National Midwifery Week: How midwives are shifting the paradigm for women’s health
A big part of maternal health centers on the fact that during pregnancy, most women are absolutely normal. In fact, pregnancy is often the healthiest time of a woman’s life. Yet, many healthy women are plugged into a healthcare system that views pregnancy through a medical/surgical lens focused on finding problems. That’s a good thing for women at high risk for developing complications. But it may also be a contributing factor for why our increasing cesarean section, induction and intervention rates are resulting in poor outcomes for too many mothers and babies.
Many national and international healthcare experts are proposing that it’s time to shift the paradigm in how we care for pregnant women. It’s time to put midwives in charge of healthy mothers and obstetricians in charge of high-risk women. In fact, in countries with the worlds’ best maternal outcomes including Finland, Sweden and Norway, midwives are on the frontlines of maternal health care.
Midwifery is among the oldest professions, yet many women don’t know what midwives do. That’s why the American College of Nurse Midwives (ACNM) is celebrating National Midwifery Week from October 7th-13th with a new campaign called, Our Moment of Truth™: A New Understanding of Midwifery Care. We talked with Tina Johnson CNM, Director of Professional Practice and Health Policy at ACNM about how they’re raising awareness of the broad spectrum of healthcare services midwives provide.
What’s the primary goal of National Midwifery Week?
First of all, it’s about celebrating midwives and the wonderful outcomes we produce for our clients. Then, it’s about highlighting our contribution to women’s health. Many people aren’t aware that certified midwives and certified nurse midwives are recognized under federal law as primary care providers for women. We don’t just do perinatal and gynecologic care. We also see patients for all kinds of issues you might take to a doctor.
And your goal for the Our Moment of Truth Campaign?
It’s to get the word out about what midwifery is and our excellent outcomes and options for women. Most women say they want a provider who really listens to them, yet many women report they aren’t having these kinds of conversations with their healthcare providers. Our goal is to let women know that kind of care might be more readily available to them with a midwife. We’re interested in developing long-term, one-on-one relationships with our patients so they’ll come back to us for everything.
Are there specific benefits to choosing a midwife?
The hallmarks of midwifery care include a holistic well-woman approach, active listening, shared decision-making and lots of education and preventive care.
Typically, midwives focus on keeping people healthy and birth normal. We’re the experts at supporting normal physiologic birth.
Pregnancy is a teaching time when you have women’s attention. If you spend more than a 15-minute visit with somebody, you really get to know them and understand what their needs are. Midwives tend to have more time than OBs. We spend time teaching women about nutrition, exercise, smoking cessation and about domestic violence and substance abuse prevention.
Obstetrics is a surgical specialty, so obstetricians spend a lot of time focusing on pathophysiology. Midwives on the other hand spend a lot of time screening for complications, but also educating patients about their choices and trying to prevent those complications. We focus on all the options, including things like pain management and the difference between induction and waiting for labor to happen normally. We also offer a range of services that OBs haven’t traditionally been comfortable with like changing positions and eating and drinking during labor. We know these things work well and are evidence based, but OBs aren’t necessarily trained to do them.
Part of your National Midwifery Week campaign includes taking an action a day as part of your advocacy campaign. What’s that about?
Much of our advocacy focus right now is about making sure women’s healthcare issues are at the forefront of national health policy. Our country spends a lot of time and energy discussing how to reduce costs for people in the Medicare system. It’s only been recently that maternal health has stepped up in terms of visibility. As a country, we spend a lot of money on childbirth. We don’t traditionally think of this as an area where we can improve care and outcomes and reduce costs. ACNM proposes that promoting normal physiologic birth would do all of those things. We’re appalled at our nation’s high cesarean and induction rates and poor maternal and infant outcomes in comparison with other developed countries. We’ve become interventionists when it comes to birth yet most women have normal pregnancies. ACNM is sitting at all the healthcare tables. We’re at the national quality forum pushing for quality measures. We want to initiate that hospitals measure for normal spontaneous births, not just their c-section rate.
We’re also advocating with other advanced practice nurses like nurse practitioners to enable us to fill the gaps we see in the healthcare workforce. With the Affordable Care Act on the horizon, we’re asking, “Who’s going to take care of all these new patients?” We have a national shortage of obstetricians and primary care physicians. Midwives and nurse practitioners want to fill those gaps, but there are barriers to our licensure and education and in the physician-only language that’s so often used to discuss healthcare. We’re trying to call attention that what we do could change that paradigm.
What can you do?
- Log on to the American College of Nurse Midwives’ website and learn more about different types of midwives, actions and advocacy opportunities you can take.
- Consider using a midwife for your pregnancy and gynecologic care.
- If you’re interested in becoming a midwife, research educational opportunities here.
- Attend the Midwifery Works Business and Networking Conference next week in New York.
- Consider having a midwife speak at your next corporate, education or hospital event and. help raise awareness of their valuable contributions to the healthcare community.
- If you want to support midwife education and development in developing countries, consider supporting this fundraising effort, sponsored by Stacey Curnow, a midwife and life coach who is raising money and matching donations for our friends at Midwives for Haiti.
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