The first nurses in the country to finish a rigorous new nurse-midwifery program will receive their degrees today (May 14) from Dallas-based Baylor University Louise Herrington School of Nursing.
The nursing school is the only one in Texas to offer the Doctor in Nursing Practice degree (DNP) in the specialty of nurse-midwifery, according to the Accreditation Commission for Midwifery Education.
With one of their goals being to eliminate unnecessary C-sections and other birth interventions, eight nursing schools in the United States have begun offering the degree program, which allows students to progress directly from a bachelor's degree in nursing to a doctorate in nurse-midwifery.
The DNP degree offers training similar to that given physicians but is more holistic and emphasizes non-intervention whenever possible, nurse-midwives say. The training centers on clinical application rather than a research-oriented dissertation.
Cesarean sections have reached the highest rate ever in the United States— nearly one in three births — and critics say physicians perform them too often, needlessly exposing mothers and babies to major-surgery risks.
"The million-dollar question is why the United States health care system has not taken advantage of midwifery for women's health," said Dr. Mary Ann Faucher, associate professor of nursing and program coordinator of Baylor's Louise Herrington School of Nursing.
"Costs are less to an insurance company because of fewer cesareans, lower rates of technological intervention, shorter length of stay and lower payroll."
While C-sections can save a mother or child's life in case of complication, the World Health Organization and U.S. health agencies say a C-section rate of 15 percent is closer to ideal than the nearly 32 percent — 1.4 million procedures — in American hospitals in 2007, the most recent year for which figures are available.
A comparison between physicians and nurse-midwives shows that outcomes of normal vaginal births at between 35 and 43 weeks of pregnancy are equal to or better than births attended by physicians.
, The comparison shows that births attended by a nurse-midwife had:
•A 33 percent lower risk of neonatal (the first 28 days of life) deaths
•A 19 percent lower risk of infant (the first year of life) mortality
•A 33 percent lower risk of babies with low birth weights.
***SOURCE: Obstetrics & Gynecology, journal of the American College of Obstetricians and Gynecologists. The study was done with adjustments for medical risks and demographics.
"We trust birthing; we trust women's bodies," Faucher said. "The best practice is when midwives collaborate with an obstetrician if there are complications."
While nurse-midwives do not perform operations, they may assist and may prescribe medicine, including pain relievers.
Nurse-midwives perform fewer episiotomies, fewer labor inductions and fewer instrumental births — those done with forceps or vacuum extractors — than physicians do, Faucher said.
More than 97 percent of births assisted by certified nurse-midwives occur in hospitals; 2 percent in freestanding birth centers; and fewer than 2 percent in homes, according to figures from the National Center for Health Statistics.
In births attended by nurse-midwives and intended to occur at home, only 9.1 percent of women were transferred to the hospital during labor or after birth. Only 1.1 percent of infants were transferred, according to a research summary compiled by the American College of Nurse-Midwives.
The American Association of Colleges of Nursing in 2004 endorsed changing the preparation for advanced nursing practice, including nurse-midwifery, from master's degrees to doctorates by 2015.
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