The history of National Midwifery Institute is intimately interwoven with the history of direct-entry midwifery credentialing in the United States and direct-entry midwifery licensure in California. Just as midwives are called to practice, so too midwives in the 1980s and 1990s stepped into additional roles as political activists, organizers, and educators, in order to ensure that midwifery could be practiced as safely and competently as possible. In this way, the lives of NMI Co-Founders Shannon Anton and Elizabeth Davis are an intimate part of the tapestry of direct-entry midwifery as it is practiced today; a tapestry that has been enhanced with the contributions of newer members of the NMI team, Erin Ryan and Molly Dutton-Kenny.

 

  • Midwifery practice is considered illegal in California: both lay midwives and nurse-midwives face arrest and prosecution for practicing medicine without a license if caught.

Pre-1974

1974

  • Nurse-midwifery legislation passes in California, allowing nurse-midwives to access licensing and legal practice—with restrictions, including physician supervision. Lay midwifery is interpreted as illegal, but lay midwives continue to practice underground.

  • Elizabeth Davis completes her midwifery apprenticeship training with Tina Garzero and John Walsh.

1977-1978

1979

  • Elizabeth Davis begins writing first edition of Heart & Hands, as a means to organize her thoughts and experience from the first few years of her practice as a midwife in California.

  • Elizabeth Davis receives BA from Antioch University in Holistic Maternity Care.

1980

1981

  • First edition of Heart & Hands is published under the title, A Guide to Midwifery: Heart and Hands.

  • Over six hundred lay midwives are serving a well-established home birth community in California. But without the benefit of licensure, they continue to be arrested and prosecuted for practicing medicine without a license.

  • Mothering magazine surveys consumers, state health agencies, and existing midwifery schools to gather more information on midwifery in the United States. The results, published in 1981, are the following: five states legally recognize lay midwifery practice (New Hampshire, New Mexico, South Carolina, Texas, Washington); four states recognize the legal practice of “granny” midwives if licensed before a certain time; nine states and the District of Columbia identify lay midwifery practice as illegal (California, Indiana, Louisiana, Maryland, New York, North Carolina, Ohio, Pennsylvania, West Virginia); eight states prohibit lay midwifery practice through judicial interpretation; eleven states have no legal recognition either for or against lay midwifery practice, and; eleven states consider lay midwifery practice legal but no further licenses are being issued.

1982

  • Elizabeth Davis offers the first Heart & Hands Midwifery Intensives course in San Francisco, California. The course developed at the request of a group of birth assistants seeking to acquire practical midwifery skills. Over the years and by demand, the course evolved to include an emphasis on the intuitive, interpersonal skills essential to effective midwifery care.


  • Elizabeth Davis is asked to serve on the initial board of the Midwives Alliance of North America (MANA) as regional representative for the Pacific states. Officially incorporated as a not-for-profit professional organization in 1982, MANA was created to foster unity among midwives, regardless of their education, certification, or licensure status. Elizabeth serves on the MANA Board for the next 5 years, with instrumental participation in drafting MANA core documents and developing national, competency-based certification.

  • Elizabeth Davis joins the Midwifery Today team of conference speakers, with first conference in Eugene OR.

Heart & Hands intensives students in class.

  • Elizabeth Davis presents keynote address at the first MANA conference.

  • MANA creates the Credentialing Committee, which works in conjunction with the MANA Standards and Practice Committee and MANA Education Committee to develop proposals for a voluntary registry for direct-entry midwives.

  • Elizabeth Davis serves as chairperson for the first MANA Pacific Regional Conference, San Francisco CA.

1983

1985

  • MANA establishes the Interim Registry Board (IRB), as a result of the work of the Credentialing Committee, Standards and Practice Committee, and MANA Education Committee in 1983-1985.

  • The IRB begins to develop a registry examination based on the MANA Core Competencies.

1986

  • The California Association of Midwives is formed in 1987 as a professional association for midwives serving the home birth population in California. The original purpose of CAM was to assist California home birth midwives in communicating with each other in order to further their education, educate the public about home birth, and to legalize direct-entry midwifery in California.

