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Certified nurse midwife

Esther Hing, Ellen Kurtzman, Denys T Lau, Caroline Taplin, Andrew B Bindman
Objective-This report describes the characteristics of primary care physicians in patient-centered medical home (PCMH) practices and compares these characteristics with those of primary care physicians in non-PCMH practices. Methods-The data presented in this report were collected during the induction interview for the 2013 National Ambulatory Medical Care Survey, a national probability sample survey of nonfederal physicians who see patients in office settings in the United States. Analyses exclude anesthesiologists, radiologists, pathologists, and physicians in community health centers...
February 2017: National Health Statistics Reports
Molly R Altman, Sean M Murphy, Cynthia E Fitzgerald, H Frank Andersen, Kenn B Daratha
INTRODUCTION: Obstetrical care often involves multiple expensive, and often elective, interventions that may increase costs to patients, payers and the health care system with little effect on patient outcomes. The objectives of this study were to examine the following hospital related outcomes: 1) use of labor and birth interventions, 2) inpatient duration of stay, and 3) total direct health care costs for patients attended by a certified nurse-midwife (CNM) compared with those attended by an obstetrician-gynecologist (OB-GYN), within an environment of safe and high-quality care...
February 15, 2017: Women's Health Issues: Official Publication of the Jacobs Institute of Women's Health
Mavis N Schorn, Mary S Dietrich, Beth Donaghey, Ann F Minnick
INTRODUCTION: The prevalence of postpartum hemorrhage has increased in the United States despite the international promotion of active management of the third stage of labor. Adherence to the international recommendations in the United States is unclear. It is also not known how the components of active management are related to other practices that may be used during the third stage of labor. The purpose of this study was to determine routine practice patterns for managing the third stage of labor in the United States...
January 2017: Journal of Midwifery & Women's Health
Nicole S Carlson, Elizabeth J Corwin, Nancy K Lowe
BACKGROUND: Women who are obese have slower labors than women of normal weight, and show reduced response to interventions designed to speed labor progress like oxytocin augmentation and artificial rupture of membranes. The optimal labor management for these women has not been described. METHODS: This retrospective cohort study compared 2 propensity score-matched groups of women (N = 360) who were healthy, nulliparous, spontaneously laboring, and obese (body mass index ≥ 30 kg/m(2) )...
January 2017: Journal of Midwifery & Women's Health
Glenn E Palomaki, Edward M Kloza, Barbara M O'Brien, Elizabeth E Eklund, Geralyn M Lambert-Messerlian
OBJECTIVE: To assess the clinical utility of cell-free DNA (cfDNA)-based screening for aneuploidies offered through primary obstetrical care providers to a general pregnancy population. METHODS: Patient educational materials were developed and validated and providers were trained. Serum was collected for reflexive testing of cfDNA failures. Providers and patients were surveyed concerning knowledge, decision making, and satisfaction. Pregnancy outcome was determined by active or passive ascertainment...
January 12, 2017: Genetics in Medicine: Official Journal of the American College of Medical Genetics
Lisbet S Lundsberg, Jessica L Illuzzi, Aileen M Gariepy, Sangini S Sheth, Christian M Pettker, Henry C Lee, Heather S Lipkind, Xiao Xu
OBJECTIVE: To examine hospital variation in intrapartum care and its relationship with cesarean rates. DESIGN: Cross-sectional survey. SETTING: Connecticut and Massachusetts hospitals providing obstetric services. PARTICIPANTS: Nurse managers or other clinical staff knowledgeable about intrapartum care. METHODS: We assessed labor and delivery unit capacity and staffing, fetal monitoring, labor management, intrapartum interventions, newborn care, quality assurance, and performance review practices...
January 2017: Journal of Obstetric, Gynecologic, and Neonatal Nursing: JOGNN
Naoko Kozuki, Luke C Mullany, Subarna K Khatry, Ram K Ghimire, Sharma Paudel, Karin Blakemore, Christine Bird, James M Tielsch, Steven C LeClerq, Joanne Katz
OBJECTIVE: To assess the feasibility of ultrasonographic task shifting by estimating the accuracy at which primary-level health care workers can perform community-based third-trimester ultrasound diagnosis for selected obstetric risk factors in rural Nepal. METHODS: Three auxiliary nurse-midwives received two 1-week ultrasound trainings at Tribhuvan University Teaching Hospital in Kathmandu. At a study site in rural Nepal, pregnant women who were 32 weeks of gestation or greater were enrolled and received ultrasound examinations from the auxiliary nurse-midwives during home visits...
