Certified nurse-midwives lead collaborative care model as solution to obstetrician shortage

January 15, 2020

LA CROSSE, Wis. -- Fewer physicians are pursuing careers in obstetrics, in part because of the intense, round-the-clock demands of the job and a high burnout rate. An unusually large number of practicing obstetricians are expected to retire within the next decade, which will add to an already acute physician shortage.

One solution to this staffing challenge is a collaborative care model used at Mayo Clinic Health System ? Franciscan Healthcare in La Crosse, where certified nurse-midwives lead the care team. Certified nurse-midwives provide care for obstetric patients who are at low to moderate risk as part of a team model described in Mayo Clinic Proceedings: Innovations, Quality & Outcomes.

Patients choose whether to use the care model, which ensures that a certified nurse-midwife is in the hospital around the clock, with generalist obstetricians on call, when needed. The nurse-midwife cares for obstetric patients only, and admits labor induction, pre-labor and active labor patients. The report says the model could be used by similar hospitals that do not employ obstetricians dedicated to labor and delivery.

"Across the country, hospital delivery units are facing a shortage of obstetricians due to a change in the workforce and increasing demands," says Gokhan Anil, M.D., an OB-GYN at Mayo Clinic Health System in Mankato, Minnesota, and first author of the report. "Innovative approaches to staffing are needed to serve the needs of the patient, increase collaboration and improve patient safety."

The collaborative care model has had several positive outcomes since it was implemented in July 2014. The primary cesarean section birth rate has declined, as have vaginal operative deliveries. And the rate of vaginal births after C-section has increased. Admissions to the neonatal ICU decreased from 14.9% in 2012 ? before the care model was offered ? to 10.9% in 2017.

"This approach also has resulted in a shorter length of stay in the hospital for our patients, which always is a good thing for patients, especially a new mother and child," says Dr. Anil, who previously was on staff at Franciscan Healthcare.

The model has won high marks from patients and helped address staffing challenges.

"Based on previous research and our experience, women who receive midwife-led continuity of care are less likely to need an intervention and are more likely to be satisfied with their care," says Costa Sousou, M.D., chair of the Department of Obstetrics and Gynecology at Franciscan Healthcare. "This team approach allows us to continue to provide high-quality care with a more sustainable and cost-effective staffing model. We think it's a model that other institutions may find worth exploring."
About Mayo Clinic Health System

Mayo Clinic Health System consists of clinics, hospitals and other facilities that serve the health care needs of people in more than 60 communities in Iowa, Minnesota and Wisconsin. The community-based providers, paired with the resources and expertise of Mayo Clinic, enable patients in the region to receive the highest-quality physical and virtual health care close to home.

Mayo Clinic

Related Labor Articles from Brightsurf:

Learning a new language changes the brain's division of labor
Learning a language later in life changes how the two halves of the brain contribute.

Women's communication shapes division of labor in household
For many couples, COVID-19 quarantine has shattered the normal routine and led some to renegotiate who does what around the house.

Researchers identify drugs that could halt preterm labor
Researchers have discovered a common molecular pathway in women who experience preterm labor and are using this insight to develop new treatments for woman who experience early labor.

Labor after previous cesarean should be considered
Labor after cesarean may be successful in over 90% of cases and thus may be considered a reasonable option for both mother and child, a study published in BMC Pregnancy and Childbirth suggests.

Study shows lower mortality from induction of labor at 41 weeks
Inducing labor after 41 instead of 42 full weeks' pregnancy appears to be safer in terms of perinatal survival, new Swedish research shows.

Imaging test may help predict the success of labor induction
When labor is induced in pregnant women, one in five women will require an emergency cesarean section.

Researchers create first-ever 'map' of global labor flow
A new study from Indiana University reveals the ebb and flow of labor -- as well as industries and skills -- across the global economy using data on 130 million job transitions among 500 workers on the world's largest professional social network, LinkedIn.

How much would you pay to eliminate child labor from your cocoa?
An increase in cocoa price by 2.8% could potentially eliminate the very worst forms of child labor from cocoa production in Ghana, according to a new economic model described in a study published June 5, 2019 in the open-access journal PLOS ONE by Jeff Luckstead and Lawton L.

To tackle child labor, start with consumers
A new study by SMU Assistant Professor Fang Xin finds evidence that educating consumers about the social impact of their purchases can help reduce child labor in global supply chains.

Induced labor not more expensive to health care system than spontaneous labor
The results of a joint study between University of Utah Health and Intermountain Healthcare show inducing labor one week early costs the same as waiting for spontaneous labor.

Read More: Labor News and Labor Current Events
Brightsurf.com is a participant in the Amazon Services LLC Associates Program, an affiliate advertising program designed to provide a means for sites to earn advertising fees by advertising and linking to Amazon.com.