  • Elizabeth Davis instigates the development of a grassroots certification mechanism for California midwives which, although unsanctioned, was foundational to forthcoming efforts to legalize midwifery in the state. Applicants were required to document minimum experience requirements, demonstrate core skills, and pass a written exam. Elizabeth Davis is known as the founder of CAM certification.

  • Elizabeth Davis presents keynote at National Organization for Women (NOW) annual convention, San Francisco CA.


  • Second edition of Heart & Hands: A Midwife’s Guide to Pregnancy and Birth is published. The second edition is reprinted in 1988, 1990, 1992, 1994.

1987

  • Aspiring midwife Shannon Anton takes her first midwifery class with midwife Ann Fuller in California.

  • Elizabeth Davis is CAM certified.

    Elizabeth Davis presents first Certification Ceremony address, California Association of Midwives, San Diego CA.

  • Elizabeth Davis presents keynote at the American Holistic Medical Association Annual Conference, Seattle WA.

1989

  • Shannon Anton joins the CAM board. She serves for seven years in a variety of roles, including CAM Region 3 Rep, CAM Certification Administrator, CAM Legislative Committee Member, Treasurer, and CAM Representative to the Certification Task Force, developers of the CPM process.


  • The National Coalition of Midwifery Educators (NCME) forms. NCME was comprised of twenty-one individuals, nine of whom represented formal midwifery education programs. NCME functioned as a support group for MANA, working closely with the Education Committee. Elizabeth Davis was an original member of NCME.


  • Shannon Anton co-organizes the 1990 CAM Conference, San Francisco CA, piloting the current three-day conference format.

  • Elizabeth Davis presents Graduation Address, University of California at San Francisco, Masters Program in Nurse-Midwifery.

1990

  • As a beginning midwifery student, Shannon Anton attends Elizabeth Davis’ Heart & Hands Midwifery Intensives.


  • The National Coalition of Midwifery Educators creates/becomes the Midwifery Education Accreditation Council (MEAC). MEAC was formed to validate the apprenticeship model of education, while maintaining a variety of routes students could utilize to become direct-entry midwives. Elizabeth Davis was a Co-Founder of MEAC.


  • MANA administers the first Interim Registry Board Registry Examination to a small number of candidates across the country.


  • Interorganizational Workgroup on Midwifery Educaton (IWG) forms, with financial support from the Carnegie Foundation. It included an equal number of certified nurse-midwives (CNMs) and direct-entry midwives, subject matter experts from the ACNM and MANA, and public members. After a series of meetings, the final recommendation of the IWG was that direct-entry midwives should create their own education, accreditation, and credentialing mechanisms. IWG members began compiling a list of direct-entry midwifery skills, with a thrust to develop national certification through MANA.

1991

  • Shannon Anton completes her apprenticeship training with Labor of Love Midwifery and is CAM certified.


  • After five years developing a national certification exam (drafted to incorporate the MANA Core Competencies, and thoroughly field-tested), the MANA Interim Registry Board incorporates as the North American Registry of Midwives (NARM), a non-profit organization supportive of, but separate from, MANA.


  • Shannon Anton becomes a member of the CAM Legislative Committee and serves in this capacity until 1998. She is actively involved in efforts leading to the passage of the California Licensed Midwifery Practice Act in 1993.

  • Elizabeth Davis and Janice Kalman serve as representatives for CAM and prime negotiators/speakers during the 1991 and 1993 attempts to legalize midwifery in California, meeting with senate and house committee members, lobbyists, and representatives of the CA Medical Board.

  • Elizabeth Davis presents keynote address at Second International Congress on Homebirth, Sydney, Australia.

  • Second edition of Heart & Hands: A Midwife’s Guide to Pregnancy and Birth is published in German.

  • Elizabeth Davis becomes a Registered Midwife (through MANA’s Interim Registry Board).

1992

  • California passes the Licensed Midwifery Practice Act. The bill went through many permutations, but thanks to an amendment authored by Elizabeth Davis and Janice Kalman, a Challenge Mechanism was included so that experienced direct-entry midwives could be licensed by assessments of their clinical experience, knowledge and skill. The Challenge Mechanism was originally provided by Seattle Midwifery School, and was the only available route to licensure in California for many years.


