The MANA Statistics Project is an ongoing project of the Midwives Alliance of North America with governance by the MANA Board of Directors. As a new contributor to the Project you are agreeing to the following: (1) You are an actively practicing midwife, (2) You are contributing data for use in your own practice, (3) You are contributing data for use in midwifery statistical reports, and (4) You are contributing data for use in birth and midwifery research.

Purpose. The MANA Statistics Project collects data from actively practicing midwives to provide quality improvement statistics for contributors; support birth and midwifery research; and provide support for midwife-led care policies.

1. Activities. After enrolling, you will be prompted to confirm your email address. Once confirmed, a MANA representative will review your account request and confirm your account. After receiving confirmation, you will register each client at the beginning of their care with you. Upon completion of their course of care, including a 6 week postpartum visit, you will complete their birth information and submit the form. All information will be de-identified by the system before it is entered into the database.

2. Time. Your estimated time commitment to participate in the project is 25-35 minutes per client who consents to participate. This time commitment includes receiving verbal consent from the client, pre-registering or logging clients, and entering information on consented clients’ courses of care into the online system.

3. Risks. The security and confidentiality of information collected from you online cannot be guaranteed. However, we can ensure that all data will be kept secure to the extent permitted by the technology being used. Information collected online can be intercepted, corrupted, lost, or destroyed, arrive late or incomplete, or contain viruses. There is a chance that we could accidentally disclose information that identifies you; however, this chance is minimized by several security protocols MANA has put in place to protect midwives. These include maintaining unique IDs to protect your confidentiality, de-identifying all shared data, and storing account data separately.

4. Benefits. You will directly benefit from your participation in the MANA Statistics Project by using our tool to view statistics and generate reports about your practice, which can allow you to track your practice over time. This information is valuable to quality assurance and quality improvement and can be provided to current and potential clients. An indirect but important benefit is the research conducted using the MANA Statistics database that can be used to guide midwifery policies that improve maternal and infant health care outcomes in North America.

5. Alternatives. Although some states and professional organizations require participation in MANA Stats or a data registry like MANA Stats, according to federal law, research participation must be voluntary. If you choose to participate in the MANA Statistics Project, you are agreeing for your data to be used in research. All data entered into the MANA Statistics Project database that is used for research will be de-identified with no connection to you or to your clients and reported as aggregate data. For example: “a 2% transport rate for all births in the database” or “87% of the births in the database were attended by CPMs”. In reporting subgroup information, MANA will avoid

identifying small or unique populations (n<10) in a way that may infer the identity of mothers or contributors.

6. Confidentiality. The confidentiality of your professional information and your clients’ health-related information will be carefully protected. To protect your identity, the system will generate a unique code for you as a midwife contributor rather than using your name. You will sign into the system using a password chosen by you. Data on your clients will likewise be listed using client codes that you assign, rather than name.

7. Contact Information: For more information about the MANA Statistics Project, please contact the MIdwives Alliance of North America: [email protected] .

8. Voluntariness: Participation in the MANA Statistics Project is voluntary. You will not lose any benefits or rights you would normally have if you choose not to participate. You can stop at any time and still keep the benefits and rights you had before volunteering. Your decision will not affect your professional standing or relationships with colleagues or the Midwives Alliance of North America. You may choose to stop participation as a contributor midwife at any time by contacting MANA administrative support. All data submitted by you, on behalf of consenting clients, prior to withdrawal from the project will remain in the system.

9. Funding: The MANA Statistics Project is an ongoing project of the Midwives Alliance of North America with governance by the MANA Board of Directors. The project has received support from the Foundation for the Advancement of Midwifery and other private foundations as well as federal agencies.

10. Conflict of Interest. Members of the Midwives Alliance of North America may also be researchers who access the data for research purposes. Researchers accessing the data may also be midwives themselves or otherwise involved as midwifery or birth professionals.

You are encouraged to ask any questions you may have about this project before deciding to participate. You may contact the Midwives Alliance of North America at [email protected] for more information. To enroll as a contributor in the MANA Statistics Project, complete and submit the enrollment form and agree to the terms and conditions.