September 2016: Obstetrics and Gynecology
(no author information available yet)
In the United States, approximately 35,000 births (0.9%) per year occur in the home. Approximately one fourth of these births are unplanned or unattended. Although the American College of Obstetricians and Gynecologists believes that hospitals and accredited birth centers are the safest settings for birth, each woman has the right to make a medically informed decision about delivery. Importantly, women should be informed that several factors are critical to reducing perinatal mortality rates and achieving favorable home birth outcomes...
2016: Obstetrics and Gynecology
(no author information available yet)
In the United States, approximately 35,000 births (0.9%) per year occur in the home. Approximately one fourth of these births are unplanned or unattended. Although the American College of Obstetricians and Gynecologists believes that hospitals and accredited birth centers are the safest settings for birth, each woman has the right to make a medically informed decision about delivery. Importantly, women should be informed that several factors are critical to reducing perinatal mortality rates and achieving favorable home birth outcomes...
August 2016: Obstetrics and Gynecology
Sarah Verbiest, Erin McClain, Alison Stuebe, M Kathryn Menard
Objectives Our pilot study aimed to build knowledge of the postpartum health needs of mothers with infants in a newborn intensive care unit (NICU). Methods Between May 2008 and December 2009, a Certified Nurse Midwife was available during workday hours to provide health care services to mothers visiting their infants in the NICU at a large tertiary care center. Results A total of 424 health service encounters were recorded. Maternal requests for services covered a wide variety of needs, with primary care being the most common...
November 2016: Maternal and Child Health Journal
Eline H Wilson, Chris Farrell, Ruth E Zielinski, Bernard Gonik
OBJECTIVE: To examine the practices and attitudes of obstetric providers in the state of Michigan on their approach to perinatal oral health. METHODS: An online survey was distributed using health care provider databases in the state of Michigan. Descriptive statistics were tabulated and Fisher's Exact Test was used for categorical variables. RESULTS: There were 146 respondents, 80 obstetrician-gynecologist (OB/GYN) and 66 certified nurse midwife (CNM) providers...
July 11, 2016: Journal of Maternal-fetal & Neonatal Medicine
Amos Grünebaum, Laurence B McCullough, Birgit Arabin, Robert L Brent, Malcolm I Levene, Frank A Chervenak
INTRODUCTION: Over the last decade, planned home births in the United States (US) have increased, and have been associated with increased neonatal mortality and other morbidities. In a previous study we reported that neonatal mortality is increased in planned home births but we did not perform an analysis for the presence of professional certification status. PURPOSE: The objective of this study therefore was to undertake an analysis to determine whether the professional certification status of midwives or the home birth setting are more closely associated with the increased neonatal mortality of planned midwife-attended home births in the United States...
2016: PloS One
Cheri Van Hoover, Lisa Holt
Historically, midwives held an important role in society as cradle-to-grave practitioners who eased individuals, families, and communities through difficult transitions across the life span. In the United States, during the first half of the 20th century, physicians assumed care for people during birth and death, moving these elements of the human experience from homes into the hospital setting. These changes in practice resulted in a dehumanization of birth and death experiences and led to detachment from what it means to be human among members of society...
May 2016: Journal of Midwifery & Women's Health
Bridget Spelke, Adrienne D Zertuche, Roger Rochat
Objectives In 2010, Georgia had the nation's highest maternal mortality rate, sixteenth highest infant mortality rate, and a waning obstetrician/gynecologist (ob/gyn) workforce. Statewide ob/gyn workforce data, however, masked obstetric-specific care shortages and regional variation in obstetric services. The Georgia Maternal and Infant Health Research Group thereby assessed each Georgia region's obstetric provider workforce to identify service-deficient areas. Methods We identified 63 birthing facilities in the 82 Primary Care Service Areas (PCSAs) outside metropolitan Atlanta and interviewed nurse managers and others to assess the age, sex, and expected departure year of each delivering professional...
