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, 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 work to increase access to midwife-led care through the following endeavors
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:
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.
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.
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, while also ignoring the key components of the midwifery model: care coordination, patient education, and time with the patient. Payment redesign is necessary to improve access to midwives.
Payment Model At-A-Glance
Payment Model Executive Summary
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.
Analysis of midwifery education in California by the Senate Health Committee (2025)