Profiles in Nursing
Agnes Reinders, Launched the Specialty of Nurse-Midwifery
She established the American College of Nurse-Midwives and developed the core practice standards
Several pivotal figures helped move midwifery from the negative image of, shall we say, an ignorant hag carrying disease from bed to bed to the well-deserved recognition of a worthy profession. One person in particular saw to it that nurse-midwives (midwives who were nurses first) gained recognition as distinct professionals. Her name during much of this groundwork was Sister Mary Theophane of the Medical Mission Sisters. Later, after she left religious life, she went back to the name Agnes Shoemaker and, after her marriage, Agnes Reinders. And through all the name and status changes, she was steadfast in her devotion to nurse-midwifery.
Reinders graduated from Catholic University in Washington, D.C., in 1941 with a bachelor's degree in nursing education. After a short stint as the assistant head nurse of a medical-surgical unit, she took over as supervisor for labor and delivery, postpartum and newborn nursery at the same local hospital. It was a perfect fit; since childhood, she had a great respect for the potential of new life.
A Distinct Specialty
Not long after the archbishop of Santa Fe asked her order to supply a midwifery service in the area. Along with one other nurse who had trained in England, Sister Theophane went to New York to attend a six-month course at the Lobenstein School of Nurse-Midwifery. According to Sally Tom, who has written extensively on Reinders, the young sister found that “Nurse-midwifery gave me a much broader concept of total maternity care than I had from my nursing background alone. It made me feel responsibility for total care…”
While serving as director of the Catholic Maternity Institute, which offered both home births and a freestanding birthing clinic, La Casita, Reinders began her attempt to organize nurse-midwives into a distinct specialty, one that would not be controlled or supervised by physicians. Like the work of another well-known nurse innovator, Florence Nightingale, Reinders’s efforts emphasized a strenuous and targeted letter-writing campaign.
The need for national educational standards and the ability to control practice were the primary impetus. She foresaw the increase in international travel and work and the need to maintain the term nurse-midwife as one that reflected the true nature of what these professionals were — namely, nurses and midwives.
Defining a Scope of Practice
Her efforts met with considerable resistance. Many nurses, even among the nurse-midwives themselves, thought of midwifery as medicine, not nursing. Not thinking that an independent association would succeed, she first wanted to bring nurse-midwives within the American Nurses Association or the National League for Nursing. Only when these two national groups denied the request did Reinders and others form the American College of Nurse-Midwives.
At the beginning, meetings were planned around the national meetings of other organizations; but by 1955, the constitution and bylaws were written. Reinders served as president-elect from 1955-1957 and then became president from 1957-1959, all the while still director of CMI. Between 1958 and 1967, she participated in multiple conferences that laid the groundwork for graduate-level nurse-midwifery programs and for the core practice standards that now guide the profession.
Today, the ACNM is the professional organization for certified nurse-midwives and now includes certified midwives. It enjoys a collaborative relationship with the American College of Obstetricians and Gynecologists and, in 2002, both groups issued a joint statement that for the first time referred to certified nurse-midwives as equals in the professional relationship; there is no mention of direction or supervision by physicians. Reinders would be pleased.
Elizabeth Hanink, RN, PHN, BSN, is a freelance writer with extensive hospital and community-based nursing experience.