July 2016: Maternal and Child Health Journal
Bobbie Posmontier, Richard Neugebauer, Scott Stuart, Jesse Chittams, Rita Shaughnessy
INTRODUCTION: Postpartum depression (PPD) affects 7% to 13% of childbearing women. Access to care may be limited by maternal time constraints and fears of being judged, labeled as mentally ill, and having their infants taken away. The study's objective was to test the feasibility, effectiveness, and acceptability of certified nurse-midwife telephone-administered interpersonal psychotherapy (CNM-IPT) as a treatment for PPD. METHODS: A prospective cohort study was conducted from 2010 to 2014...
July 2016: Journal of Midwifery & Women's Health
Y Tony Yang, Laura B Attanasio, Katy B Kozhimannil
BACKGROUND: Despite research indicating that health, cost, and quality of care outcomes in midwife-led maternity care are comparable with and in some case preferable to those for patients with physician-led care, midwifery plays a more important role in some U.S. states than in others. However, this variability is not well-understood. OBJECTIVES: This study estimates the association between state scope of practice laws related to the autonomy of midwifery practice with the certified nurse-midwifery (CNM) workforce, access to midwife-attended births, and childbirth-related procedures and outcomes...
May 2016: Women's Health Issues: Official Publication of the Jacobs Institute of Women's Health
Giuseppe Chiossi, Stefano Palomba, Sara Balduzzi, Maged M Costantine, Angela I Falbo, Giovanni B La Sala
Objective To investigate whether different antenatal care models could account for differences in operative delivery rates and adverse neonatal outcomes among low-risk pregnant women, and to identify independent variables associated with delivery modes and adverse neonatal outcomes. Study design Retrospective cohort from a single center of singleton, term, live births between January 2012 and June 2014. Rates of cesarean deliveries, operative vaginal deliveries, and neonatal morbidities were analyzed among women followed by private obstetrician-gynecologists versus national health system providers (certified nurse midwifes supervised by obstetrician-gynecologists), and adjusted for potential confounders...
June 2016: American Journal of Perinatology
Kathryn L Andersen, Indira Basnett, Dirgha Raj Shrestha, Meena Kumari Shrestha, Mukta Shah, Shilu Aryal
INTRODUCTION: The termination of unwanted pregnancies up to 12 weeks' gestation became legal in Nepal in 2002. Many interventions have taken place to expand access to comprehensive abortion care services. However, comprehensive abortion care services remain out of reach for women in rural and remote areas. This article describes a training and support strategy to train auxiliary nurse-midwives (ANMs), already certified as skilled birth attendants, as medical abortion providers and expand geographic access to safe abortion care to the community level in Nepal...
March 2016: Journal of Midwifery & Women's Health
Susan A DeJoy, Heather Z Sankey, Anissa E Dickerson, Audrey Psaltis, Amy Galli, Ronald T Burkman
This article examines the history and present state of the midwife as laborist. The role of the midwife and obstetrician laborist/hospitalist is rapidly evolving due to the need to improve patient safety and provide direct care due to reduced resident work hours, as well as practice demands experienced by community providers and other factors. Models under development are customized to meet the needs of different communities and hospitals. Midwives are playing a prominent role in many laborist/hospitalist practices as the first-line hospital provider or as part of a team with physicians...
November 2015: Journal of Midwifery & Women's Health
Susanna R Cohen, Celeste R Thomas, Claudia Gerard
There is a national shortage of women's health and primary care providers in the United States, including certified nurse-midwives and certified midwives. This shortage is directly related to how many students can be trained within the existing system. The current model of midwifery clinical training is based on apprenticeship, with one-on-one interaction between a student and preceptor. Thus, the number of newly trained midwifery providers is limited by the number of available and willing preceptors. The clinical learning dyad model (CLDM), which pairs 2 beginning midwifery students with one preceptor in a busy practice, addresses this problem...
November 2015: Journal of Midwifery & Women's Health
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