Maternal Health | Frontier Nursing University

At the heart of Frontier Nursing University is a talented and diverse community of students, alumni, faculty, staff, Couriers and preceptors. Spotlight blogs feature members of our FNU community who are focused on the mission of educating nurse-midwives and nurse practitioners to deliver quality healthcare to underserved and rural populations.

It’s one thing to identify a problem. It’s quite another to find a solution. Yet that is what FNU Doctor of Nursing Practice (DNP) Alumni Kimberly Jones-Beatty, CNM, DNP, Class 37, is striving to do.

The problem has become increasingly well known, as the alarming numbers depicting the maternal mortality crisis in the United States persist. In 2018, there were 17 maternal deaths for every 100,000 live births in the U.S. — a ratio more than double that of most other high-income countries, and the U.S. has the highest maternal mortality rate among developed countries.^ The data is even more concerning for Black and American Indian/Alaska Native (AIAN) women, who have pregnancy-related mortality rates that are over three and two times higher, respectively, compared to the rate for white women.*

The data confirm the problem, but it does not offer a solution. Jones-Beatty, who works as a certified nurse-midwife within the OB/GYN department at Johns Hopkins University in Baltimore, Maryland, has been practicing midwifery for 12 years.

“I work in a dual clinical/research role through providing ambulatory obstetric care and overseeing clinical research in the Johns Hopkins Integrated Research Center for Fetal Medicine,” Jones-Beatty said. “As a clinical practitioner, I strive to provide evidence-based care. As a researcher, I see that we contribute to evidence-based care through translational research; by generating new knowledge or validating existing knowledge in both basic science and clinical research and applying it to clinical practice to improve patient care and outcomes. It’s the best of both worlds.”

Jones-Beatty put her research passion and skills to work in her DNP project, which focused on learning more about the maternal mortality crisis and its potential solutions.

“My DNP project focused on improving postpartum care,” she said. “Maternal morbidity and mortality are at an all-time high in the United States, and research shows that the majority of cases occur within the postpartum period. The American College of Obstetricians & Gynecologists (ACOG) has called for a paradigm shift in postpartum care by moving away from the single six-week visit and instead incorporating an ongoing postpartum process beginning in the antenatal period to impact adverse pregnancy outcomes and maternal morbidity and mortality rates. The aim of the project was to increase effective postpartum care through patient preparedness, early one-to-three-week patient follow-up, and comprehensive postpartum visits from 0% to 80% in eight weeks.”

To implement the project, Jones-Beatty followed ACOG’s recommendations in creating a postpartum planning tool. The tool included reviewing the importance of postpartum care and postpartum warning signs that warrant further evaluation. It also incorporated a population health registry for early one-to-three-week postpartum follow-up to ensure that postpartum patients were recovering from childbirth as expected and a comprehensive postpartum note template to help provide complete documentation of recommended postpartum visit components.

“The project aim was met at 88%,” Jones-Beatty said. “The planning tool effectively increased patients’ knowledge of postpartum warning signs. The registry was effective in obtaining postpartum right care scores, which translates into patients recovering from childbirth as expected. The note template was effective in guiding effective postpartum care office visits. Next steps will include reviewing the impact of the interventions on clinic-specific patient populations, overall maternal morbidity and mortality rates, and examining differences by race.”

While more study and research are required to address maternal mortality, Jones-Beatty’s work was duly recognized for its significance. She recently presented her project as a poster presentation at the Society for Reproductive Investigation’s Annual Meeting in Boston, Massachusetts.

“Attending the meeting was a great experience, with networking opportunities and the chance to hear about new practice perspectives, guidelines, and other original research within reproductive health,” she said.

Jones-Beatty’s love for research and information paired well with Frontier’s emphasis on data-driven analysis and decision-making.

“I decided to pursue a doctorate in nursing practice at Frontier due to its strong reputation, online format, and faculty expertise,” she said. “FNU’s DNP curriculum provides instruction on leading quality improvement in the clinical setting, as well as exposure to evidence-based practice, health policy and advocacy, and system/ organizational leadership. Collectively, I feel prepared to impact any healthcare setting I choose to work in through a deep understanding of the education and skills that exemplify nurse leaders who are ready to change the landscape of the current healthcare environment.”

Jones-Beatty is well-prepared to continue to excel as both a researcher and a clinician. Both roles hold equal value to her as she seeks to positively impact her current and future patients and colleagues.

“I plan to continue working both clinically and in research, contributing to evidence-based practice, improving obstetric healthcare, and decreasing adverse pregnancy and neonatal outcomes,” she said.

FNU is proud of Jones-Beatty for her dedication to research and midwifery. She is a shining example of bringing FNU’s Culture of Caring to her community.

Interested in reading more stories about our alumni? Visit the FNU Alumni stories page.

^Roosa Tikkanen et al., Maternal Mortality and Maternity Care in the United States Compared to 10 Other Developed Countries (Commonwealth Fund, Nov. 2020). https://doi.org/10.26099/411v-9255

*Artiga, S., Pham, O., Orgera, K., Ranji, U. (2020). Racial Disparities in Maternal and Infant

Health: An Overview. Issue Brief. Kaiser Family Foundation, November 10, 2020

Frontier Nursing University (FNU) graduate Angela (Angie) Chisholm, CNM is improving maternity care with an uniquely informative new podcast, entitled “Midwifing America.”

The podcast is on a mission to reimagine women’s healthcare in the United States. In the wake of a mounting maternal health crisis, each Midwifing America episode highlights stories from health care providers and the women they serve to illustrate the state of maternity care.

Angie, one of the four podcast hosts, graduated from FNU’s CNEP (Class 49) in 2009. She served as a nurse-midwife in collaborative hospital practice for seven years in Corvallis, Ore., providing team-based care and supervising family practice residents.

She has also served as a midwife at the Corvallis Birth & Women’s Health Center, where she works to incorporate collaborative maternity care models between the birth center and local hospital.

Though her focus is often skin-to-skin care, Angie is passionate about improving all maternity healthcare.

“I believe that birth centers have the potential to address health disparities and maternity care shortage crisis,” she said. “As more and more hospitals stop offering maternity care, it seems reasonable that those communities deserve local and safe options for prenatal care and deliveries. One of my goals is to show other communities and hospitals that embracing birth centers and out-of-hospital care – instead of viewing them as competition – leads to the best outcomes.”

Angie and her team of three other Oregon-based midwives started Midwifing America to begin having these important conversations with nurses, midwives, physicians and mothers.

“Much of what I have learned is that social media and audience engagement has the potential to change how we deliver care,” she said.

To that end, Angie has produced The Heart of Touch Film and web series to highlight the importance of skin-to-skin care for newborns.

Angie’s experience at FNU helped prepare her not only to provide quality care and listen to women, but also to see herself as an advocate for issues that need to be addressed.

“This big picture vision is something I really took to heart,” she said.

Her access to mentorship by FNU faculty and staff who want to grow the midwifery profession made all the difference for her as she continues to lead the way for better maternal care.

In addition to her multimedia efforts, Angie also serves on the ACNM National Membership & Marketing Committee and is Chair of Oregon Affiliate Public Relations.

Angie, your dedication to improving maternal health is inspiring to all of us in the FNU community. Thank you!