June 18, 2013
Twenty years ago this June, Bronson Women’s Service opened its doors at Bronson Methodist Hospital as the first hospital-based nurse-midwifery practice in Southwest Michigan. Since then, they have served more than 20,000 women and brought more than 13,000 babies into the world.
“We came at a time when nurse-midwifery in the state was still fairly new, and yet the hospital was willing to embrace a vision of what the model of care could be with certified nurse midwives (CNM),” said Joan Slager, CNM, one of the founding midwives at Bronson Women’s Service. “Bronson has staunchly stood behind and preserved that vision for twenty years and we’ve enjoyed wonderful collaboration with our physician colleagues and unflagging support from Bronson’s administration.“
Today, Bronson Women’s Service is one of the largest nurse-midwifery practices in Michigan. In addition to its 13 nurse-midwives, the practice employs four obstetrician-gynecologist physicians who are available for consultation, collaboration or referral depending on the needs of the individual patient. A CNM and physician provide in-house hospital coverage for patients at all times. The practice also works closely with maternal fetal medicine specialists, dieticians and social workers.
Midwives are educated to provide a full range of women’s healthcare including primary care, gynecologic services to women of all ages and maternity care. “We do not perform surgeries. That’s where our physician partners come in,” said Slager. Midwives often appeal to those who seek a more individualized, holistic approach to childbirth.
“Pregnancy is not a disease to be treated,” said Slager. “Nurse-midwives believe that pregnancy and birth are normal processes to be supported. We believe it is essential to treat the whole woman and her family, not just individual body parts.”
Patient education is a core value of midwifery. Midwives spend additional time with patients during office visits and during labor which provides an opportunity to listen to women and address the questions they have during pregnancy. “Spending time with a woman to offer support and education about her physical and emotional changes helps to normalize the pregnancy process,” said Slager. “We teach her how to maintain good health habits and provide anticipatory guidance to assist with common discomforts. We consider patients active participants in all aspects of care, and it takes a lot of education to help each woman know what she’s capable of.”
The outcomes data for patients of Bronson Women’s Service show positive results, despite serving a relatively high patient population who often present with psychosocial issues and many have significant health risk factors. They have a challenging case load including patients with conditions like diabetes, hypertension, and multiple gestation, yet instances of epidurals and cesarean-sections are lower than the national norm.
Bronson Methodist Hospital offers women the option of Vaginal Birth after Cesarean Section (VBAC). Patients seeking VBAC who live in areas outside of Kalamazoo often receive their prenatal care close to home, and then transfer to Bronson so they can deliver without surgery. Bronson Women’s Service boasts about an 80 percent success rate for women attempting VBAC. “It’s the best of both worlds for our patients,” said Slager. “They can plan for a natural experience and if the delivery gets complicated, they’re surrounded by an array of medical expertise.”
Bronson Women’s Service’s growth from delivering 500 babies in 1993 to nearly 1,400 in 2012 has been ahead of the national trend. One Center for Disease Control and Prevention study showed a record high in 2009, when 8.1 percent of U.S. babies were delivered by midwives. At Bronson Methodist Hospital, one of every three babies is delivered by a nurse-midwife.
The rising popularity of midwife-assisted births correlates with a larger cultural shift toward a more natural lifestyle, from organic diets to yoga for stress relief. Slager and her colleagues have enjoyed the shift in attitudes about midwifery throughout the years.
“We’ve seen the pendulum swing. When I first started, mothers of pregnant patients worried, saying, ‘nobody did this when I was having a baby.’ Now women are referred to us by their mothers. Patients have come to accept and expect care that focuses on healthy and normal.”
Five of the midwives have been with Bronson Women’s Service since the practice’s beginnings. They’ve provided clinical education to more than 75 nurse-midwifery students from at least six midwifery education programs. Slager said that 15 nurses who used to work in Bronson’s labor and delivery unit have gone on to become nurse-midwives. “We’re really proud to have inspired other women to take that next step professionally and learn to provide this kind of care.”
On Tuesday, June 18, staff, former patients and partners will gather to celebrate Bronson Women’s Service and its two decades of dedication to helping women have safe and satisfying birthing experiences. At the ceremony, the president of the American College of Nurse Midwives (ACNM), Ginger Breedlove, will recognize Bronson Women’s Service as one of the country’s most notable midwifery practices, presenting the practice with ACNM’s, With Women for a Lifetime Gold Commendation.
For more information, visit bronsonhealth.com
About Bronson Methodist Hospital
Bronson Methodist Hospital, located at 601 John St. in downtown Kalamazoo, Mich., is the flagship of Bronson Healthcare, a not-for-profit healthcare system serving all of southwest Michigan and northern Indiana. With 434 licensed beds and all private rooms, Bronson Methodist Hospital provides care in virtually every specialty — cardiology, orthopedics, surgery, emergency medicine, neurology, oncology — with advanced capabilities in critical care as a Level I Trauma Center; in neurological care as a Joint Commission certified Primary Stroke Center; in cardiac care as the region’s first accredited Chest Pain Emergency Center; in obstetrics as the leading BirthPlace and only high-risk pregnancy center in southwest Michigan, and in pediatrics as one of only six children's hospitals in the state.
Bronson serves the largest percentage of Medicaid patients in the area and provides a substantial benefit to the community through outreach and charitable care. It is the recipient of the 2005 Malcolm Baldrige National Quality Award, the nation's highest presidential honor for quality and organizational performance excellence. In 2009, the hospital received the AHA McKesson Quest for Quality Prize awarded annually to only one U.S. hospital and joined the top five percent of hospitals in the nation to be designated a Magnet Hospital for Nursing Excellence. It was also a Thomson Reuters 100 Top Hospital from 2009-2011. For the past five years, Bronson has been ranked in the top five percent of hospitals in the nation as a Healthgrades Distinguished Hospital for Clinical Excellence (2009-13). In 2013, it was named one of Healthgrades America’s 100 Best Hospitals. For more information, visit bronsonhealth.com.
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. More information about ACNM can be found at www.midwife.org.