  • Shannon Anton is nominated to the NARM Board of Directors. She served on the NARM Board from 1993 to 2018.


  • The first of five NARM Certification Task Force (CTF) meetings is held. Original planners of the meeting envisioned a small gathering of developers, but Elizabeth Davis, in conjunction with Ruth Walsh of NARM, called key representatives in every state to invite them to attend, so that the development of certfication would be democratic and inclusive. Forty states were represented. Working in small groups, midwife practitioners and educators discussed what had and had not worked with their respective state licensing or certification processes. On this basis, the CTF drafted a competency-based certification process (now known as the PEP, or portfolio evaluation process) but also drafted guidelines for other routes of access, including Experienced Midwife and Foreign Trained Midwife categories. It was then decided that skills and knowledge would be based on a job analysis survey conducted through NARM.

  • Shannon Anton serves as CAM Representative to the NARM Certification Task Force (CTF).

1993

  • Shannon Anton becomes NARM Board Accountability Chairperson and Director of Accountability; continues to 2018.


  • CAM defers all certification to NARM; all CAM certified midwives qualify for the NARM CPM.


  • Shannon initiates Study Group in response to apprentice midwives and former students in Heart & Hands Midwifery Intensives in the San Francisco Bay Area who desired a midwife-facilitated group learning process to more deeply explore certain topics.


  • Shannon Anton co-founds Bay Area Homebirth Collective, a group of independent midwifery practices dedicated to promoting midwifery care and home birth. The group is "committed to using the collective power of our diverse practice styles and geographic locations to provide families with resources such as classes, support groups, social gatherings, and informative talks and/or panels throughout the year."


  • The first NARM Certified Professional Midwife (CPM) Credential is issued.


  • Elizabeth Davis' book, Women's Sexual Cycles: Understanding Your Moods and Desires at Every Stage of Life, is published (now re-titled, The Rhythms of Women’s Desire: How Female Sexuality Unfolds at Every Stage of Life). The book has been released in German, Hungarian, Lithuanian, and Chinese editions.

  • Elizabeth Davis presents a keynote address at the Birth Gazette Conference at The Farm, Tennessee.

1994

  • NARM Job Analysis is initiated by NARM and the National Assessment Institute. An extensive survey, which included all possible aspects of midwifery knowledge and skill and took an average of 12 hours to complete, was mailed to 3000 midwives practicing in out-of-hospital settings across the country. The survey was returned by 850 midwives: two-thirds were direct-entry midwives; one-third were certified nurse-midwives. The survey results formed the basis for a new version of the NARM Written Examination and also served to inform the CTF in developing national certification.


  • Shannon Anton and Elizabeth Davis co-found the Midwifery Institute of California (later to become National Midwifery Institute, Inc.). Enroll first student.


  • Midwifery Institute of California applies to be part of MEAC’s accreditation pilot program.


  • First midwife licensed in California.


  • Elizabeth Davis is issued the NARM CPM credential.


  • Shannon Anton is issued the NARM CPM credential.


  • Shannon Anton is licensed as CA LM #5 through the Seattle Midwifery School's Challenge Mechanism; she is one of three California midwives to participate in the pilot of this process.

  • Elizabeth Davis presents lectures and workshops at the Midwifery Today Pacific Rim Midwifery Conference, Honolulu HI.

1995

  • Midwifery Institute of California is pre-accredited by MEAC.


  • NARM contracts with Schroeder Measurement Technologies (SMT) to oversee test development, test administration, and the portfolio evaluation process.

1996

 

  • Co-authored with Carol Leonard, Elizabeth Davis' book, The Women's Wheel of Life, is published, and has since been released in Australian and Hungarian editions.


  • Elizabeth Davis receives Lifetime Achievement Award from the Midwives Association of Florida.

  • Elizabeth Davis participates in Future Birth Lecture Series, Australia, with keynotes in Perth, Adelaide, Melbourne, Sidney, and Brisbane.

  • Elizabeth Davis presents keynote at Birth Without Borders Conference, Chang Mai, Thailand.

  • Elizabeth Davis presents lectures and workshops at Midwifery Today Conference in London, England.

