Looking Back, Looking Forward: Using Our Power for Good

As I undertook the daunting task of writing my final editorial as the Editor-in-Chief of the Journal of Midwifery & Women's Health (JMWH), I began by reading my inaugural editorial. In January 2008, I stated my primary goal as the incoming Editor-in-Chief was to maintain the high standards of this well-respected journal while supporting its continued evolution.1 At the time, I had no idea how much change would take place in the years ahead. The Journal has grown in size and reach, its content and authorship have broadened, the midwifery profession has thrived in some areas and struggled in others, and scholarly publishing has become increasingly complex.

Some of the Journal's key metrics provide a sense of the growth that has occurred. Between 2008 and 2020, the number of new manuscripts received annually increased from 248 to 627. The number of peer reviewers has quadrupled with nearly 500 individuals now serving as reviewers. In my first year as Editor-in-Chief, the Journal contained 574 print pages, and there were 253,311 downloads of full-text articles from the Journal's website. Last year, there were 836 print pages and 744,887 downloads. The number of times articles in JMWH were cited by other articles in a given year increased from 514 cites in 2008 to 2622 cites in 2021.

These numbers are impressive but what is more meaningful to me is that the Journal is highly respected within and beyond the midwifery profession. The editors receive submissions from authors around the world who represent a wide range of professions and disciplines. The continued increase in downloads and citations demonstrates JMWH content is attracting attention from readers and considered a trustworthy source. There are articles in the Journal that have documented midwifery's advancement, and others that serve as a beacon for its future. Pioneering and dedicated editorial efforts to promote health equity2, 3 and intentional language4-7 can be seen throughout the pages of JMWH and the Journal's website.8, 9 The editors have developed a virtual issue filled with resources to help authors navigate the contemporary publication process,10 including avoiding unethical predatory publishers.11 The Journal's editorial policies have been recognized as exemplars for other journals.12

The editorials I have written for JMWH have been a powerful opportunity for me to speak directly to midwives and our colleagues about a variety of subjects related to health and health care, the midwifery profession, and scholarly publishing. Having this platform to share ideas and calls for action has been a privilege, and I have sought to use this space to elevate topics that would benefit from more awareness and open discussion. It is very meaningful to have heard that some of the editorials I considered most important also resonated for readers, such as the ones about inclusive language3 and images,13 antiracism,14 having a life beyond work,15 mental illness,16 and the many ways of midwifing.17 There have also been instances in which the best use of my platform was to make room for other voices that needed to be heard.18, 19

One of the fundamental commitments of the JMWH editors is mentoring authors and reviewers. I have always considered one of my best skills as an editor to be helping authors improve their writing while maintaining their voice, and the pride and joy authors have when their work is published is one of the most rewarding aspects of being Editor-in-Chief. The decades of mentorship by JMWH editors have helped grow the cadre of midwifery authors and reviewers, some of whom have gone on to become Editorial Board members and editors for both JMWH and other journals.

I certainly did not make all of the accomplishments and progress of the past 14 years happen myself, but I helped them happen and am proud of how the Journal has evolved during my tenure. I am deeply grateful to the extraordinary partners I have had in this work: the JMWH Deputy Editors Tekoa King, Patricia Aikins Murphy, and Ira Kantrowitz-Gordon; Managing Editor Brittany Swett; and Editorial Board members. Of course, JMWH could not exist without the authors whose scholarly work fills the Journal's pages, and the peer reviewers whose assessments and recommendations improve individual manuscripts and the Journal as a whole. The contributions of each of these individuals is sincerely appreciated. JMWH is the official journal of the American College of Nurse-Midwives (ACNM), and I am thankful that ACNM's staff and volunteer leaders have always respected the editorial independence that is necessary for the integrity of a society-owned journal.

As I step down as Editor-in-Chief, I want to part with what has become my mantra in this role and beyond: use your power for good. I came into this position not entirely comprehending the power that accompanied it. I knew I would have the weighty responsibility of making decisions to accept or reject manuscripts. What I did not anticipate was the larger influence I suddenly gained because I was an editor; people perceived me to be an authoritative source on many different topics and sought my input as such. This provided me with opportunities to make changes that positively affected not only the Journal but also the midwifery and editor professions. While I have had reservations about power because of its negative connotations, power is not inherently bad or good. Power is, as Dr. Martin Luther King, Jr. so eloquently stated, the ability to achieve purpose and effect change. Whether power is a positive or negative force is determined by how that ability is used and what the goals of change are. Each of us can choose how we use the power we wield. We can help or harm. We can lift or oppress. We can unite or divide. We can value or demean.

While being an editor comes with unique power, all midwives have power as highly educated professionals. Using power is not a new concept for our profession. Midwives have always been changemakers, and advocacy is woven into the fabric of the profession. The goal of effecting change is present throughout the hallmarks of midwifery that define and guide our profession. Advocacy of non-intervention in normal processes; promotion of person-centered care for all; empowerment of persons seeking midwifery care; and advocating for informed choice, shared decision making, and the right to self-determination are all ways midwives use our power.20

Power is both a tool and a responsibility. Across roles in practice, education, research, and the many other areas in which midwives work, there are countless ways to make a positive difference and create change. The scale of how people use their power varies. The world needs midwives who use their power for good by providing compassionate, evidence-based care to individual patients, as well as midwives who use their power for good at the systems level by helping to build structures that support populations and our profession. Most people can only change the world incrementally, but if we all do that, there will be real change. While the saying “midwives hold the future” is used to reflect the literal work of our hands guiding newborns into the world, midwives also help bring forth a better future for health care and the health of all the individuals we serve.

One of the best ways to use power for good is to share it with others. As midwives strive to build a more equitable and inclusive profession, sharing power is essential. A vital way that midwives can share power within the profession is by serving as clinical preceptors. Precepting falls within the broader category of mentorship, which is an important method of sharing our power with others. Mentoring does not need to be formal. Midwives are mentors every time we answer a colleague's request for help or advice with our time and input, or invite a colleague with less experience to join us in collaborative work. To paraphrase Michelle Obama, for every door that has been opened to you, open a door to others.

Finally, part of using power for good is knowing when it is time to give it to someone else. As I alluded to in my first editorial and fully understand now, one of the Journal's greatest strengths is that it is both enduring and ever changing. Editorial transitions are important for the continued development and betterment of a journal. Midwifing JMWH as its Editor-in-Chief has been one of the greatest honors of my career. As I step down from this position, it is my pleasure to welcome Melissa D. Avery, CNM, PhD, FACNM, FAAN, as the 14th Editor-in-Chief of JMWH. Melissa and I have been working together closely for the last few months, and she brings tremendous experience and enthusiasm to this role. I look forward to seeing the continued evolution of the Journal under her leadership.

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