Friday, January 30, 2015

Delivering with a midwife

Marie Henderson, CNM, MSN

Now in its 21st year, Mass General's Vincent Obstetrics and Gynecology Nurse-Midwifery Service delivers 26 percent of the babies born at the hospital and participates in the national benchmarking efforts of the American College of Nurse Midwives, where all clinical outcomes are documented. Recently, Mass General was involved in a public service announcement – put together by the college’s Massachusetts affiliate that appeared during an episode of “Call the Midwife,” a public television series chronicling the lives of midwives and their families in London’s East End during the 1950s. Marie Henderson, CNM, MSN, director of the Mass General Nurse-Midwifery Service, explains how midwifery has evolved and is an integral part of a multidisciplinary team at Mass General.

What is the role of the midwife?

A nurse-midwife provides gynecological care, family-planning services and primary care for a
woman throughout her pregnancy, delivery and post partum. Midwives are experts in normal labor and delivery and are trained to identify any deviations from normal. Midwives promote
immediate skin-to-skin contact after birth, breastfeeding within the first hour of life and the bonding of the family unit. After the birth of her baby, we encourage the woman to care for herself and her family by leading an active lifestyle and making appropriate nutritional choices.

What is the history of midwifery at Mass General?

When Mass General opened in 1821, obstetrical patients were not admitted. Women of means and middle-class women had their babies at home. Hospitals were for destitute women who had no safe place in which to give birth. Before the 20th century, traditional midwives were informally trained and attended almost all births. Physicians who attended birth in 1821 were “practitioners of midwifery” and went into the patients’ homes. In the state of Massachusetts, midwifery had been very restrictive. The Commonwealth didn’t issue licenses for
nurse midwives to practice until 1977. Seventeen years later, Obstetrics was established at the MGH along with a multidisciplinary team that included a midwife to provide midwifery care to the low and moderate-risk
childbearing population. 

How has midwifery evolved?

There are 15 midwives at Mass General who continue to be the newest members of the Advanced Practice of Registered Nurses (APRNs) and also leaders in what can happen at the legislative level. The latest regulations of the Board of Nursing states midwives no longer need a supervising physician to practice midwifery but do need a clinical relationship with a physician. One aspect of my job is to make midwifery visible to the Mass General community. I want women to know midwifery care is a great option for childbearing.

Do you think the series “Call the Midwife” has helped the public better understand midwifery?

The series portrays caring, educated and professional women who demonstrate the midwifery skill set and have a clinical relationship with an obstetrician. We chose to do a public service announcement because we wanted viewers to know that midwifery care is an option in this state, and at Mass General. 

Visit the OB-GYN Department website for more information about Mass General's Nurse-Midwifery staff.

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