Midwifery

Midwifery care provides a range of primary health care, gynecologic, family planning, preconception, antepartum, intrapartum and postpartum care services for women from adolescence to beyond menopause. Midwives provide comprehensive assessment, diagnosis and treatment of different health conditions using evidence-based clinical guidelines as well as clinical expertise. Midwifery care has been shown to improve birth outcomes for both mothers and babies (American College of Nurse Midwives, 2012; American College of Obstetricians and Gynecologists, 2014; Rosenstein et al., 2015) therefore implementation of the midwifery model of care is essential in continuing to advocate and advance the health of women and families.

The purpose of the Evidence-Based Postpartum Midwifery Clinical Guideline is to provide global access to free and comprehensive postpartum guidelines that are vital in delivering optimal clinical care to patients. Currently, there is not any free, centralized, standardized documentation of clinical guidelines for midwifery interventions. This guideline available via the Omaha System platform creates a comprehensive collection of postpartum guidelines from the Centers for Disease Control (CDC), World Health Organization (WHO), American College of Obstetricians and Gynecologists (ACOG) and the American College of Nurse Midwives (ACNM). The guidelines used the Omaha System’s standardization criteria to define the category, target and care description groupings. It then identified different postpartum concerns including pain management, postpartum hemorrhage, hypertension, vaginal hematomas, thyroiditis and many others.

Problems included in the guideline were identified by the doctoral nursing practice student in collaboration with the midwifery advisor; interventions were synthesized from the literature and then reviewed by practicing, community midwives in Minnesota. Their suggestions and feedback were used to update and modify the initial draft. An Omaha System expert also evaluated the guideline and recommended changes. The guideline was presented at an Omaha System expert panel and feedback from the panel guided final revisions to the guideline. The project sought to create postpartum guidelines in order to enhance the usability of the Omaha System platform for midwives. Gaps in knowledge under the midwifery umbrella still exist and will continue to be integrated into the guideline in the future.

References:

American College of Nurse Midwives. (2012). Definition of Midwifery and Scope of Practice of Certified Nurse-Midwives and Certified Midwives. https://www.midwife.org/About-Midwives

American College of Obstetricians and Gynecologists. (2014). Safe Prevention of the Primary Cesarean Delivery. American College of Obstetricians and Gynecologists. https://www.acog.org/-/media/project/acog/acogorg/clinical/files/obstetric-care-consensus/articles/2014/03/safe-prevention-of-the-primary-cesarean-delivery.pdf

Rosenstein, M. G., Nijagal, M., Nakagawa, S., Gregorich, S. E. & Kuppermann, M. (2015). The Association of Expanded Access to a Collaborative Midwifery and Laborist Model With Cesarean Delivery Rates. Obstetrics and Gynecology, 126(4), 716–723.