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Midwifery as a career.

From: Heather Wierima (hwierima@hotmail.com)
Tue, 8 Oct 2002 18:29:50 -0500 (CDT)

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Hi, my name is Heather and I am a nursing student at the University of North Dakota. I have found some information regarding the use of Certified Nurse Midwives in the health care setting as both beneficial to maternal and fetal outcomes and being cost effective. I have an interest in childbirth and pursuing midwifery as a career and would appreciate any knowledge or advice on this issue. Gabay & Wolfe (1997) state that Certified Nursing Midwives play an increasingly important role in remedying two different problems in the U.S. obstetric care –the excessive use of costly and often unnecessary medical intervention during birth to normal, low-risk women in U.S. hospitals and our country’s slow progression in improving health status of newborns. Gabay & Wolfe (1997) also state that CNM’s can provide more individualized care that reduces the rate of medical intervention (thus cost), and that the resulting outcomes are comparable to those in births attended by physicians. Spatz (1996) supports this by stating that CNM’s use fetal monitoring less frequently, use fewer medications, perform fewer technical procedures, and are less likely to induce labor, but CNMs still demonstrate infant clinical outcomes that are equivalent to physicians. Furthermore, Cutlip (1997) indicates that the objective of hospital midwifery programs is to offer low-risk patients the level of personal support and individual attention that the CNMs provide, while ensuring physician back-up should a complication develop that exceeds the nurse-midwife’s scope of practice. Thus allowing OB physicians time for more-complicated cases and allowing them to focus on the high-tech births and medical procedures they prefer. Ultimately this provides the patient with the best of both worlds –the personal attention and care a midwife provides with all the backup needed should an emergency arise during labor and delivery. Now that I have this information I would appreciate any response on the use of CNMs in a hospital setting or any personal clinical experience pertaining to this issue. Thank you, Heather, College of Nursing student, University of North Dakota.

Cutlip, K. (1997). Midwifery goes mainstream as hospitals expand options and cut costs. Hospital Topics. 75(3), p.17-21.

Gabay, M., Wolfe, S.M. (1997). Nurse-midwifery: The beneficial alternative. Public Health Reports. 112(5), p.386-394.

Spatz, D.L. (1996). Women’s health: The role of advanced practice nurses in the 21st century. Maternal/Fetal Nursing. 31 (2), p.269-277.

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