HEALTH CARE: Midwives -Tradition & Technology

TRAVERSE CITY – Pam Bradshaw describes her practice as a place where East meets West.

As one of several certified nurse midwives in the area that offers deliveries in a hospital setting, her patients are able to choose health care that blends both tradition and technology.

“It’s not the most radical delivery, but it’s not the most high-tech either,” Bradshaw, CNM, said, who shares a private practice with Peg Dunn at New Life Nurse Midwifery Service in Traverse City. “I care for women the same as doctors. The difference is the mother and her family and I get to know each other.”

Traditionally, midwives of yesteryear were the only option for many women. But with the onset of medical technology and accessibility, many of today’s mothers grew up in a time when birth in a hospital was the standard choice. There is a huge difference, however, in what today’s midwives have to offer.

“When people think of traditional midwives, many think they are not formally educated,” said CNM Jan McAllister, who was certified through the American College of Nurse Midwives (ACNM).

Studies by the ACNM show that 68 percent of all CNMs have a master’s degree and four percent have a doctoral degree. Each year, over 400 CNMs pass the national certification exam–a number that has increased by 25 percent each year since 1991.

As the number and education of midwives increase, women all over Michigan are exercising their choices in prenatal and birth care.

“Women have a lot of choices that they didn’t have before,” McAllister said, who has witnessed the number of obstetric care providers double in the last six years locally. “Some women want no intervention at all during birth, while others want every gizmo and gadget related to birth. Our goal is to provide individualized prenatal and women’s health care to meet their needs.”

And meeting the needs of many women means combining midwifery tradition with medical technology.

Mary Gadbaw Davis, CNM, MSN, works with each of her mothers to determine what amount of technology and tradition they’re comfortable with.

“The mother needs to be where she feels absolutely the safest,” Davis said. “Women are meant to have babies, but there is a lot of fear and pain associated with birth. But being a hospital doesn’t make the fear go away.”

Davis contends one of the best ways to alleviate the fear associated with birth is to layout a “birth plan,” which depicts how much medical intervention the mother wants.

The difference in Davis’ practice is that she doesn’t actually deliver the baby in hospital births. Because she doesn’t have hospital privileges, a family care physician delivers the baby while Davis stands by for labor support. The essential aspect is that Davis remains the one consistent person throughout the mother’s birth.

“I have the doctor read the birth plan and gently let anyone know if they violate it,” she explained. “It gives the mother a sense of control over an environment that doesn’t allow a whole lot of control. My job is to create an environment where the mom feels they can let go and still be supported.”

This network of support is the fundamental difference that most midwives identify in their practice. With longer appointments and a greater exploration of personal preferences and fears, not only does the mother get to know the midwife, but her family does as well.

“The biggest part of providing care is being able to sit down and talk with the mother and family,” McAllister said. “My job is to teach women to keep themselves healthy, the baby healthy and be informed about the choices they need to make.”

All of McAllister’s deliveries are done at Munson, where she has hospital privileges. She also works one day a week at Kalkaska Memorial Health Center with women who eventually come to Munson for delivery. McAllister enjoys the combination of a private practice and hospital privileges and has a great working relationship with consulting physicians.

McAllister recently began her private practice after Munson discontinued its Nurse Midwifery Service. The service was started in 1992 to meet the needs of Medicaid patients at a time when very few physicians were taking new or Medicaid patients. But with the surge in providers in the last six years and increased coverage by insurance providers, Munson decided to instead offer hospital privileges to four certified nurse midwives, according to McAllister. Other midwives in the area offer home births and other combinations.

Regardless of where a birth takes place, Bradshaw contends, “It’s just neat being invited to someone’s birth.” BIZNEWS