By: Susan E. Stone, DNSc, CNM, FACNM, FAAN
Those of us engaged in women’s health care know that there’s a troubling trend affecting women in the U.S. We have the most expensive healthcare system in the world, yet American women are more likely to die during childbirth than women in any other developed country. Maternal mortality rates have nearly doubled over the past 20 years, even as healthcare technology has advanced.
While the causes are multifactorial and not easily resolved, there is widespread agreement that we must take action to improve outcomes for women and their families. Many healthcare experts point to collaborative care models as one promising strategy.
As an education provider, Frontier Nursing University (FNU) has an obligation to equip our students with an understanding of and appreciation for collaboration. All of our students are either becoming certified nurse-midwives and nurse practitioners or advancing their education to the doctoral level as a nurse-midwife or nurse practitioner. Our graduates will provide care to women throughout their lives.
In recognition of National Midwifery Week in October, FNU hosted a digital summit to explore how today’s nurse-midwife plays an important role in collaborative care. The event called Today’s Nurse-Midwives: Creating a Collaborative Community of Care brought together a number of industry leaders to explore the latest and discuss changes that are needed now. FNU partnered with the American Association of Birth Centers (AABC) to kick off the event with live streamed sessions from the AABC Birth Institute in Scottsdale, AZ. FNU and AABC have a longstanding history with a shared mission of increasing maternity care options for women through midwifery and birth center care.
Placing Patients at the Center of Care
Healthcare systems should strive to implement patient-focused team care. For too long, the economics of healthcare have eroded quality leaving the industry with inflated costs and low patient satisfaction.
When the patient is at the center of care, the patient’s needs and desires are more likely to be heard. Nurse-midwives, as part of the healthcare team, serve as excellent advocates for patients. This is particularly important as more and more women are seeking out-of-hospital care.
Focusing on what is best for the patient not only leads to better health care outcomes and improved patient satisfaction, but also greater efficiency and lower costs.
Educating Physicians and Nurse-Midwives to Work Together
Too often in healthcare settings, health care providers are operating in silos. Poor relationships can lead to a lack of appropriate consultation, and miscommunication can lead to poor outcomes. Teams improve results when they make an effort to collaborate and communicate and keep the patient at the center of their efforts.
Adding nurse-midwives to the health care team improves quality and decreases cost. A team approach that includes physicians, nurse-midwives and other providers as necessary delivers better care to women and families. A collaborative environment allows team members to excel in using the specific skill set in which they are educated.
At FNU, our goal is to educate nurse-midwives so that they are prepared to work in collaboration with physicians. In some cases, physicians may not understand the scope of a nurse-midwife’s capabilities particularly if they’ve had no exposure to them. Successfully working together comes down to the basics of trust, listening and relationship building.
Making Change Happen Now
Understanding the challenge is certainly a step in the right direction, but not enough. We must also work hard to implement solutions. The digital summit presented several practical models that are working well and could be adopted by healthcare systems across the country.
If our goal is to improve outcomes and decrease the maternal mortality rate, we have to work together. We need more interprofessional education for health professions and more nurse-midwives joining maternity care teams. Finally, we must strive to create women’s care services in which collaborative care is the norm, not the exception.
View Digital Summit Sessions
FNU invites you to view all sessions from Today’s Nurse-Midwives: Creating a Collaborative Community of Care on YouTube here. Visit the digital summit website here.
References
Avery M, Montgomery O, Brandl-Salutz E. Essential components of successful collaborative maternity care models: the ACOG-ACNM project.Obstetrics And Gynecology Clinics Of North America [serial online]. September 2012;39(3):423-434. Available from: MEDLINE, Ipswich, MA. Accessed November 12, 2015.
K. Davis, K. Stremikis, C. Schoen, and D. Squires, Mirror, Mirror on the Wall, 2014 Update: How the U.S. Health Care System Compares Internationally, The Commonwealth Fund, June 2014.
Pullen, L. & Vega C. CDC Data Reveal Increased Maternal Mortality Rates. Medscape Education Clinical Briefs, 01/26/2015
Smith, D. C. (2015), Midwife–Physician Collaboration: A Conceptual Framework for Interprofessional Collaborative Practice. Journal of Midwifery & Women’s Health, 60: 128–139.
Carrie Belin is an experienced board-certified Family Nurse Practitioner and a graduate of the Johns Hopkins DNP program, Johns Hopkins Bloomberg School of Public Health, Georgetown University School of Nursing, and Johns Hopkins School of Nursing. She has also completed fellowships at Georgetown and the University of California Irvine.
Angie has been a full-scope midwife since 2009. She has experience in various birth settings including home, hospital, and birth centers. She is committed to integrating the midwifery model of care in the US. She completed her master’s degree in nurse-midwifery at Frontier Nursing University (FNU) and her Doctorate at Johns Hopkins University. She currently serves as the midwifery clinical faculty at FNU. Angie is motivated by the desire to improve the quality of healthcare and has led quality improvement projects on skin-to-skin implementation, labor induction, and improving transfer of care practices between hospital and community midwives. In 2017, she created a short film on skin-to-skin called 
Justin C. Daily, BSN, RN, has ten years of experience in nursing. At the start of his nursing career, Justin worked as a floor nurse on the oncology floor at St. Francis. He then spent two years as the Director of Nursing in a small rural Kansas hospital before returning to St. Francis and the oncology unit. He has been in his current position as the Chemo Nurse Educator for the past four years. He earned an Associate in Nurse from Hutchinson Community College and a Bachelor of Science in Nursing from Bethel College.
