Understanding Low-Intervention Childbirth & It’s Benefits

Understanding Low-Intervention Childbirth & It’s Benefits


Hey Vanderbilt Health. Today, we are gonna be talking about the midwifery model of care and what that looks like and how to navigate it maybe for some people who are confused about it and just about our phenomenal
program here at Vanderbilt. I’m a huge fan of this program personally, I’m not gonna lie, I had all of my babies delivered by our Vanderbilt midwives and I’m pleased to have
one of them here today. Lori, think you so much for joining me. So let’s dive right into this. What is the midwifery model of care? What does that even mean? – So the midwifery model of care is the care of individuals with respect to their physical care, psychological care and
their social wellbeing. So as certified nurse midwives, we care for the individual
over their whole life cycle, so teens to menopause. It includes pregnancy and birth experience as well as gynecological care. – I think that’s a really
important thing to note because I think for a lot of people, they think of a midwife just
in terms of birthing babies. – Right – But you guys do so much more then that. And that’s, the abundance
of what you’re offering to patients here in
middle Tennessee, right? – Yes, definitely. – Awesome. So can you talk a little
bit more specifically about maybe some of the different things that you’re routinely seeing people for in the model of care? – Sure, sure. We largely care for women with their pregnancy and their birth. – Okay, okay. – So we care for them in the office during their pregnancy and then at Vanderbilt University Medical Center for their birth, but we also do a wide range
of gynecological services. – Okay. – So well woman care, PAP
smears, we do procedures, colposcopies and biopsies
and things like that. And we care for, like I
said, the whole life cycle, so teens with contraception or older folks with menopause issues. – That’s great. And why would people
choose to see a midwife? Why this model? – Well, the midwifery model of care is based on a relationship and it’s the relationship that’s formed between the provider, the individual, maybe the health, the family, as a part of the healthcare team, and it’s that relationship that helps empower individuals to make choices and participate in their healthcare and by doing so, by creating these sort of relationships, it’s been proven to, that these individuals
have better health outcomes and much greater satisfaction
in their healthcare. – Yeah, I would definitely say that was true for me, it really was a phenomenal experience with every one of my kids, so I’m grateful for what you guys provide to so many people here. Talk a little bit about how this compares to traditional obstetrics. How the model is different, how it’s the same, as well as maybe the team-based approach, if that’s the same?
– Sure, sure. So most certified nurse midwives participate in a team-based approach, so we interact with a variety
of healthcare professionals like mental healthcare
providers, social workers, physical therapists, chiropractors, acupuncturists, just to name a few. But we also work very closely
with our physician colleagues to ensure the best, most optimal
healthcare for our clients. So physicians work with
low risk individuals obstetrically and gynecologically, but they are experts in high risk. They are experts in surgical intervention and that is the opposite of our expertise. As certified nurse midwives, we primarily care for individuals with lower risk healthcare needs. We tend to be, we’re experts in normal, we are experts in low intervention, we are experts in normal birth and normal gynecological care. We consult with our physician colleagues when we have higher risk conditions, because as certified nurse midwives we are able to care for women with higher risk conditions, we collaborate with the physicians to come up with a team
approach for that care and at Vanderbilt, we’ve created a really
unique model of care, a collaborative care approach where we take the individual, their certified nurse midwife and a maternal fetal medicine specialist, who is the specialist
in high risk obstetrics, and together we meet and individualize the
care for that individual, which allows them to have a higher risk pregnancy in this case but within the confounds
of midwifery care. – Wow. – So we come up with a plan of care that addresses the high risk needs and the low risk needs and people have been very, very satisfied with this model of care, because it allows them the ability to stay within the midwifery model and still have their high
risk needs attended to. – Right, right. I think Vanderbilt is a place where you would want your
high risk needs attended to because of the expertise you have here. – Absolutely, we have a fabulous NICU, the neonatal folks are there and can be there at any birth, should we need them. – Right. – Our physician colleagues
