Midwifery Presentation by Triangle Midwives

Midwives: Changing Health Care for the

Better

Tuesday, November 5, 13

Midwifery:An Ancient Commitment,A Modern Success Story


Mary Breckinridge

Frontier Nursing Service

1925


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.


Increased CNM-Attended Births


• 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


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.


Emphasis on Primary Care

Primary Care During Pregnancy

Labor & BirthPrimary CareNon-Maternity


0

1

2

3

4

Infant Mortality

Low Birthweight

CNMs MDs

Neonatal Mortality

CNMs Have Excellent Outcomes


0 15 30 45 60

Forceps/Vacuum

Cont. Fetal Mon.

Epidural

Induction

Cesareans

CNMs MDs

Midwives Use Birth Interventions Appropriately


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”


Midwifery Prenatal Care

Listen to WomenProvide Emotional

SupportPregnancy and Birth

EducationCollaborate with

Physicians

Midwifery Prenatal Care = Excellent Outcomes


70

77.5

85

92.5

100

Satisfied Use Again

CNMs No CNMs

Higher Satisfaction Rates with CNMs


MD

• Consultation

• Collaboration

• Referral

Collaborative Practice


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?


0

25

50

75

100

Hospital Birth CenterHome

98%

1%1%

Where do midwives attend births?


• Nationally accredited education program

• National certification exam

• State licensure

• Professional liability insurance

• Continuing competency assessment

Midwives meet the following criteria:

Credentialing Nurse Midwives


• 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


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


http://www.midwife.org

http://www.midwife.org

http://www.TriangleOBGYN.com




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


• 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...


http://www.TriangleMidwives.com

http://www.TriangleMidwives.com

http://www.myMidwife.org

http://www.myMidwife.org

With Women…

…For a Lifetime


Health & Medicine

Midwifery Presentation by Triangle Midwives