Introducing Midwife Program

The Coalition has long advocated for universal newborn hearing screening and was delighted when a few hospitals in the state of MI started voluntarily doing this for their new babies back in 1997. By 2002, most Michigan hospitals were doing this on every newborn with some just doing it on babies with risk factors.  In 2007, hearing became mandated as part of the Newborn Screening program for all babies born in Michigan.

Access Barriers for Out-of-Hospital Births

However, many out-of-hospital births were not having their hearing screening done as a matter of routine due to lack of access to the screening machines for the out of hospital birth population. Understandably, this population were not seeking clinical services, and many of them are Amish and for them, it is a major hardship to have this done at locations far from their homes.

Advocacy, Collaboration & Program Development

Midwives shared this information with the State of Michigan Early Hearing Detection Intervention (MI-EHDI) program their frustration with not being able to offer hearing screens. They became aware of another state who was able to provide access for midwives. MI-EHDI shared their frustrations with The Coalition.  From a result of several conversations, a partnership began to be formed around the Michigan Midwives Association, Individual midwives, and MI-EHDI, to try to solve this issue. It was discovered that hearing screening equipment was so expensive, that hospitals wrote grants to obtain them. The Coalition with a 501c3 nonprofit status, became the grant writer to the Carls Foundation to obtain hearing screening machines, comparable to what most hospitals were using. These machines screen the hearing from the outer ear all the way to the brainstem of screened babies.   

Grant Funding & Hearing Screening Equipment

Using the grant funds, The Coalition purchased and own the machines & partners with the MI-EHDI program to distribute them to midwives and or midwife-friendly centers that have undergone proper training, have agreed to follow state protocols, sign an agreement with the MCDHHDBP and report the results of all their screens to EHDI within 14 days. The grant provided initial funding for the hearing screening equipment, calibration for three years, initial supplies, training costs. In addition, a loose partnership with Central Michigan University Audiology department assisted in providing training personnel for this project. To ensure longevity of the project, participating midwives collect nominal fees from parents to pay the Coalition, to ensure ongoing maintenance, annual calibration, insurance and supplies for the screened babies.  Midwifes using machines are required to purchase supplies from the Coalition, to ensure the program is funded and able to complete it’s mission. Supplies can be ordered thru the “visit our shop” button or ordered by sending an email to: [email protected]. 

Training, Partnerships & Program Sustainability

Equipment was distributed in the spring of 2014 and are assessed annually by the Michigan Coalition for Deaf, Hard of Hearing and DeafBlind People and MI-EHDI to ensure continual optimal placement. Over 70 midwives, doulas and student midwives have had training to perform hearing screenings and have access to portable A-ABR machines to test babies which are located throughout the state. In 2018, the Coalition wrote another grant and was awarded funds to increase the total number of machines available to midwives. The vast majority of machines have  HOST home with a limited few available Travel machines to ship as needed.

Machine Hosting, Costs & Ongoing Maintenance

While trained and participating midwives have access to the machines at no cost, there are costs assessed via the supplies to pay for ongoing maintenance, insurance, and repairs for the machines. All machines are calibrated annually. The Coalition strives to schedule this at the Annual Spring conference/training with the midwives to minimize interruptions and traveling constraints with the machines. Midwives need to share either the machines, or screen other midwives babies who don’t have access for their babies to keep the screens accessible as possible for all out of hospital birth babies. Midwives form their own agreements on how to best achieve this.

Hearing Screening Options for Non-Participating Midwives

Midwives do not have to participate in this program for their babies to be screened. The EHDI program encourages all midwife practices to have a hearing screening policy, to ensure they are educating their families appropriately on the hearing screening program and have local hearing screening resources. We recognize the fact that if they don’t offer the screenings themselves, it is rare to get 100% hearing screening participation from all families.  In their policies, they can list local community sites that are friendly to out of hospital births, or to other hearing screening service providers that serve all babies in the area.  It is also rare for a practice to have 100% refusals if a midwife is educating her parents appropriately about the purpose of the hearing screens. A list of community sites friendly to the homebirth population is hosted on the State of MI website on the EHDI page under community birth providers. Midwives can also make arrangements with other midwives who do have access to a hearing screening machine to do them for them. Please be respectful of their time and supply cost and understand why they may need to charge for the service.  For a sample hearing screening policy, contact Nan at the Michigan EHDI program or check with the Midwife App listed above. Email:  [email protected].