
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.
We have new resources!
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, facilitated by the Institute for Medicaid Innovation (IMI). After the midwifery learning collaborative concluded, the members of this coalition envisioned a continued collaboration of diverse health care and community-based experts to carry on the work of midwifery integration in California. Click here to read IMI’s report on California. Click the spotlight tab for stories about MACa coalition members and the work they do.

We are working to increase access to midwife-led care through the following endeavors
Scroll down for NEW resources!
Educate Stakeholders About Midwifery
There is so much misunderstanding about what midwives do. Learn more about what midwives do and the midwifery model of care
Check out our webinar series to inform stakeholders
Subscribe to our YouTube Channel
Read press articles about coalition members
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, & Advancing Midwifery Care in Medi-Cal
Click here for a short video summary of Best Practices in Contracting & Reimbursement
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.
View the coalition’s recommendations to DHCS: Easy Wins & Other Recommendations to Improve Access to Midwives in Medi-Cal in the Short Term
Read the Institute for Medicaid Innovation’s Stakeholder Checklist for Midwifery Access for health plans, state agencies, midwives, physicians, policymakers, community organizations, and more
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 philosophy of care, but are not reimbursed. Payment redesign is necessary to improve access to midwives.
Click to read about our California Midwifery Payment Model:
NEW! Payment Model At-A-Glance
NEW! Payment Model Executive Summary
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 Providers
Homebirth
Birth Center
Hospital Providers
Eisner Health Ob/Midwife hospitalist group
Kaiser
Community Midwifery with planned Hospital Birth
Birth Centers that have closed
Antelope Valley Birth Center
Santa Rosa Birth Center
Midwifery Professional Organizations
Community Partners
African American Infant and Maternal Mortality Initiative (AAIMM), represented by staff at Black Maternal Health Center of Excellence at Charles R. Drew University
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.