  • Third edition of Heart & Hands: A Midwife’s Guide to Pregnancy and Birth is published. This edition is reprinted in 1997 and 1999.

1997

  • The CTF meets for the final time at the annual MANA Conference. All midwife attendees were asked to advise the NARM Board on the certification process. The educational aspect of certification was discussed, and NARM subsequently decided that this should include one of the following: 1) graduation from a MEAC accredited program; 2) participation in a state or province recognized midwifery program that has been evaluated by NARM for educational equivalency; 3) completion of the Portfolio Evaluation Process (PEP).

  • Elizabeth Davis presents keynote and workshops at annual convention of the Australian College of Midwives, Tasmania.

1998

  • Shannon Anton serves as NARM Liaison to the MEAC Board (2000-2018)


  • Midwifery Institute of California celebrates its first three graduates.


  • Due to substantive changes in the program–relocating the office to Vermont, and changing its name to National Midwifery Institute—Midwifery Institute of California relinquished pre-accreditation status.

2000

  • Elizabeth Davis presents plenary address, New York Open Center, Art of Birthing Conference, New York NY.

  • Elizabeth Davis presents address to California Family Health Council Annual Convention, Sacramento CA.

2001

  • Elizabeth Davis presents lectures and workshops at Midwifery Today Conference, The Hague, Netherlands.

  • First student graduates from National Midwifery Institute, Inc.

2002

  • National Midwifery Institute is approved as a route to licensure for aspiring midwives in California.


  • NMI’s first graduate, Julie Hunn, receives her license through NMI’s Certificate Program.


  • Shannon Anton becomes NARM Board Vice-Chairperson (2003-2018)


  • Two students graduate from National Midwifery Institute, Inc.

2003

  • Shannon Anton and Elizabeth Davis receive the California Association of Midwives Brazen Woman Award for their contributions to the advancement of midwifery.


  • Fourth edition of Heart & Hands: A Midwife’s Guide to Pregnancy and Birth is published, and is reprinted numerous times.


  • Elizabeth Davis presents keynote at Hungarian Conference on Birth and Midwifery, Budapest, Hungary.

  • Elizabeth Davis presents lectures and workshops at the Midwifery Today conference, Bad Wildbad, Germany.

  • Elizabeth Davis presents lectures and workshops at the Midwifery Today/MANA Conference, Oaxaca, Mexico.

  • Elizabeth Davis is guest instructor at the Scuola Elementale Di Arte Osterica, Florence, Italy.

  • Erin Ryan becomes assistant instructor of Study Group Course Work for National Midwifery Institute, Inc.

  • Two students graduate from National Midwifery Institute, Inc.

2004

  • National Midwifery Institute, Inc. accreditation renewed.


  • Elizabeth Davis presents lectures and workshops at the Midwifery Today Conference, Oaxtepec, Mexico.

  • Four students graduate from National Midwifery Institute

2005

  • National Midwifery Institute Challenge Process for California Midwifery Licensure is approved by the California Medical Board. Over fifty midwives complete the NMI Challenge Mechanism before the program is suspended in 2014 due to legislative changes.


  • Elizabeth Davis presents lectures and workshops at the Midwifery Today Conference, Bad Wildbad, Germany.

  • Elizabeth Davis presents keynote at the Humanization of Childbirth Congress, Rio De Janeiro, Brazil.

  • Elizabeth Davis presents lectures and workshops at the Midwifery/Doula Conference, Graz, Austria.

  • Two students graduate from National Midwifery Institute, Inc.

2006

  • Elizabeth Davis presents lectures and workshops at Midwifery Today Conference, Oslo, Norway.

  • Elizabeth Davis presents keynote address at Birth Conference, Berlin, Germany.

  • Elizabeth Davis presents lectures and workshops at the annual Midwifery/Doula Conference, Graz, Austria.

  • Elizabeth Davis presents lectures and workshops at the Midwifery Today Conference, San Jose, Costa Rica.

  • Three students graduate from National Midwifery Institute, Inc.

2007

  • Elizabeth Davis is guest instructor at the Scuola Elementale Di Arte Osterica, Florence, Italy.

  • Elizabeth Davis presents lectures and workshops at the Midwifery Today Conference, Bad Wildbad, Germany.

