Many midwives recognize the Journal of Midwifery & Women's Health (JMWH) as a collection of articles that discuss a variety of topics germane to our profession. For the last 20 years, I have been a member of the Journal's editorial team, and during that tenure, I found something more in these pages. The Journal itself has a voice and an identity I would like to honor.

In the summer of 1978, the year I graduated from Georgetown University's midwifery certificate program, the Journal of Nurse-Midwifery published Helen Varney Burst's American College of Nurse-Midwives (ACNM) presidential address in which she defined nurse-midwifery as being in the middle of a 3-ring circus surrounded by competing interests from the siloed professions of medicine, nursing, and lay midwifery.1 Lily Hsia's editorial in that issue discussed the pros and cons of ACNM assuming a role in the education of lay midwifery groups. This was a heated controversy at the time. Ms. Hsia's editorial noted that “The barriers between health professions can be as treacherous as the high open sea.”2(p 6) Both Helen Varney Burst and Lily Hsia stated that change is uncomfortable and that midwives must be open to “a variety of thinking” to avoid polarization.1, 2

This concept, that change is uncomfortable, which means one needs to consider a variety of thinking [perspectives] in order to avoid polarization, was a succinct summation of my career as a midwife and a mantra for the work I was doing. During the 1980s and 1990s interprofessional territorial battles were a major barrier to optimal health care delivery. Midwives frequently struggled with miscommunication, no communication, and poorly coordinated teams. Yet steadily during those decades, like a drumbeat, the Journal published content that acknowledged that problem and presented solutions. Multiple articles documented ways midwives expanded practice to fill gaps in health care and address the problems created by interprofessional barriers. Theme issues and individual articles described midwives’ work as perinatal triage providers,3 in primary care,4 and in expanded gynecologic roles.5 The clinical content was accompanied by a medley of articles that illustrated how midwives were effecting uncomfortable change by engaging in interprofessional collaboration.6-8 Each article addressed one aspect of the evolution occurring in health care. However, when I looked at the Journal during that era as a whole, I could see how the Journal subtly yet clearly expressed the impact midwives were having on the provision of health care services, and more importantly, how they were doing it. Midwives were expanding our scope of practice to address multiple gaps in health care services. Interprofessional collaboration was the process used to effect those changes.

A primary role of scholarly journals is to publish new research and clinical reviews to provide readers with current scientific evidence. As new evidence is introduced, the journal publishes them, and sometimes those findings can be uncomfortable to the reader, particularly if they challenge long-held beliefs or practice patterns. Some of those changes stand the test of time, but others do not survive as strong evidence for practice. All health care providers have lived through the cycle of biomedical publication in which therapies are introduced, heralded, disproven, and then withdrawn.9 This Journal gives voice to many perspectives so readers can learn of new evidence but also get a broader perspective. For example, distance learning was once a new idea for educating health care professionals. It was first widely adopted by the midwifery profession and introduced in this Journal.10 Other innovations that could change practice, such as CenteringPregnancy and trauma-informed care, needed initial leverage to gain traction, and this Journal provided a trusted platform for those ideas to be introduced to a broad audience.11-13 Furthermore, commentaries that address problems in standard practice, such as the vaginal birth after cesarean calculator based on race,14 provide important insights. Studies that voice the concerns and experiences of underserved populations support necessary change in clinical practice, education, and research.15-17 With this wide-ranging perspective, the Journal takes that second essential step of considering a variety of thinking.

This Journal continues to provide a forum for addressing and resolving challenges faced by the profession. A lot of the interprofessional conflicts referred to in these pages in past decades have diminished. Today the Journal publishes articles written by authors from many different disciplines and has a readership that extends beyond midwifery. However, some intraprofessional debates are a current challenge that the Journal can help us evaluate. Articles that address topics and potential changes to practice that some find contentious give readers the opportunity to listen to a variety of perspectives. Examples include the role of men in midwifery,18 adverse outcomes of home birth,19 transgender care,20 and racism in our profession.21 These subjects about which there is disagreement must be considered by all of us via considering diverse perspectives because Helen Varney Burst and Lily Hsia were right: polarization is an unsuccessful dead end.

As articles in the Journal openly discuss change and present different perspectives, I also want to honor the Journal's leadership in health care through the language used in articles published herein. Words matter. When an individual is described in written text as only a small component of who that person might be, that individual immediately becomes invisible or limited to that one role in the reader's mind. When we narrow the definition of a person to refer to them as a diabetic, uterus, pregnancy, or study sample, that incomplete view, by definition, prevents a full understanding of that person. This Journal was one of the first academic publications to explicitly and formally adopt people-centered language.22, 23 This deliberate writing style, which honors the individual in the broadest way possible, in every sentence, allows us to hear each other better and more deeply. In this, the Journal itself is a midwife to the professional dialogue and provides an example of how we can avoid being narrow in our thinking, which is a classic prerequisite to becoming polarized.

Later this year, the senior editorial team of this Journal will change, and a new team of highly qualified midwives will become the editors for these pages. Last month, Dr. Patty Aikins Murphy described the evolution of this Journal over the last 40 years. She discussed just a little of what it meant to her to be part of this journey, and her text spoke for many of us who have been involved in the Journal. I second her thoughts knowing I can never fully express the benefits of being part of this team of fabulous partners. JMWH is the face of the profession for the larger health care arena, and it is the voice of midwifery clinicians, educators, and researchers as we talk to each other. The content in these pages reflects changes in the profession over time, but I have found that the Journal also helps define the profession over time. As you listen to the subtle messages inherent in the changed focus of articles over the course of your career, you too will see how the Journal is a midwife to midwives. Midwives are always engaged in a dance of balance as we practice the core values of the midwifery model of care while adapting and evolving to meet the needs of succeeding generations. The Journal is on this same life course. It has been an honor to be a part of this journey; thank you.