territory, or federal district will have a geographically defined organization, which will be the official affiliate
organization to the American College of Nurse Midwives (ACNM).
The purpose of affiliates is to allow for effective state-level initiatives, including educational programs,
legislations and regulations favorable to midwifery practice, networking events, public relations campaigns,
and other initiatives. Each affiliate will set its own priorities, so long as these are consistent with ACNM
national positions and policies.
In January 2011 a handful of Hawaii Certified Nurse Midwives began the process of organizing a Hawaii
state ACNM affiliate. The common consensus was that midwives needed to have a voice in the increasingly
changing health care climate in the state of Hawaii. The core group consisted of an interim board of officers,
Roxanne Estes, Maureen Shannon, Annette Mannat and JoAnn Johansen, who worked relentlessly through
busy schedules and challenging distances to obtain the official affiliate organization for the State of Hawai’i.
The ACNM Board of Directors approved this affiliate on May 11, 2011. Our organization is called: Hawai’i
Affiliate of the American College of Nurse Midwives and has adopted the acronym: HAA
The acronym HAA was chosen as the Hawaiian word “Ha” which means “the breath of life”. The initial
interim board of the Hawaii Affiliate of the American College of Nurse Midwives were of consensus that like
the first inhaled breath of life at birth so too was the initial first breath of the organization. The first breath of
life is deep and usually harder to inhale than ongoing breathing; therefore we equated our first breath of
organization to the Hawaiian word “Ha” or HAA. Knowing that the first breath will be the most difficult
however ongoing breathing should flow effortlessly, and that is our desire for this organization.
The first member meeting and conference is scheduled for January 29 , 2012, entitled “The Face of
Midwifery in Hawaii” . A showcase of Hawaii midwifery practices will be the focus of this conference. Guest
speakers include Holly Kennedy, current present of the ACNM with a presentation on her current research
on Normal Birth. Regional representative Michelle Grady will also be present to assist with this historic first
meeting of the Hawaii Affiliate of the American College of Nurse Midwives.
We look forward to our organization’s strength and future accomplishments we hope to
have much participation from many midwives in the state, as there is much work to do.
Roxanne Estes, CNM, MSN
Interim President 2011