The Midwifery Initiative in Virginia, West Virginia, and Maryland aims to increase access to nurse-midwifery education in rural areas through a collaborative distance learning program. The program allows students to take core courses at their home university in the first year and midwifery courses at Shenandoah University in the second year. Students receive degrees from their home universities and a certificate from Shenandoah. This hybrid model addresses the lack of nurse-midwives in rural areas by making midwifery education more accessible and flexible for students in remote locations.