18-YEAR REVIEW SHOWS OVERWHELMING EVIDENCE OF HIGH-QUALITY CARE OF CERTIFIED NURSE-MIDWIVES
A systematic review to be published in the September/October 2011 issue of Nursing Economic$ reports that care provided by certified nurse-midwives (CNMs) is associated with comparable or better outcomes than care managed exclusively by physicians.
OF HIGH-QUALITY CARE OF CERTIFIED NURSE-MIDWIVES
Silver Spring, MD – A systematic review published in the September/October 2011 issue of Nursing Economic$ reports that care provided by certified nurse-midwives (CNMs) is associated with comparable or better outcomes than care managed exclusively by physicians. The findings were included in “Advanced Practice Nurse Outcomes 1990-2008: A Systematic Review,” authored by Robin P. Newhouse, PhD, RN, NEA-BC, et.al. The review is the first of its kind in 20 years.
Through a comprehensive evaluation of the evidence from 21 studies of CNM care, the review concludes that there is high quality evidence that women cared for by CNMs are less likely to experience a cesarean delivery, episiotomy, or severe perineal trauma. Women cared for by CNMs are also more likely to choose non-pharmacologic approaches to manage pain, and they have higher breastfeeding rates.
CNMs are licensed to practice and write prescriptions in all 50 states, territories, and the District of Columbia. Under federal law and in many states, they are recognized as advanced practice nurses (APNs). Nurse practitioners, nurse anesthetists, and clinical nurse specialists are also considered APNs. A growing number of states also recognize certified midwives (CMs). CMs have the same midwifery education and scope of practice as CNMs; they come from a variety of backgrounds other than nursing. Global standards have recently confirmed that nursing education is not a pre-requisite for midwifery practice.
CNMs and CMs are primary care providers for women throughout the lifespan, with a special emphasis on pregnancy, childbirth, and gynecologic and reproductive health. While most CNMs and CMs provide care for women who give birth in hospitals, many also attend births in birth centers and at home. The word “midwife” means “with woman.”
“It is exciting to see decades of research on midwifery care summarized and reviewed in this systematic review,” says ACNM President Holly Powell Kennedy, CNM, PhD, FACNM, FAAN. “The question is not whether CNMs and CMs provide excellent care—the research demonstrates consistently and overwhelmingly that they do. Our challenge is how to use this information. Every woman deserves midwifery care and some may require the services of an obstetrician. Partnering with the American College of Obstetricians and Gynecologists, ACNM is working to disseminate successful models of collaboration between midwives and obstetricians. It’s time to optimize our maternity care workforce so that all women have access to quality care.”
The study appeared in the September/October 2011 issue of Nursing Economic$ (Vol. 29, No. 5).