Obstetrician and nurse-midwife collaboration: Successful public health and private practice partnership

Jennifer Shaw Battista, Annette Fineberg, Barbara Boehler, Blanche Skubic, Deborah Woolley, Zoe Tilton

Research output: Contribution to journalArticle

26 Citations (Scopus)

Abstract

Objective: To evaluate maternal and neonatal outcomes of collaborative maternity care for a socioeconomically diverse patient population in a California community hospital. Methods: Collaborative practice structure and clinical guidelines were analyzed, as were de-identified electronic medical records for all primiparous women who delivered term singletons between 2000 and 2010 (N=4,426). Demographics, care processes, and perinatal outcomes were compared among women seen prenatally in a private collaborative practice compared with a Federally Qualified Health Center prenatal clinic run by nurse-midwives. Results: Evidence-based practices were used to achieve excellent perinatal outcomes. Three quarters of women received intrapartum nurse-midwifery care (74.4%). Few differences were seen in management or outcomes among women from different prenatal clinics despite significant variation in demographic and clinical characteristics. Private practice patients were older, less likely to be obese, and more likely to speak English compared with counterparts from public health clinics. They were also more likely to use hydrotherapy or epidural analgesia, or experience severe perineal laceration and repair. Overall, pharmacologic pain relief methods were limited: less than a quarter of primiparous women used narcotics (21.2%), epidural analgesia (23.7%), or warm water immersion (23.2%). Labor induction and augmentation, and cesarean delivery rates (12.5%), were similar among groups and low overall. Conclusion: A collaborative practice of low-tech, high-touch care results in high-quality maternity services. The care model holds promise for replication to address health disparities by limiting obstetric interventions and warrants further investigation with regard to associated costs and resultant outcomes.

Original languageEnglish (US)
Pages (from-to)663-672
Number of pages10
JournalObstetrics and Gynecology
Volume118
Issue number3
DOIs
StatePublished - Sep 1 2011
Externally publishedYes

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Public Health Practice
Nurse Midwives
Private Practice
Epidural Analgesia
Hydrotherapy
Demography
Induced Labor
Perinatal Care
Lacerations
Electronic Health Records
Evidence-Based Practice
Narcotics
Community Hospital
Health
Touch
Midwifery
Immersion
Obstetrics
Public Health
Nurses

ASJC Scopus subject areas

  • Medicine(all)

Cite this

Obstetrician and nurse-midwife collaboration : Successful public health and private practice partnership. / Shaw Battista, Jennifer; Fineberg, Annette; Boehler, Barbara; Skubic, Blanche; Woolley, Deborah; Tilton, Zoe.

In: Obstetrics and Gynecology, Vol. 118, No. 3, 01.09.2011, p. 663-672.

Research output: Contribution to journalArticle

Shaw Battista, Jennifer ; Fineberg, Annette ; Boehler, Barbara ; Skubic, Blanche ; Woolley, Deborah ; Tilton, Zoe. / Obstetrician and nurse-midwife collaboration : Successful public health and private practice partnership. In: Obstetrics and Gynecology. 2011 ; Vol. 118, No. 3. pp. 663-672.
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