Nizhoni Institute of Midwifery is a non-profit 501(c)(3), originally incorporated in Idaho and registered as a non-profit public benefit corporation in California. Nizhoni offers a three-year direct entry program which teaches students how to provide comprehensive, individualized maternity and well-woman care to low-risk clients in a variety of settings. Students of our school learn through academic study, individual and group inquiry, and clinical education in order to develop midwifery expertise and critical thinking skills and are prepared as graduates to offer safe, competent, and compassionate midwifery care and leadership. Since the conception of Nizhoni Institute of Midwifery in 2003, the organization has experienced significant and continual growth.
In 2009, Nizhoni Institute of Midwifery became one of nine nationally accredited direct-entry midwifery programs in the United States. We are the only program accredited by the Bureau of Private and Postsecondary Education and legally operating in the state of California. In 2014, Nizhoni also received approval by the Veterans Administration for funding education of students with VA benefits, and has just been approved to issue I-20 Student Exchange Visitors Program for students coming from outside the US. These strides have motivated our organization to expand where there is a great need of educated and well-trained midwives.
Gerri Ryan, co-founder of the corporation and outgoing Executive Director, has been a practicing midwife since 2003 and doula since 1995. She retired in August 2017 in order to return to full-time midwifery practice. She remains involved with the Nizhoni Institute as a faculty member and registered preceptor.
Claudia Breglia, LM, CPM, currently serves as the Chief Operating Officer and primary contact for the organization. Both Claudia and the entire Nizhoni organization are driven to establish a permanent campus location within San Diego as well as expand services throughout California. This expansion of our school supports the Nizhoni Institute of Midwifery in our commitment to provide foundational and continuing education to midwives, to support midwifery as a profession, and to improve the health of women and their families in any and all socioeconomic circumstances.
In 2003, Nizhoni began instructing four students in a private home, using our personal resources, books, and teaching models. Two years later, we began our national accreditation process. However, prior to national accreditation, we needed to acquire state approval, which took two and a half years. During that time, we were not allowed to continue our program until completion of the accreditation process with the Bureau of Private and Postsecondary Education. In June of 2007, we were granted temporary accreditation by the Bureau contingent upon national accreditation. At last, we were able to enroll students again. Since then, we pursued national accreditation and achieved pre-accreditation status in 2009 followed by full accreditation status in February 2010. We are proud to serve 54 students in four distinct cohorts. Nizhoni has achieved 100 percent licensure of our graduates with 85 percent passing their boards on the first attempt.
Nizhoni is a Navajo word which conveys the spirit and practice of “the beauty way” as experienced and expressed through living in balance and harmony with the world. As midwives and students, we seek that balance as we honor both our valued birthing traditions and contemporary midwifery and medical knowledge. Graduates of the Nizhoni Institute of Midwifery are prepared to function as independent care providers for women and newborns. As midwives, we bring harmony and balance to childbearing and assist each woman to discover the transformative nature and experience of giving birth. As an institution providing midwifery education, we create and foster a strong commitment to excellence in midwifery care and practice in any given place or circumstance, encouraging midwives and those we serve to embrace and exemplify “The Beauty Way.”
As our commitment to improving outcomes in birth and health care in the United States and throughout the world, Nizhoni Institute of Midwifery is dedicated to providing current, relevant, and clinically robust education in the art and science of midwifery.
History of Nizhoni
Nizhoni Institute of Midwifery was founded in response to the need of advanced standards for direct-entry midwifery education. Previous models of midwifery education lacked a structured residential format. Instead, these models relied on the preceptor to provide the student a complete clinical education. Without uniform training and education, apprentice midwives can only be as strong as the preceptor teaching. This outdated apprenticeship model tended to compound errors in clinical judgment and often lacked evidence-based practices.
The Nizhoni model is unique in that we expand the scope of midwifery education by providing students a consistent and interdisciplinary foundation. This foundation is provided by a diverse group of academic and clinical faculty including licensed direct-entry midwives, certified nurse-midwives, physicians, and other health care and administrative professionals, all committed to improving maternal and infant outcomes. Our small cohort of students attend weekly classes where they learn both didactic and clinical information from instructors. Our interdisciplinary approach has placed Nizhoni Institute in a unique position to promote public health and to foster a spirit of cooperation between health care professionals in the area of maternal-child health.