Brandy Jackson serves as the Director of Undergraduate Nursing Programs and Assistant Educator at Wichita State University and Co-Director of Access in Nursing. Brandy is a seasoned educator with over 15 years of experience. Before entering academia, Brandy served in Hospital-based leadership and Critical Care Staff nurse roles. Brandy is passionate about equity in nursing education with a focus on individuals with disabilities. Her current research interests include accommodations of nursing students with disabilities in clinical learning environments and breaking down barriers for historically unrepresented individuals to enter the nursing profession. Brandy is also actively engaged in Interprofessional Education development, creating IPE opportunities for faculty and students at Wichita State. Brandy is an active member of Wichita Women for Good and Soroptimist, with the goal to empower women and girls. Brandy is a TeamSTEPPS master trainer. She received the DASIY Award for Extraordinary Nursing Faculty in 2019 at Wichita State University. 
Dr. Sabrina Ali Jamal-Eddine is an Arab-disabled queer woman of color with a PhD in Nursing and an interdisciplinary certificate in Disability Ethics from the University of Illinois Chicago (UIC). Dr. Jamal-Eddine’s doctoral research explored spoken word poetry as a form of critical narrative pedagogy to educate nursing students about disability, ableism, and disability justice. Dr. Jamal-Eddine now serves as a Postdoctoral Research Associate in UIC’s Department of Disability and Human Development and serves on the Board of Directors of the National Organization of Nurses with Disabilities (NOND). During her doctoral program, Sabrina served as a Summer Fellow at a residential National Endowment of the Humanities (NEH) Summer Institute at Arizona State University (2023), a summer fellow at Andrew W. Mellon’s National Humanities Without Walls program at University of Michigan (2022), a Summer Research Fellow at UC Berkeley’s Othering & Belonging Institute (2021), and an Illinois Leadership Education in Neurodevelopmental and related Disabilities (LEND) trainee (2019-2020).
Vanessa Cameron works for Vanderbilt University Medical Center in Nursing Education & Professional Development. She is also attending George Washington University and progressing towards a PhD in Nursing with an emphasis on ableism in nursing. After becoming disabled in April 2021, Vanessa’s worldview and perspective changed, and a recognition of the ableism present within healthcare and within the culture of nursing was apparent. She has been working since that time to provide educational foundations for nurses about disability and ableism, provide support for fellow disabled nursing colleagues, and advocate for the disabled community within healthcare settings to reduce disparities.
Dr. Lucinda Canty is a certified nurse-midwife, Associate Professor of Nursing, and Director of the Seedworks Health Equity in Nursing Program at the University of Massachusetts Amherst. She earned a bachelor’s degree in nursing from Columbia University, a master’s degree from Yale University, specializing in nurse-midwifery, and a PhD from the University of Connecticut. Dr. Canty has provided reproductive health care for over 29 years. Her research interests include the prevention of maternal mortality and severe maternal morbidity, reducing racial and ethnic health disparities in reproductive health, promoting diversity in nursing, and eliminating racism in nursing and midwifery.
Dr. Lisa Meeks is a distinguished scholar and leader whose unwavering commitment to inclusivity and excellence has significantly influenced the landscape of health professions education and accessibility. She is the founder and executive director of the DocsWithDisabilities Initiative and holds appointments as an Associate Professor in the Departments of Learning Health Sciences and Family Medicine at the University of Michigan.
Dr. Nikia Grayson, DNP, MSN, MPH, MA, CNM, FNP-C, FACNM (she/her) is a trailblazing force in reproductive justice, blending her expertise as a public health activist, anthropologist, and family nurse-midwife to champion the rights and health of underserved communities. Graduating with distinction from Howard University, Nikia holds a bachelor’s degree in communications and a master’s degree in public health. Her academic journey also led her to the University of Memphis, where she earned a master’s in medical anthropology, and the University of Tennessee, where she achieved both a master’s in nursing and a doctorate in nursing practice. Complementing her extensive education, she completed a post-master’s certificate in midwifery at Frontier Nursing University.
Dr. Tia Brown McNair is the Vice President in the Office of Diversity, Equity, and Student Success and Executive Director for the Truth, Racial Healing, and Transformation (TRHT) Campus Centers at the American Association of Colleges and Universities (AAC&U) in Washington, DC. She oversees both funded projects and AAC&U’s continuing programs on equity, inclusive excellence, high-impact practices, and student success. McNair directs AAC&U’s Summer Institutes on High-Impact Practices and Student Success, and TRHT Campus Centers and serves as the project director for several AAC&U initiatives, including the development of a TRHT-focused campus climate toolkit. She is the lead author of From Equity Talk to Equity Walk: Expanding Practitioner Knowledge for Racial Justice in Higher Education (January 2020) and Becoming a Student-Ready College: A New Culture of Leadership for Student Success (July 2016 and August 2022 Second edition).