Pipeline

We work with key stakeholders to identify and address barriers to midwifery education and workforce expansion. We advocate for innovative solutions to increase the number of midwifery education programs and clinical placements for student midwives.

The MACa Team

Midwifery Professional Organizations  

Advocacy Groups

State Agencies

  • California Department of Health Services (DHCS)

  • Los Angeles Department of Public Health

  • Perinatal Equity Initiative

Medi-Cal Health Plans 

  • Blue Shield of California Promise Health Plan

  • LA Care Health Plan

  • Partnership Health Plan

Join MACa!

What other ways can you or your organization help advance midwifery in California? Check out this checklist!

We are currently looking for health plans and local and state agencies to join as members to the MACa team. We are thrilled about our progress as a group and are excited & invested in growing our team to further our shared goals. Not a health plan or state and local agency? That’s ok, fill out the form anyways and tell us why you’re interested!

The minimum requirement for participation is joining our monthly meetings. We hope you will be inspired to join one of our working groups and help push the work along between meetings.