  • Five students graduate from National Midwifery Institute, Inc.

2008

  • National Midwifery Institute, Inc. accreditation renewed.

  • Elizabeth Davis presents workshops at the Mid-Atlantic Conference on Birth and Primal Health Research, Canary Islands.


  • Seven students graduate from National Midwifery Institute

2009

  • International Confederation of Midwives (ICM) issues global standards of midwifery. The ICM standards are essential pillars to strengthen midwifery worldwide by preparing fully qualified midwives to provide high quality, evidence-based health services for women, newborns, and childbearing families.


  • Orgasmic Birth: Your Guide to a Safe, Satisfying and Pleasurable Birth Experience, by Elizabeth Davis and Debra Pascali-Bonaro, is published. The book has since been released in French, Dutch, Greek, Korean, Hungarian, and Spanish editions.

  • Elizabeth Davis makes public presentations in Budapest, Hungary, to support the legalization of home birth midwifery.

  • Elizabeth Davis presents lectures and workshops at Midwifery Today Conference, Strasbourg, France.

  • Elizabeth Davis presents lectures and workshops at the annual Midwifery/Doula Conference, Graz, Austria.

  • Elizabeth Davis presents lectures and workshops at the Birth Practices in Bulgaria Conference, Sophia, Bulgaria. This was the first time midwives in Bulgaria convened.

  • Elizabeth Davis presents lectures and workshops at Midwifery Today Conference, Moscow, Russia.

  • Eight students graduate from National Midwifery Institute.

2010

  • Elizabeth Davis presents lectures and workshops at the Midwifery Today Conference, Bad Wildbad, Germany.

  • Twelve students graduate from National Midwifery Institute

2011

2012

  • Fifth edition of Heart & Hands: A Midwife’s Guide to Pregnancy and Birth is published.

  • Elizabeth Davis presents workshops at the Mid-Pacific Conference on Birth and Primal Health Research, Honolulu HI.

  • Sixteen students graduate from National Midwifery Institute.

2013

  • Shannon Anton serves on MANA Conference Planning Committee, St. Louis MI.


  • National Midwifery Institute, Inc. accreditation renewed.


  • Challenge Mechanism suspended due to changes to the California Licensed Midwifery Practice Act.


  • Shannon Anton attends US MERA meetings as NARM Board member.


  • Elizabeth Davis presents workshops and public events in Paris, France and Amsterdam, Netherlands.

  • Twenty-four students graduate from National Midwifery Institute

2014

  • Elizabeth Davis presents lectures and workshops at the Midwifery Today Conference, Bad Wildbad, Germany.

  • Elizabeth Davis receives the Midwifery Today Lifetime Achievement Award at the Midwifery Today Conference, Bad Wildbad, Germany.


  • 2015-2018: Shannon Anton serves as NARM Board member of US MERA Equity Task Force.


  • 2015-2018: Shannon Anton serves as member of US MERA Direct Assessment Education Task Force.

2015

 
 

  • Shannon Anton serves on Accreditation Review Committee member for MEAC.


  • Seven students graduate from National Midwifery Institute.

2016

2017

  • Elizabeth Davis presents lectures and workshops at the Midwifery Today Conference, Helsinki, Finland.

  • Erin Ryan creates and launches National Midwifery Institute’s Virtual Study Group, meeting weekly online.

  • Eight students graduate from the National Midwifery Institute, Inc.

2018

  • Shannon Anton retires from her positions as Program Co-Director of National Midwifery Institute, Inc. and Study Group Course Work Instructor.

  • Erin Ryan becomes Study Group Course Work Instructor and, with assistance from Molly Dutton-Kenny, completely revises and updates the modules.

  • Elizabeth Davis invites Erin Ryan to share National Midwifery Institute directorship with her, and Erin becomes Program Co-Director.

  • Molly Dutton-Kenny joins National Midwifery Institute, Inc. as its first Clinical Director.

  • Elizabeth Davis presents lectures and workshops at the Midwifery Today Conference, Bad Wildbad, Germany.

  • Fourteen students graduate from the National Midwifery Institute, Inc.

To learn more, view the NMI Handbook.