Characteristics of Spontaneous Births Attended by Midwives and Physicians in US Hospitals in 2014

Thornton, Patrick

doi:10.1111/jmwh.12638

Cited by 6 publications

(4 citation statements)

References 26 publications

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“…A review of 2014 birth certificate data for spontaneous vaginal births in hospitals showed that women with births attended by midwives vs. physicians were demographically similar on key variables such as age, race, education, marital status, and insurance type. 18 Though women who birth in community settings (e.g., home or freestanding birth center) are disproportionately white according to 2018 vital statistics data, 15 a study of a national sample of birth centers using 2007-2010 data reports 23% of birth center births were to nonwhite women. 6 That same study found that only 24% of birth center births were to Medicaid participants, far below the proportion of births covered by Medicaid.…”

mentioning

confidence: 99%

Midwifery and Birth Centers Under State Medicaid Programs: Current Limits to Beneficiary Access to a High‐Value Model of Care

et al. 2020

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Birth center services must be covered under Medicaid per federal mandate, but reimbursement and other policy barriers prevent birth centers from serving more Medicaid patients. r Midwifery care provided through birth centers improves maternal and infant outcomes and lowers costs for Medicaid beneficiaries. Birth centers offer an array of birth options and have resources to care for patients with medical and psychosocial risks. r Addressing the barriers identified in this study would promote birth centers' participation in Medicaid, leading to better outcomes for Medicaid-covered mothers and newborns and significant savings for the Medicaid program. Context: Midwifery care, particularly when offered through birth centers, has shown promise in both improving pregnancy outcomes and containing costs. The national evaluation of Strong Start for Mothers and Newborns II, an initiative that tested enhanced prenatal care models for Medicaid beneficiaries, found that women receiving prenatal care at Strong Start birth centers experienced superior birth outcomes compared to matched and adjusted counterparts in typical Medicaid care. We use qualitative evaluation data to investigate birth

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mentioning

confidence: 99%

Midwifery and Birth Centers Under State Medicaid Programs: Current Limits to Beneficiary Access to a High‐Value Model of Care

et al. 2020

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“…The argument has been made that studies comparing birth outcomes between provider types without stratifying for women’s risk status result in apples to oranges comparisons. Thornton (2017) examined the characteristics of spontaneous vaginal births attended by CNMs and physicians in U.S. hospitals and reported that in U.S. hospitals CNMs cared for women with a range of risks similar to those of women who were attended by physicians. Women who were cared for by CNMs had fewer labor inductions, epidural analgesia use, third- and fourth-degree lacerations, and newborn admissions to the neonatal intensive care unit.…”

Section: Discussionmentioning

confidence: 99%

Comparison of Nurse-Midwife and Physician Birth Outcomes in the Military Health System

Hamlin

Grunwald

Sturdivant

et al. 2021

Policy, Politics, & Nursing Practice

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The purpose of this study is to identify the socioeconomic and demographic characteristics of women cared for by Certified Nurse-Midwives (CNMs) versus physicians in the Military Health System (MHS) and compare birth outcomes between provider types. The MHS is one of America’s largest and most complex health care systems. Using the Military Health System Data Repository, this retrospective study examined TRICARE beneficiaries who gave birth during 2012–2014. Analysis included frequency of patients by perinatal services, descriptive statistics, and logistic regression analysis by provider type. To account for differences in patient and pregnancy risk, odds ratios were calculated for both high-risk and general risk population. There were 136,848 births from 2012 to 2014, and 30.8% were delivered by CNMs. Low-risk women whose births were attended by CNMs had lower odds of a cesarean birth, induction/augmentation of labor, complications of birth, postpartum hemorrhage, endometritis, and preterm birth and higher odds of a vaginal birth, vaginal birth after cesarean, and breastfeeding than women whose births were attended by physicians. These results have implications for the composition of the women’s health workforce. In the MHS, where CNMs work to the fullest scope of their authority, CNMs attended almost 4 times more births than our national average. An example to other U.S. systems and high-income countries, this study adds to the growing body of evidence demonstrating that when CNMs practice to the fullest extent of their education, they provide quality health outcomes to more women.

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“…Another systematic review identified exclusively U.S.-based studies and found similar results, with equivalent or superior outcomes in initiating breastfeeding, operative and cesarean births, and perineal lacerations (Newhouse et al, 2011 ). Additional research since 2011 confirmed Newhouse et al's finding (Hamlin, 2017 ;Thornton, 2017 ). From a policy perspective, midwifery care can be a cost-effective and sustainable approach to meeting society's women's healthcare needs (Renfrew et al, 2014).…”

Section: Nurse-midwivesmentioning

confidence: 91%

“…Births attended by CNMs and CMs occur primarily in hospitals; more than 94% of births in the United States occurred in hospitals in 2014, although the number of home and freestanding birth center births has been rising (ACNM, 2018 ;MacDorman, Mathews, & Declercq, 2014 ). Research has demonstrated fewer interventions, including lower cesarean birth rates, among CNM-attended births versus physician-attended births, as well as outcomes at least comparable to physician-attended births (Blanchette, 1995 ;Hamlin, 2017 ;MacDorman & Singh, 1998 ;Newhouse et al, 2011 ;Rosenblatt et al, 1997 ;Thornton, 2017 ).…”

Section: Nurse-midwivesmentioning

confidence: 99%

Overview of Advanced Practice Registered Nursing

Lindeke¹,

Avery²,

White³

2018

Advanced Practice Nursing Roles

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Advanced practice registered nurses (APRNs) are at the forefront of the rapidly changing healthcare system, filling myriad roles in organizations where they provide cost-effective, high-quality care. APRNs are found in virtually every area of the American healthcare system: clinics, hospitals, community health, government, administration, policy-making boards, and private practice. In addition, APRNs have expanded practice into international and trans global arenas. They serve the most economically disadvantaged as well as the elite. APRNs are deans, educators, consultants, researchers, policy experts, and, of course, outstanding clinicians.Advanced practice registered nursing is an exciting career choice with many opportunities and challenges. The challenges are often related to the rapidly changing healthcare environment that is contingent on funding decisions made at the state and federal levels of governmental funding. Prospective payment systems, health inequities, required outcome measures, and spiraling costs are daily APRN practice realities. Technology improves diagnostic and treatment results; genetic research is unraveling complex pathophysiology and immunotherapy; and sophisticated "big data" electronic infrastructures change the way information is gathered, stored, analyzed, and shared. Innovative care models are common and include telehealth programs, integrated or complementary modalities, and retail clinics. These and other trends result in a rapidly changing healthcare system, ready for the influence and influx of APRNs.Graduate education prepares APRNs to be key players in these complex systems. Midrange nursing theories provide strong conceptual foundations for APRN practice and nurse scholars. Nursing research uncovers scientific evidence for best practice, and research utilization skills enable APRNs to bring fresh ideas and proven interventions to healthcare consumers.

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Characteristics of Spontaneous Births Attended by Midwives and Physicians in US Hospitals in 2014

Cited by 6 publications

References 26 publications

Midwifery and Birth Centers Under State Medicaid Programs: Current Limits to Beneficiary Access to a High‐Value Model of Care

Midwifery and Birth Centers Under State Medicaid Programs: Current Limits to Beneficiary Access to a High‐Value Model of Care

Comparison of Nurse-Midwife and Physician Birth Outcomes in the Military Health System

Overview of Advanced Practice Registered Nursing

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