Editor's Note: This week, we're celebrating National Midwifery Week! Today's guest post is by local nurse midwife and Friend of EmDo, Leigh Ann Joel. Leigh Ann is a hospital-based CNM who provides a collaborative model of care with obstetricians through Women's Health Alliance. Today, she's sharing one of the ways that she provides local families with the best care possible.
Let me tell you why I love collaborative care ...
I‘ve wanted to deliver babies since I was nine. I can’t tell you why, but I just did. I still do. It may have had something to do with Little House on the Prairie, but that’s another blog for another day. I became a nurse so I could be a labor and delivery nurse. I became a midwife so I could catch the babies! I was tired of stepping aside for the big moment. I also didn’t always like the way I saw women treated, but that was more than 20 years ago. Even before I was wise, I knew that no matter what was happening, birthing women needed to feel safe, cared-for, and heard.
I knew women’s bodies and the process of birth demanded respect.
Birth is Normal. It is. Pregnancy and birth are physiologic processes, except when they aren’t. Breathing, seeing, eating, walking, peeing, pooping, menstruating are also normal physiologic processes unless something goes wrong. We might be uncomfortable, or maybe we’re truly sick. We turn to medicine, in all it’s different forms, to help us stay safe and get back on track.
In fact, every one of our body systems has a medical specialty devoted to it. The specialists we turn to spend years preparing and practicing so they can help us. Fortunately for mothers and babies, so does the field of obstetrics.
In a collaborative practice where obstetricians and nurse-midwives are each able to do what they do best, everyone benefits. Of course the specialties of midwifery and obstetrics have a huge territory of overlap. This is fabulous and means more choices for families. Between us, midwives and obstetricians, we’ve got it covered.
As a midwife, my specialty is keeping low-risk women low-risk, and not turning them into high-risk women with unnecessary medical intervention. I’m not afraid of technology. I appreciate it, but I use it judiciously and with intent. Usually, if I give a mom education, support, and guidance, along with my hard-earned expertise, she will almost always make the best choice for herself and her family.
Perhaps a mama wants support for a natural birth, standing at the bedside, without an IV, drugs, or continuous fetal monitoring. Bring it on! This is my specialty. Perhaps mom wants an elective induction, with an epidural, and doesn’t want to feel a thing. She has other demands on her energy. She needs her baby born so she can get back home and get on with things. That’s great too. I will make sure both mamas understand the risks and benefits of intervention, or lack thereof. I will give them information, and I will share my experience. I will do my best to keep them safe and healthy. They will make their own choices and both will feel well cared for and supported.
But maybe a mama starts out planning an unmedicated birth, and after 48 hours she has a fever, she’s exhausted, and the baby’s heartbeat pattern is worrisome. With supportive physicians who respect me and trust my practice, I can collaborate. I can have a discussion with the physician I’m on-call with at the hospital and utilize their specialized medical knowledge and skill.
Together, we provide the best care.
Maybe I know the mama needs antibiotics, but I want to review the best drug choice and dose to treat her infection. Maybe I want a physician present for the birth with an extra set of hands, or maybe we need to deliver baby quickly with the help of forceps, vacuum, or a C-section.
Maybe that very same physician is caring for a patient that has been pushing for 3 hours. She might collaborate with me for some “midwife tricks” to get the baby to rotate and be born. Maybe that “trick” is just patience, or maybe I’ll share some others I have up my sleeve.
With collaborative practice, midwives and obstetricians work together, support each other, and learn from each other.
We never stop learning.
In my practice, patients can have the care and attention they need from a midwife, but the safety net of a hospital and a physician who is immediately available, who knows their medical history.
Our patients never stop benefitting from the best of both worlds.