The School of Nursing opened applications for its new nurse-midwifery program last week.
The new master of science in nursing will allow students to take two years of virtual classes for nurse-midwifery skills, which emphasize a holistic and individualized model of care, and then participate in a clinical program during the third year of the program. The nursing school created the virtual nurse-midwifery curriculum to boost the range and number of students the program can enroll, which will subsequently end its current nurse-midwifery program partnership with Shenandoah University next fall.
Nurse-midwives are nurses who assist pregnant people throughout their term and labor and can also serve as primary care providers. The program follows the midwifery model of care, which advocates for treating birth as a standard physiologic process and using few medical interventions, like epidural anesthesia and the use of instruments during births.
Tarnisha Hemphill, an assistant professor in nursing and midwifery, said students take virtual classes only during the first two years of the program so they can focus on 420 hours of clinical immersion work per semester during their last year in the program, which will consist of a 32-hour in-person work week. She said students will travel to campus for one week at the beginning of their third year of the program for a skills-intensive training session with midwives before they begin their clinical immersions.
“There will be no other courses they need to take, so they should be able to fully immerse themselves into just their clinical component,” Hemphill said.
Hemphill also said students will be required to attend a workshop on how to start a birthing center by the end of their second year in the program.
Hemphill said the virtual program will boost the amount of geographic and racial diversity in the program, which in turn will help decrease racial disparities in maternal care. Black and Indigenous mothers have a maternal mortality rate three times higher than white mothers, according to the program’s website, and studies have shown that people giving birth prefer to have health care providers who look like them, Hemphill said.
“Patients should have a voice in their care, and we as midwives are here to listen,” Hemphill said. “So we believe in just changing the philosophy and the thought process behind providing care to women will help decrease this maternal mortality rate.”
Hemphill added that the program also wants to educate students on home births and community births done in birth centers that prioritize shared decision making between the patient and the care providers.
“We feel like it is important to emphasize community births and home births because that is another way of answering the maternal mortality rate,” Hemphill said. “So exposing our students more to not only hospital birth midwifery but community birth and home births, we have that in our program as well.”
The American Academy of Pediatrics recommends that candidates for home births should include only people experiencing low-risk pregnancies and with certified personnel present to assist with the birth and possible transfer to a hospital if needed. While the AAP does not recommend home births — which can increase the likelihood of neonatal seizures and low Apgar scores, the assessment of an infant’s condition post-birth — planned home births attended by a midwife resulted in “very low and comparable rates” of perinatal death compared with planned hospital birth attended by a midwife or physician, according to a study by the University of British Columbia.
The program, which received pre-accreditation from the Accreditation Commission for Midwifery Education in August, comes during a maternal health care crisis in the United States, nursing faculty said.
Suzan Ulrich, an associate professor of nursing and the director of midwifery education, said the maternity care system in the U.S. is “broken” and tinged with racial disparities in mortality rates and health care quality. She said providers often perform procedures like inductions and cesarean sections when they’re not needed, which can have “huge repercussions.”
Ulrich said the program will address these issues by teaching students how to give patients individualized, culturally appropriate care that avoids “overtreating” patients and helps educate and support pregnant people during labor and pregnancy.
“Our system is broken,” Ulrich said. “Midwifery and birth centers and listening to women is the way to fix it.”
GW previously offered a midwifery program for nearly a decade — where students would complete master of science in nursing courses at GW and midwifery courses at Shenandoah University for a midwifery certificate — but GW stopped admitting students into the program this fall, Ulrich said.
She said the nursing school started its own midwifery program because they felt “limited” by the number of spots available at Shenandoah for GW students in the program. The virtual nature of the program expands the number of students who are able to take the course like those in rural areas and students who prefer a more flexible learning schedule, Ulrich added.
“It’s a proven model, but it opens up the possibility for somebody in a rural area in Idaho to become a midwife and not have to move to D.C. to go to GW,” Ulrich said.
Ulrich said a lack of practicing midwives who can take on teaching students has created a barrier to becoming a midwife. She also said the program plans to partner with community birth centers to provide grants to students and is applying for Health Resources and Services Administration grants for the next academic year.
Cara Padovano, an assistant professor of nursing and associate dean of the master of science in nursing program, said the nursing school is committed to building a robust nationwide midwifery program that teaches students across the country and creates as many competent and diverse nurse-midwives as possible.
“I am really so happy that we have the opportunity to prepare outstanding certified nurse-midwives and continue to meet the needs of our Washington, D.C. community and communities nationwide,” Padovano said.
Melissa Saftner, a clinical professor and the specialty director of the nurse-midwifery program at the University of Minnesota, said there is a “very small” number of midwifery programs compared to nurse anesthetist programs and nurse practitioner programs. Saftner said when providers build trust with their patients, they are more likely to believe pregnant people who raise concerns about their health and treatment.
“The midwifery model of care has been shown to have as effective, if not more effective, outcomes when compared to care provided by physicians like OB-GYNs or family medicine doctors, and it’s really patient-centered,” Saftner said.
