Certified Nurse-Midwives
Amy Meier, CNM, MSN
Kay Smolley, CNM, MSN
200 West Campbell Avenue, Campbell
(408) 583-0522
Philosophy of Nurse-Midwifery Care:
a. Childbirth is a normal, physiological process
b. Individualized care
c. Strong emphasis on informed consent & patient education
History of Nurse-Midwifery in America
a. Mary Breckenridge & the Frontier Nursing Service in 1925 - first midwifery practice
b. Expansion in 1940’s – 1950’s
1) Shortage of OB’s
2) Increased access to health insurance
3) Childbirth Without Fear was written in 1944 by Dick-Read
c. 1954 – American College of Nurse-Midwives (ACNM) was founded
d. CNMs practicing in California since 1960 - Madera County
e. By 1984, nurse-midwives practicing in all 50 states
Our Background/ Education
a. Graduate Education
b. Board Exam –American Midwifery Certification Board
c. Currently primary provider in 11.3% of all births in state of California in 2004 (>43,000 births) & 8% of all births in US in 2005 (>306,000 births)
d. >4000 CNMs in clinical practice in U.S. & approx 877 in CA
e. 97% of CNM births occur in hospitals, 1.8% in freestanding birth centers, 1.1% in homes
Outcomes
a. Nurse-midwifery care is just as safe as care by a physician; Over 50 published studies
b. Refer to articles provided. Studies look at outcomes including neonatal mortality, low birthweight, cesarean section, use of resources & show that CNMs provide a safe & cost effective alternative for maternity care particularly for low to moderate risk women.
CNM Care
a. Caseload – includes anterpartum, intrapartum, postpartum & gyn/family planning
b. Typical Prenatal Visit
c. Typical Birth
Scope of Practice
a. Consultation – first trimester bleeding, pelvic inflammatory disease, social induction
b. Collaboration – gestational diabetes, mild preeclampsia, VBAC, chorioanionitis
c. Referral – preterm <35 weeks gestation, instrumental or operative delivery, severe preeclampsia, ectopic pregnancies, placenta previa, breech, twins (for some CNM practices, twins are eligible for collaborative care)
d. Training for obstetrical emergencies – shoulder dystocia, hemorrhage, cord prolapse
Nurse-Midwives in the area
a. Our practice – Cedar OB/Gyn, www.cedarobgyn.com
b. West Valley Women’s Health, Los Gatos
c. Altos Oaks Medical Group
d. Kaiser Permanente, Santa Teresa, Redwood City
e. Yelena Kolodji – home birth midwife
f. To come: freestanding birth center, Sanctuary Birth
g. Find a Midwife: www.midwife.org, “For Consumers”