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Groundbreaking Nurse Midwives Program Helps UI Health Close In On 'Baby-Friendly' Status

Tuesday, July 16, 2013

Nearly a third of the women who deliver their babies at the University of Illinois Hospital & Health Sciences System give birth without a physician's care. Instead, these women receive their care during pregnancy and childbirth from UI Health's nurse midwives service, the largest practice of its kind in the country.


Now, the midwives are bringing their expertise to the UI Health's efforts to achieve "baby-friendly" status, a highly sought designation offered by the World Health Organization and UNICEF for health systems that support breast feeding, rather than the use of infant formula, which increases risk for childhood obesity and diabetes. Midwives are members of the UI Health's baby-friendly committee.

"Right after we perform a delivery, we put the baby on the mom's chest, and we promote breast feeding within the hour," says Kathleen Harmon, RN, APN, MS, CNM, interim director of the service. "We've been doing it for years. Before it was called 'baby-friendly,' we were already there."

In all, the midwifery service has overseen approximately 12,000 births since midwives received delivery privileges at UI Health in 1992. The service currently includes 16 nurse midwives, all of whom have received advanced training that includes master's degrees, certification as an advanced nurse practitioner and, in some cases, doctoral degrees.

The midwives also are clinical faculty for the College of Nursing Midwifery/Women's Health Practitioner program, which is ranked fifth (of 37) in the nation by U.S. News & World Report. They not only precept student nurse midwives and women's health nurse practitioners, but also UI Health Family Medicine residents, medical students and nursing students, and work very closely with obstetrics and gynecology residents in labor and delivery.

"We're trained to provide care for normal, low-risk pregnancies and deliveries, as well as postpartum care and well woman care for a lifetime," says Penny Feldman, RN, APN, MS, CNM, interim associate director of the service. This care includes the same evaluations women receive from obstetricians, such as blood work, pap smears, physical exams, genetic screenings, and ultrasounds.

The service provides this care at seven locations within the UI Health System. Through their work in these locations, the midwives make care available to a population that includes underserved, socioeconomically disadvantaged women, who are provided care regardless of their ability to pay. "We don't turn anyone away," Feldman says.

The midwives act as patient advocates, seeing to it that, whenever possible and medically safe, each woman has the birth experience she wants, whether it's an all-natural birth, a tub birth or a delivery with full use of anesthesia. In particular, the service is expert in providing care for women who want to have vaginal deliveries after a prior birth by Cesarean section, which is considered a high-risk procedure. In all, more than 70 percent of these patients ultimately are able to deliver vaginally.

"We have women who come from all over the Chicago area seeking us out because we do that," Harmon says.

Such pregnancies are co-managed by UI Health's outstanding ob-gyn physicians, who are experts in high-risk pregnancies. The collaboration between the midwives and these doctors is another strength of the service.

"It's the best of both worlds," says Erin Farah, RN, APN, MS, CNM, interim associate director. "Patients can have that natural experience, but if something were to go wrong, we have a team of experts right down the hall who can step in and help."

At the same time, the service goes beyond most ob-gyn prenatal care in the extent that it educates patients about their pregnancy and delivery. "That education empowers women to believe in their bodies. Women's bodies know what to do, and we help them let their body do it," Harmon says.