Cochrane Library Review Emphasizing Benefits of Midwife-Led Care Supports Conclusion of Recent US Midwifery Care Study
American College of Nurse-Midwives Says All Evidence Points to Midwives as Excellent Maternity Care Providers for Moms, Their Babies
Silver Spring, MD – The Cochrane Library’s review concluding that midwife-led care in the United Kingdom (UK) and several other countries offers an excellent maternity care option for women is consistent with a 2012 US study finding that care provided by certified nurse-midwives (CNMs) is safe and effective, according to the American College of Nurse-Midwives (ACNM), the leading professional organization of CNMs and certified midwives (CMs) in the US.
This Cochrane Library review examined 13 studies on public health systems in Australia, Canada, New Zealand, and the UK involving 16,242 women at varying levels of risk for complications during pregnancy. It concluded that midwife-led continuity of care was associated with a number of benefits for mothers and babies, while producing no specific adverse effects when compared with physician-led care, or when the care between providers was shared.
The 5 study authors concluded, “Most women should be offered midwife-led continuity models of care.”
Additionally, the studies in the review provided further information about normal, healthy birth. “The underpinning philosophy of midwife-led care is normality and the natural ability of women to experience birth without routine interventions,” the review stated. Compared to other health care practitioners, midwives tend to minimize the use of labor induction, epidurals, episiotomies, and other interventions unless they are medically necessary.
A 2012 US systematic review published in Women’s Health Issues found differences in technology between physicians and CNMs, but concluded that the evidence indicated safe and effective care by CNMs.
“These large-scale reviews provide consistent evidence that midwives provide high-quality care for moms and babies,” said ACNM President Ginger Breedlove, CNM, PhD, APRN, FACNM. “They are vitally important because they help to raise awareness of midwife-led care, including the support for normal, healthy birth, at a time of rising health care costs and a shortage of OB-GYNs. The more evidence that points to safe care provided by midwives, the more midwives will be valued as leading providers of maternity care in the US and around the world.”
The US review, Comparison of Labor and Delivery Care Provided by Certified Nurse-Midwives and Physicians: A Systematic Review, 1990 to 2008, found the differing approaches to practice by CNMs and MDs to be well documented, especially regarding the use of technology during labor and delivery. The US authors added, “Yet, the findings provide evidence that care by CNMs is safe and effective. CNMs should be better utilized to address the projected health care workforce shortages.”
Meg Johantgen, PhD, RN, the lead author of the US-based article, said, “In the US, we are trying to develop more effective and integrated models of care delivery where professionals collaborate across disciplinary boundaries. As the mandates of health care reform put increasing demands on our primary care system, CNMs could provide an important solution.Currently, they are an underutilized resource.”
About the American College of Nurse-Midwives
The American College of Nurse-Midwives (ACNM) is the professional association that represents certified nurse-midwives (CNMs) and certified midwives (CMs) in the United States. With roots dating to 1929, ACNM sets the standard for excellence in midwifery education and practice in the United States and strengthens the capacity of midwives in developing countries. Our members are primary care providers for women throughout the lifespan, with a special emphasis on pregnancy, childbirth, and gynecologic and reproductive health. ACNM reviews research, administers and promotes continuing education programs, and works with organizations, state and federal agencies, and members of Congress to advance the well-being of women and infants through the practice of midwifery.
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