Nurse-midwifery grows in popularity with mothers and students
When Amanda Tam told her mother that she planned to have her first baby with a certified nurse-midwife, her mother asked a simple question: “Why wouldn’t you go to a doctor?” That response was mild compared to those people in Tam’s family who told her she was “crazy.”
Today, more than three years, two babies and 19 hours of labor later, Tam is a true believer in the advantages of bringing a baby into the world with a midwife. “A midwife sits with you through the entire labor,” she said. “Midwives understand that it’s important to let your body do what it naturally wants to do.”
Tam made a personal choice, but she is part of a growing trend. According to a recent study published in the Journal of Midwifery and Women’s Health, midwives attended the births of 8.1 percent of the country’s babies in 2009—a record high.
That trend is also apparent in the University of Colorado’s two faculty midwifery practices, both of which attend births at the University of Colorado Hospital. The Center for Midwifery (CFM), a boutique private practice, opened in 2005 with two practicing midwives. During its first month, CFM had five births. Today, the center has five full-time certified nurse-midwives and brings 35-50 babies into the world each month.
“Midwives have been ‘catching’ babies forever,” said Jessica Anderson, MSN, assistant service director at the center. “We don’t say ‘delivering’ babies, because we are just there to be with women and families.”
The original faculty practice, the University Nurse Midwives (UNM), cares for middle-income women and the underserved in the metro Denver area, including refugee and low-income women. With 20 certified nurse-midwives on staff, UNM handles 60-80 births every month.
“Our patients learn, when they receive care in our practice, that we take the time to listen, to educate and to support their health,” said Amy Nacht, associate director at UNM. “We connect them with community resources and provide comprehensive women’s health care.”
Class of 2013
CU College of Nursing student Stacy Moore, RN, who plans to complete her studies to be a certified nurse-midwife in August, has helped deliver more than 15 babies, but she still remembers the first time she guided the baby with only her hands and no assistance.
“It was an amazing experience and nerve-racking at the same time, because you literally have this life in your hands,” she said. ”Those nerves, though, should never really stop, no matter how many babies you catch.”
Moore traces her interest in women’s health to an undergraduate experience shadowing a physician in Ecuador who ran a non-profit agency serving pregnant teenage girls. “I remember helping a woman during labor,” she said. “I had no experience, so I was in shock. I was in awe of both the physician and the woman giving birth.”
After two and a half years as an emergency department nurse in South Carolina, Moore decided to move across the country to attend school at the Anschutz Medical Campus. “I love the mountains, I wanted to live out west and CU [College of Nursing] had one of the top [certified nurse-midwifery] programs in the nation.”
Ask what made the program so appealing, and Moore doesn’t hesitate to praise the faculty and the large variety of clinical experiences she received at the two very different midwifery practices located on one campus. “It didn’t feel like I was in one place with one clinical experience,” said Moore. “Having two different practices with distinct patient populations allows us the opportunity to have a variety of experiences as if we’re at separate locations.”
Moore also believes her training has given her room to develop her own style of bringing babies into the world. “There’s a lot of art in obstetrics,” she said. “So there’s room for your personal touch.”
Jessica Anderson found her calling to become a certified nurse-midwife when she was working as a nurse and began to wonder if women were being given enough voice in their labor and delivery. “I had to ask myself ‘Are we really honoring the process of childbirth? Can I do this for 20 more years and bite my tongue?’ The answer was ‘No.’”
Anderson describes the relationship between a pregnant woman and a certified nurse-midwife as a “partnership.”
“We go through the journey together and make decisions together, spend time talking about labor, about birth, about becoming parents,” she said. “There’s no magic to what we do. We guide families.”
She points out that the university’s nurse-midwives provide the same standard of care as a woman seeing an obstetrician/gynecologist would receive. If it is needed, midwives refer a woman to a physician at any point in the pregnancy or labor.
CFM is the only hospital midwifery practice in the Denver metro area to offer water births, an option that Amanda Tam used for her second child. She labored in a tub, covered with water to her chest.
“It was warm, buoyant and eased my pain,” she said. “When the baby was born I reached down and grabbed him and lifted him out of the water before he took his first breath.”
The College of Nursing nurse-midwife graduate program has space for 12 students in each class, with 11 currently enrolled. The program could take from 12 to 24 months to complete, because requirements vary for post-master’s students. Nancy Lowe, PhD, chair of the Division of Women, Children and Family Health in the College of Nursing, believes that graduating students are in a perfect position to practice what they have learned.
“We’re in a midwife-friendly state, and our students have had experience both in the classroom and in their clinicals with two thriving, stable faculty practices,” she said. Those students who might want to continue to earn a PhD also have the opportunity to observe faculty nurse-midwives doing research, like the work Marie Hastings-Tolsma, PhD, is doing on a Fulbright Award in South Africa.
Because of their varied clinical experience, students who graduate from the program can go into the community of their choice and provide care to a diverse range of patients. “We want them to be culturally competent,” said Nacht. “Here they will learn to care for both an educated population and an underserved population, and they will leave feeling confident they can handle themselves in both environments.”
Today, Amanda Tam has two healthy sons, 3-year-old Oliver and 14-month old Nolan. Her mother, who watched her deliver both boys, has a new attitude toward nurse-midwives.
“My mom had three C-sections, so she never saw a baby born,” said Tam. “She has a lot more respect for women who give birth and what midwives do. This changed her.”