Presidential priorities: 50 years of wisdom as the basis of an action agenda for the next half-century

Each of the living presidents of the American College of Nurse-Midwives (ACNM), past and current, was asked to select one or more issues that were of particular importance during her term(s) in office. Some of the issues identified by the presidents were amenable to review using existing quantitative data; this article presents those findings. The substantial increase in growth of ACNM membership in the 1980s and 1990s as well as the plateau that occurred at the beginning of the 21st century is documented. The relationship between ACNM and the professions of nursing, medicine, and other public health providers is illustrated. The increase in the number of Certified Nurse-Midwife/Certified Midwife (CNM/CM) education programs and the evolution and current profile of curriculum models are discussed. Finally, expansion of the scope of midwifery practice and the growing number of opportunities for entrepreneurial practice are presented in terms of current practice profiles, practice sites and settings, various employer-employee relationships, and the variety of financial reimbursement streams. This article is intended to complement the broader body of information about ACNM's history, and particularly, to supplement the richness of information derived from the qualitative and historical research inquiries conducted by others.