An old tradition may be turning into a more common solution for the rural shortage of obstetrical services: midwifery. Data from the American College of Nurse-Midwives shows "The number of family medicine physicians and ob/gyns delivering babies in rural areas continues to decline, but nationwide, from 1996 to 2006 when the most recent data was collected, the number of births attended by certified midwives increased by 33 percent, reaching a record high of 317,168 in 2006," Candi Helseth reports for the Rural Monitor Newsletter.
The original midwifery model focused on rural outreach when Frontier Nursing Service founder Mary Breckinridge opened the first American midwifery school in Eastern Kentucky's Leslie County in 1925. Today, the Frontier School of Midwifery and Family Nursing, an outgrowth of the original FNS, still has a rural focus, "with its operation of a college that offers graduate level nursing-related degrees and a rural health service that includes five clinics, home health, and a 25-bed critical access hospital where CNMs deliver babies," Helseth writes. While midwifery is most commonly associated with birthing, the midwife model of care focuses heavily on prevention and education, Helseth reports.
"We guide women, educate them, counsel them and empower them. We provide evidence-based care. And we consider pregnancy and birth a normal process," Juliana Fehr, who heads the Nurse Midwife Initiative at Shenandoah University in Winchester, Va., told Helseth. "We want them to have their babies the way they choose." One challenge facing midwifes is regulations that vary widely from state to state. "The medical system needs to include midwives with nurse practitioners, physicians and other medical providers as part of a health care network that works in collaboration as a team providing a safe place for the woman and baby," Fehr told Helseth. "The major gap in those teams right now in many states is the midwife. Too often, she’s still not there." (Read more)
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