Midwifery Care from the Client’s Perspective

by Melissa Garvey, ACNM Writer and Editor

Our friends at Science and Sensibility have an interesting post that should be generating more discussion. The post explores certified nurse-midwife Mary Ellen Doherty’s study in the Journal of Perinatal Education called “Midwifery Care: Reflections of Midwifery Clients.”

Doherty conducted her study to describe the experiences of women who chose midwives as their health care providers throughout the lifespan. She and her team interviewed 12 women who had received prenatal, birth, postnatal, well-woman gynecologic, contraceptive, and primary health care services from midwives.

Five themes emerged from the data. As a member of the ACNM communications team, I’m particularly interested in two of them: 1) decision to seek midwifery care and 2) midwives as primary health care providers throughout the lifespan.

What Makes Women Choose Midwives?

That’s the million-dollar question here at ACNM. We exist to support and promote certified nurse-midwives and certified midwives. We know midwifery patients are extremely satisfied with their care. But how do we get a woman who has never considered a midwife to realize what she’s missing?

The women in Doherty’s study said they chose a midwife because of:

• a brochure from a midwifery practice along with one from ACNM that exuded “competence, confidence, compassion, and kindness.” (Go, ACNM Communications Department!)
• the recommendation of friends who had already given birth and had a positive experience with midwifery.
• an obstetrician’s recommendation.
• an insurance company’s recommendation.
  

Midwives as Primary Health Care Providers

All 12 of the women in this study discovered that midwives provide services beyond prenatal, birth, and postnatal care. Just among this sample of 12 women, midwifery services included:

• Contraceptive care
• Treatment for vaginal infections
• Flu shot administration
• Throat culture
• Annual exam
• Pap smear
• Treatment referral and support for postpartum depression
• Other health care referrals and recommendations for both patient and family members
  

Because this study was a phenomenological study, small sample size is not considered a limitation. However, Doherty notes that because her study focused on a “self-selective and purposive sample,” its results are not representative of all women. The majority of women were Caucasian, highly educated, married to their child’s father, and self-identified as “middle class.” Still, there’s a lot to learn from their answers…

…and a lot to add! Here’s where you chime in. What made you decide to choose a midwife? And what health care services do you receive from your midwife?

How to Brand Midwifery

by Melissa Garvey, ACNM Writer and Editor

This week I came across an interesting post by Sam Ford about the problem many midwives and their supporters struggle with every day. How do you clearly communicate what a midwife is? It’s a loaded term with all sorts of cultural baggage and preconceptions, which typically triggers associations like home birth and no pain control.

Ford’s post didn’t grab my attention merely because of the subject matter. Many people who have come before him have astutely pointed out that the midwife brand needs a makeover. In fact, ACNM members say that limited public awareness of midwifery is the number-one barrier to practice. What impressed me is that Ford actually took a stab at evaluating why existing advocacy campaigns and PR initiatives have not made a large impact on the US public.

The biggest hurdle to overcome is that many have painted midwifery in extremes: as only for parents who completely oppose medical intervention, almost as eschewing all that modern medicine and technology has given us.

A thoughtful follow-up post at Babble.com further articulates the problem:

As a culture, we tend to see only the extremes. We love a good, clear fight, even at the expense of facts. When it comes to birth, there are “the crunchies” and there are “the medicalized maniacs.”

In between these two extremes is where you’ll find the majority of modern midwives. What does that look like? It depends. Midwives serve as primary care providers, giving annual exams, reproductive health services, and family planning counseling to women of all ages. Most midwives work in hospitals. Some work in birth centers or homes. They can order medications, ultrasounds, and epidurals. They exercise those privileges when needed or when requested by the mother. Most midwives spend a longer amount of time with their patients—just like nurse practitioners tend to give longer annual exams than OBGYNs.

How do you boil that down into a brand? It’s complicated. Try choosing a picture to represent midwifery. Should the midwife be a woman or a man? Should s/he be wearing a white lab coat, scrubs, professional attire, or casual dress? Should his or her patient be a teenager, a pregnant woman, or an older woman going through menopause? Even among ACNM staff, there are wide variations of opinion on this topic.

It’s almost as if there’s too much information to shove into a brand. At ACNM, we’re pouring resources into raising public awareness of midwifery. We just launched Evidence-Based Practice: Pearls of Midwifery. Last year we released midwifery postage stamps We’re vamping up our media relations and social media efforts. But there’s still more work to be done.

In your view, what is it that defines midwifery? Do you think it’s possible to rebrand midwifery in America?

The Evidence is In: Texting Helps Teen Moms

by Melissa Garvey, ACNM Writer and Editor

In February, ACNM signed on as an outreach partner with Text4Baby and I posed the question, “Do you expect Text4Baby to make a meaningful difference in the lives of women and their babies?” I found the answer this week on MTV’s 16 and Pregnant. Watch the clip below for an inside look at how Text4Baby is, without a doubt, making a difference.

MTV Shows

Text “BABY” to 511411 to sign up for free.

Seattle, Here We Come!

It’s time for midwives and their fans to start getting excited about the ACNM 54th Annual Meeting & Exposition. This special annual event is geared toward midwives and other women’s health experts, but also includes free activities for anyone interested in midwifery and women’s health. Here’s what you can look forward to:

Become a Midwife Forum
If you’re interested in a career in women’s health, visit the Washington State Convention & Trade Center for a free, interactive career event on Saturday, May 23, noon – 3 pm. Meet practicing midwives, interact with student midwives, and experiment with birth simulators, pelvic models, and more.


Celebrate Midwifery Party
If you already went to midwifery school, show your school spirit at the Celebrate Midwifery Party, Monday, May 25, 8 pm – midnight. The school that shows the most spirit will win a free student registration to the 55th ACNM Annual Meeting in Washington, DC. Start celebrating now by submitting song requests to ylandon@acnm.org. Include your name, school, and requested song. You may also dedicate the song to a particular person or class.
This event is open to registered meeting attendees only.


Tuesday Night at the Movies
Come to the Sheraton Seattle Hotel, Metropolitan Ballroom A, Tuesday, May 26, 7:30 pm – 10:30 pm for free admission to two pregnancy and birth films: Home Delivery and Laboring Under an Illusion: Portrayal of Childbirth in the Mass Media.