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Midwives are in crisis.

Their profession has been at the center of a wave of breast and ovarian cancer cases, and now the American Academy of Obstetricians and Gynecologists has announced that they need to change their way of teaching midwives.

In a statement, the group called for an “urgent” overhaul of their curriculum and an end to their reliance on an oral exam for routine procedures. 

The academy’s statement, which the National Nurses United affiliate called “disappointing,” said the curriculum should emphasize the benefits of breastfeeding, which are more difficult to demonstrate during a mammogram, as well as the importance of using a nurse practitioner as a primary care provider. 

In the past, the academy has stressed the importance and safety of breastfeeding and offered a “Babies First” policy, in which nurses are instructed to offer their children breast milk in a way that is consistent with their beliefs about what constitutes a healthy, breast-feeding experience for their babies. 

But the academy’s new policy, which came out Monday, is more blunt than that.

It says midwives should stop teaching a “breast and ovarian system” of birth control that “has been associated with breast and other cancers of the breast, ovarian, uterus, cervix, vulva, bladder, and penis.” 

The statement says, “The AAP’s emphasis on breastfeeding is inconsistent with the AAP’s long-standing position that a breast-milk system should be used only in the context of a single-person, one-to-one encounter.” 

“Breast-milks should not be used as a substitute for safe birth control, including effective birth control with the potential to prevent, detect, and treat cancer,” the statement says. 

According to the AAP, the breast- and ovarian systems are “complementary to birth control and have the potential for protecting against a variety of sexually transmitted infections.” 

Midwives have been the target of some of the worst breast and cervical cancer cases in recent years. 

Since 2014, there have been more than 1,100 cases of breast cancer and more than 7,400 cervical cancer deaths in the U.S. The CDC says there has been a significant increase in new cases since 2013, with the rate of new cases quadrupling in the last 10 years.

It’s also been a time when women have had to rely more heavily on the use of “breastsaid,” which includes vaginal douches and pills. 

And it’s not just women who are being taught a new way of treating their cancers. 

“There are still many women who don’t understand the risks of the birth control pill, and the dangers associated with the breast,” the academy said.

“The academy is calling on midwives to learn to use safe, effective birth-control methods, and to teach this knowledge to their patients, especially those who are new to the practice of midwifery.” 

According the AAP: The academy’s recommendations are also designed to provide a foundation for improving the care of all women who use the birth-contraception pill, which can be used safely and effectively, but can also increase the risk of cervical cancer. 

While the academy recognizes the need for improved communication and information to support and educate women about the risks and benefits of the pill, it also recognizes that women must be able to decide for themselves when and if they want to use it. 

Nurse midwives also have the opportunity to provide care for people with complex medical conditions, including those with epilepsy, cancer, heart disease, and other conditions. 

However, the new guidelines call for the introduction of a new “birth control pill education program” that includes more patient-centered, information-oriented content and better training for midwives, according to the National Center for Birth Control Policy and Research. 

Last week, the American College of Obstetrics and Gynaecologists, the nation’s largest medical association, issued a statement that calls for the elimination of oral exams for routine breast and cervix exams and for all procedures requiring a mammography or pap smear. 

It says the new curriculum is based on a “model that ignores the important role of oral health and mammography in the prevention and management of breast, cervical, ovarian and uterine cancer.” 

Amber Burdick, president of the National Association of Midwives, told the Associated Press the new recommendations are a “major step in the right direction.” 

She said the organization welcomes the Academy’s guidance and says it is “working to develop a curriculum that reflects the current evidence.” 

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More from the AP: New York City to pay $7.5 million to settle lawsuits over rape allegations

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