EMS World

OCT 2018

EMS World Magazine is the most authoritative source in the world for clinical and educational material designed to improve the delivery of prehospital emergency medical care.

Issue link: https://emsworld.epubxp.com/i/1032353

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Page 28 of 87

WOMEN'S HEALTH 28 OCTOBER 2018 | EMSWORLD.com S ince the beginning of time, there have been references to women helping women give birth, the Old English definition of midwifery. Midwifer y continues today and in fact is increasing in the U.S.: Out-of-hospital births now account for approximately 6% of American births, up from 1% in the 1960s. There were almost 60,000 out-of- hospital births in the U.S. in 2014. While most occurred in home settings, 18,000 were in birth centers, which are freestanding, home- like facilities designed for the midwifery model of pregnancy and birth. As more and more women seek alter- native ways to normalize bir th due to the ever-rising rate of inter ventions like c-sections (now at an astounding nation- al average of 34%), midwifer y care will continue to grow. This ar ticle discusses what a midwife is and how EMS and mid- wives can work together. Types of Midwives While the medical model of care views pregnancy and birth as a condition that requires management, the midwifery model views it as a normal function of a woman's reproductive life. A midwife's goal is to keep birth as low-risk as possible. This doesn't mean midwives are opposed to intervention should the need develop, especially if the mother and baby require advanced medi- cal care. The mother's desire for a vaginal or out-of-hospital birth never overrides the safety of her or her child. There are three t y p e s of mid w i ve s in the U.S.: the cer tified nurse midwife (CNM), cer tified midwife (CM), and cer- tified professional midwife (CPM). Each has its own governing body that awards n ati o n al ce r ti f i c ati o n , m u ch like th e National Registr y of Emergency Medi- cal Technicians. As with other licensed medical professionals in the U.S., states regulate the scope of practice within each cla ssification of midwife, usually with boards to oversee licensure. A certified nurse midwife is an RN who has gone back to a graduate school pro- gram, traditional or distance learning, to obtain a master's degree in midwifer y. Their nursing back ground and advanced degree enable them to provide a broad range of women's healthcare ser vices from puber ty to grave. These midwives primarily practice in hospitals, but some practice in out-of-hospital settings. Sub- ject to state law, CNMs can typically con- duct Pap smears, write prescriptions, and attend to pregnant and birthing women, including scrubbing for c-sections. Nurse midwives are cer tified by the American Midwifer y Certification Board (AMCB) and exist in all 50 states. States can adjust the CNM scope of practice to their unique needs. EMS AND MIDWIVES: NAVIGATING THE OUT-OF- HOSPITAL TRANSFER By Jessica Arno, NRP, CPM These specialists can be a big help to EMS and new mothers when something goes wrong

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