Midwives: Changing Health Care for the

Better

Tuesday, November 5, 13

Midwifery:An Ancient Commitment,A Modern Success Story

Tuesday, November 5, 13

Mary Breckinridge

Frontier Nursing Service

1925

Tuesday, November 5, 13

The Growth of Midwifery

Published research that shows CNMS:

• Provide high-quality care• Have comparable or better outcomes• Have high levels of patient satisfaction• Lower costs due to fewer interventions.

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Increased CNM-Attended Births

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• Pregnancy, birth, and newborn care

• Women’s primary health care

• Family planning

• Advanced clinical practice (first assistants, circumcision, colposcopy, ultrasonography)

• Education and Public Health

We Do More than Deliver Babies:

Scope of Midwifery Practice

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Philosophy of Care• Focus on prevention and individualized

education

• View pregnancy as a normal process

• Provide compassionate and family-centered care

• Encourage women’s participation in decision-making

• Use technology appropriately...minimize interventions

• Consultation, collaboration and referral with members of the health care team.

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Emphasis on Primary Care

Primary Care During Pregnancy

Labor & BirthPrimary CareNon-Maternity

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0

1

2

3

4

Infant Mortality

Low Birthweight

CNMs MDs

Neonatal Mortality

CNMs Have Excellent Outcomes

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0 15 30 45 60

Forceps/Vacuum

Cont. Fetal Mon.

Epidural

Induction

Cesareans

CNMs MDs

Midwives Use Birth Interventions Appropriately

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Midwives Provide Effective Labor

Support• Twice as much freedom to move in labor• Twice as much intermittent monitoring• Twice as many non-medicated births• Half as many episiotomies• Supportive care during labor • Collaborates with patient’s doula

“High Touch, Low Tech”

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Midwifery Prenatal Care

Listen to WomenProvide Emotional

SupportPregnancy and Birth

EducationCollaborate with

Physicians

Midwifery Prenatal Care = Excellent Outcomes

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70

77.5

85

92.5

100

Satisfied Use Again

CNMs No CNMs

Higher Satisfaction Rates with CNMs

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MD

• Consultation

• Collaboration

• Referral

Collaborative Practice

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32%

32%

9%

9%

8%

11%

Hospital MD Owned Gov./MilitaryMidwife Owned Education Non-profit/Health Ctr.

Hospital

MD Owned

Gov./Military

Midwife Owned

Education

Non-Profit/Health Ctr.

Where are midwives employed?

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0

25

50

75

100

Hospital Birth CenterHome

98%

1%1%

Where do midwives attend births?

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• Nationally accredited education program

• National certification exam

• State licensure

• Professional liability insurance

• Continuing competency assessment

Midwives meet the following criteria:

Credentialing Nurse Midwives

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• A modern success story built on an ancient commitment

• Maternity, gynecological, well-woman care

• Emphasis on primary care and health promotion

• The midwifery model: high-touch, low-tech

• Excellent outcomes, satisfied patients, and value-added service

• Quality, professional care.

Midwives: Changing Health Care for the Better

Tuesday, November 5, 13

Find A Midwife

•www.midwife.org to find a midwife in your community.

•Triangle Midwives is the only private practice in Wake County with midwives.

TriangleMidwives.com

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Delivery Statistics:~ 2009 - delivered 700 babies~ Midwives managed, consulted or collaborated with 80% of those patients~ Midwives delivered 70% of the 700 babies

Cesarean Section Rates:~ Nationally - 31 - 34%~ Triangle Midwives: Primary - 17%; Repeat - 26 - 29%~ Low risk midwifery patients: 12 - 14 %~ High risk midwifery patients: 16 - 20%

Vaginal Birth After Cesarean Section (VBAC) Rates:~ 75% success rate

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• Triangle Midwives has 6 Certified Nurse Midwives

• All deliveries are at WakeMed Cary Hospital

• For patients, www.TriangleMidwives.com,www.myMidwife.org.

• www.GotMom.org, ACNM’s online breastfeeding resource.

Learn more...

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With Women…

…For a Lifetime

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