Collaboration among different health care specialists is key to effective health care, especially when it comes to a woman giving birth. Everyone wants the best care possible for mother and child. Now, one University of Minnesota researcher is investigating the best way to provide collaborative care by improving the clinical environment into which babies are born.
Health Talk recently spoke to Melissa Avery, Ph.D., R.N., C.N.M., professor and chair of the Child and Family Health Cooperative in the University of Minnesota School of Nursing to discuss her latest research. Here’s what she told us:
HT: Why is there a need to reevaluate the current maternity care model?
MA: We’re in a complex healthcare system where outcomes for the entire country are not exactly what we’d like. The U.S. infant mortality rate is higher than most other developed countries. The cesarean section rate is nearly 33 percent. We’re also facing a predicted shortage of maternity care providers in the future. So, looking at the current care model and how it could be improved might help us provide better maternity care to all women.
You’ve recently put together a new analysis looking at how midwives and obstetricians (ob-gyn physicians) can successfully collaborate in maternity care models. What did your analysis find?
We found that important pieces of a successful collaborative maternity care model include: mutual respect and trust between midwives and obstetricians making it easier to share responsibilities, and a need for regulations that allow midwives to practice their full scope of care to promote successful collaboration. We also found that collaborative practice not only works, but it can also lead to improved patient outcomes.
Which parts of your recommended model are different from what we’re currently doing?
Most births in the U.S. are currently performed by physicians—the majority of whom are obstetricians. Nurse-midwives only attend 8 percent of all births in the United States. Given that most women have healthy, low-risk pregnancies and healthy babies, 50 to 70 percent of births could conceivably be attended by midwives. When complications do arise, midwives consult with obstetricians and other health professionals. So, basically, more midwife involvement where nurse-midwives are full partners in collaborative practices with physicians would be different from the current U.S. model.
Evidence supports midwives as safe and high quality care providers and that they can be a good way of delivering quality care at a good value.