Since our first cohort in 2003, we have seen continual growth in the need for qualified and well-trained midwives within California and in other states. For instance, Utah has a need for a residential program which trains midwives and care providers. Our goal is fill this need by opening small micro-classrooms in Utah in order to provide learning opportunities for the more rural areas. We are creating a training model that can easily be replicated in other rural areas throughout the United States. We believe this model will allow midwifery to thrive and become the primary mode of maternity care in this country which will reduce maternity costs while providing families the gold standard of maternity care in various communities.
Academic Program Overview
Nizhoni offers a three-year direct entry program which teaches students how to provide comprehensive, individualized maternity and well-woman care to low-risk clients in a variety of settings. Students complete a 38-module program, more than 2,000 hours of clinical skills and a range of specific birth experiences that prepare them for the national exam. After successful completion, graduates apply to the Medical Board of California for their midwifery license and begin practicing as independent care providers. Our current student base draws from the southern California region. Students commute one day per week for their didactic education to the San Diego campus. In addition to classroom training, students work with midwives or birth centers in their area to complete their clinical education.
Our original cohort began with only four students. Over time, our cohorts increased to 10 students but in the last three years, our annual student base has increased to approximately 16 students. These students are carefully selected from approximately 36-44 students who apply each year. We project that this number will continue to increase over time as the need for midwifery schools in the United States continues to grow. Most states either regulate direct-entry midwifery or allow its practice by interpretation of existing law. As of 2017, 30 states including California have laws that license, register, certify or otherwise regulate the practice of direct-entry midwives. Several other states are drafting legislation, and most require a MEAC accredited midwifery education. In order to address this future need, we are now working to expand into other areas of California.
Students complete 38 learning modules by attending class one day a week. To accommodate three cohorts, classes are held typically two days per week, Thursday and Friday. In addition to weekly classes, Nizhoni holds monthly seminars which offer the students an opportunity to practice clinical Skills and Drills in a controlled setting. These clinical classes are generally held after regularly scheduled classes or on the weekends. Students also work on these skills in the clinical settings of their clinical faculty, midwives and in birth centers. This allows us to have limited administrative staff on a part-time-only basis which keeps overhead costs low.
Our classrooms and administrative offices are located at 3944 Murphy Canyon Road, Suite C-200, in San Diego, California. We lease two academic and two clinical classrooms of approximately 2,521 square feet. Our current lease runs through October 2019. Nizhoni has a long-term goal of acquiring a permanent location for our school within San Diego.
Organization and Management
The Nizhoni Institute of Midwifery is governed by an active board of trustees which meet quarterly in order to review financials, and assist us in planning and implementing our organizational goals. The Board of Trustees takes reports from staff, but has the final vote in the direction this organization takes. The Board of Trustees is responsible in part for setting our annual budget and reviewing the quarterly budget report.
Nizhoni has two Co-Directors consisting of an Executive Director and a Dean of Students. The Executive Director reports to and takes direction from the President of the Board. Our Dean of Students has the primary responsibility for monitoring enrollment projections and outcomes. The Dean also monitors student and faculty evaluations, complaints, needs, and desires. Student records such as clinical forms, transcripts and documentation are also managed by the Dean. In addition to the Co-Directors, there are several staff members and part-time faculty dedicated to the mission of Nizhoni. Operations of the organization are managed by the Executive Director who is accountable to the Board of Trustees. The Chief Operating Officer has primary responsibility for implementing changes in marketing strategy to foster program growth and to maintain or surpass the financial goals of the institution. The Chief Operating Officer also oversees human resources, asset acquisition, as well as tracking and management of facilities. Our budget is monitored monthly by our Chief Operating Officer. These budget reports are also reviewed by our Treasurer and then entire Board of Trustees during quarterly meetings. The Treasurer is responsible for directing the budget and monitoring adherence to the financial plan.