Certified nurse-midwives working for a federally qualified health center in New Jersey are credited with helping reduce the Cesarean section rate at one of the state's hospitals, according to a report in the Plainfield Courier-News this week.
A Muhlenberg Regional Medical Center spokesperson said "mothers receiving collaborative midwifery care spend less time in the hospital and have fewer Caesarean births." The newspaper reported that while the Caesarean section rate for the state was 33.1 percent in 2003, Muhlenberg's rate was 22 percent, the state's second lowest.
The certified nurse-midwives work at Plainfield Health Center, a federally qualified health center that refers its maternity patients to Muhlenberg Regional. Founded in 1991, the Plainfield midwifery program was expanded in 2003 to include more nurse-midwives and increased use of midwives for delivering babies. The program now has seven full-time and three part-time nurse-midwives. The article said, "The health center's largely low-income patients may now be receiving better obstetrical care than patients at hospitals in affluent communities, where Caesarean rates are much higher."
According to the report, "Of the 1,055 births at Muhlenberg in 2004, 739 were through the Plainfield Health Center, and of those, 66 percent -- 485 births -- were delivered by nurse-midwives."
"Since women across the country are confused and anxious over the research and opinion regarding Cesarean section, we are grateful that midwifery care in New Jersey is receiving this sort of affirmation and we hope that more hospitals and health-care systems will take heed of this news," said Katherine Camacho Carr, CNM, PhD, president of the ACNM. "
The article makes another key point: Muhlenberg Regional Medical Center serves a large minority, low-income patient population. Because such patients are less likely to receive prenatal care, they are more likely to have high-risk pregnancies requiring caesareans. But, the midwifery philosophy of care emphasizes working with patients to minimize potential complications, such as premature labor, that are more prevalent in these high-risk patients; these minimal interventions often result in lower costs and better health outcomes for mother and newborn.
ACNM recently issued a call to Congress to investigate the nation's rising Cesarean section rate and the impact that rise is having on women's health indicators and the financial health of the country's health-care system.
See http://www.midwife.org/press/display.cfm?id=461 for more info.