ANA\California SUPPORTS SB 520 (Caballero): Post-Secondary Education - Master’s Degree: Midwifery

SB_520_Support_Apr2025.pdf

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Apr 14, 2025 

The Honorable Anna Caballero 

California State Senate 

1021 O Str., Suite 7620 

Sacramento, CA 95814 

RE: SB 520 (Caballero) Post-Secondary Education: Master’s Degree: Midwifery - SUPPORT 

Dear Senator Caballero, 

On behalf of the American Nurses Association\California (ANA\C), we are proud to support SB 520 (Caballero). ANA\C is a bi-partisan professional nursing organization representing the interests of more than 500,000 licensed registered nurses in California. Our mission is to optimize nursing contribution to the health and well-being of individuals, families, and communities. As a state-level professional advocacy organization, ANA\C has been extensively involved in legislative efforts supporting many bills that became  California’s laws and are currently assisting in making California a place of Nursing Excellence.  

SB 520 (Caballero), which would establish the California Nurse-Midwifery Fund within the Department of  Health Care Access and Information (HCAI) for the purpose of establishing California-based master’s degree nurse-midwifery education programs.

California is experiencing a maternity care and labor and delivery crisis. This is despite the fact that the United States and California have a higher maternity and newborn death rate than other high-income countries. Further, over 50 maternity units in California have closed since 2013 and 20 freestanding birth centers have closed in just over three years. Midwifery care has demonstrated excellent clinical outcomes, but they are underutilized and can be mobilized to help address provider shortages. When midwives are integrated into health systems, they find more positive health outcomes, including spontaneous vaginal birth, labor after Cesarean (TOLAC), vaginal birth after  Cesarean (VBAC), breastfeeding, patient confidence and control, patient-centered care, and lower costs.  We also see fewer undesirable health outcomes: cesarean birth, operative vaginal delivery, induction of labor, episiotomy, perineal lacerations, use of pain medicine, epidural anesthesia, continuous fetal monitoring, NICU admissions, preterm birth and low birth weight infants, infant emergency department visits and hospitalizations, and neonatal deaths.

There is currently only one nurse-midwifery master’s degree program in California, at CSU Fullerton. This lack of educational opportunity places limitations on the workforce potential and ultimately on access to high-quality reproductive healthcare in California.  SB 520 would establish a Nurse-Midwifery Fund within the Department of Health Care Access and Information (HCAI). Combining both state and private funds, this fund will support new nurse-midwifery master’s degree programs to help the state meet its goals for reducing maternal and infant mortality. For these reasons, ANA\C supports SB 520 and thanks you for introducing this important measure.  

Respectfully,  

Dr. Marketa Houskova, DNP, MAIA, BA, RN  

Chief Executive Officer

1107 9th St. Suite 350 Sacramento, CA 95814

O: (916) 346-4590

E: ANAC@anacalifornia.org