are always on staff. They’re always on the floor. Oftentimes, we never see them and they know that we’re there, they know that our family is there, they know about what’s going on with this baby and the pregnancy, and they’re able to intervene at any point should baby need it, so if we need a surgical
intervention, they’re there, but if we don’t need them, then it’s just the midwifery atmosphere. – Right. Talk a little bit about the setting for where care would be offered. – Sure. So midwifery care can be offered
in a variety of settings, so women’s healthcare is typically
in an outpatient setting. – Yep. – It might be in a traditional medical building such as this, or it could be in a birth center setting, so an exam, an exam setting. – Right. – Exam space, excuse
me, in a birth center. – Right. – So the majority of midwifery-led birth is done in a hospital
setting such as Vanderbilt, but it’s also possible for families to enjoy out of hospital birth in a birth center or in, or home birth. – Right. – And that’s kind of dependent upon the state regulations and requirements around birth centers. – Vanderbilt midwives
do not deliver at home. – We do not.
– Right? – We do not. At Vanderbilt, we deliver
at the Vanderbilt hospital, and then there is also
a birth center in town. – Right, which is great. So can you talk about, and you’ve mentioned this a little bit but I’d love for you
to go a little bit more about how the midwifery approach and being informed in that way really compliments other models of care. – Sure. By working in a team approach, the nurse midwives are very passionate about evidence-based care, so we try and look at the literature and look and see what
does the evidence show us and what’s best for
this individual’s care? By being involved in the research, certified nurse midwives
often lead research and participate in research, which has driven the lower
intervention model of care and also improved health
outcomes for women. At Vanderbilt we’ve been able to be a part of many teams that have been created to improve outcomes for mothers and babies. So being a part of those teams, we work collaboratively with different team members from across disciplines to come up with the best approach for healthcare for these individuals. One program that we’ve been, or one team that we’ve been really proud to be a part of is one that was created at Vanderbilt to lower the primary C-section rate. And that’s comprised of individuals from different disciplines
across that hospital to really lower that rate. – And it’s been lowered, which is tremendous.
– Yes, yes. – That’s amazing.
– Yes. – Incredible. So if somebody is watching this and they’re wondering would this be a good fit for them or not, what would you say to them? And is there a right or wrong model? – There’s not a right or wrong model. I think it’s a very individualized thing. I think it’s important for individuals to look at themselves, look at what do they
need out of their care, whether it’s obstetrics
or gynecological care, what are their risk factors, and then to investigate what are the options around them? So find out what models of
care are in your community and then within those models of care, what kind of care do they offer? So as I mentioned, as certified nurse midwives at Vanderbilt, we care for the individual whether they’re pregnant or they have gynecological concerns, but check in to see what
the scope of practice is. – Right. – And then, once you find that, really doing your homework to
find out about that practice. Find out their history,
find out their experience. At Vanderbilt, our
nurse midwifery practice has been around for almost 25 years. – We’re one of the oldest
in the city, right? – We are the oldest in the city. – The oldest. – And we have well over a hundred years of experience amongst ourselves. – Yes, well over. – Well over. We have a variety of
experiences, of personalities, of expertise, of interests and we work really well together to complement each other and provide a variety of care types to individuals who would
like to seek our care. – I think that was really informative. And I love how you spoke to kind of the scope of care that you offer, because I think that’s a question a lot of people have, like if I have a baby, am I done? – Right. – And you’re not done with getting care provided by our midwives. – We get that question a lot. People will say, well, why do I need you, I’ve already had a baby? – Right. – And we provide the full complement of healthcare to women in need. – Awesome. Well, thank you so much for your time. – Thank you. – Yeah, it was my pleasure. And if you have questions for us, feel free to leave them in the comments. We’ll be happy to respond to those. I’ll send them over to Lori and make sure that they get answered. And also check out our
website for more information about this incredible program
right here in Nashville. Thank you. – Thank you – You bet, bye bye!

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