Survey of Connecticut Nurse‐Midwives

Abstract

Descriptive data on nurse-midwifery income, workload, job definitions, employment benefits, and clinical practices are limited. Information about nurse-midwifery practice today is important for the growth of the profession and for future policy initiatives. A survey of nurse-midwives in Connecticut was conducted in 2005. This article reports state-specific data about income, workload, job definitions, employment benefits, and clinical issues, such as vaginal birth after cesarean. Full-time midwives in Connecticut worked an average of 77 hours per week, had a mean salary of 79,554 dollars, and 87% had on-call responsibilities. A "typical" Connecticut midwife had an "average" full-time work week consisting of two 24-hour call days and three 7-hour office days, seeing 19 to 24 patients per office day. Most held Master of Science in Nursing degrees, worked in physician-owned practices, and attended births in hospitals or medical centers. Health insurance, paid sick time, and retirement plans were offered to most respondents. Almost all respondents provide gynecologic, antepartum, and postpartum care, but few offer newborn care. There is significant variation in restrictions on midwives offering vaginal birth after cesarean and on length of scheduled appointments. Data on expanded practices, such as first-assisting caesarean sections and endometrial biopsies, are reported for the first time.

A Profile of Colorado Nurse—Midwives

“…This finding was in contrast to the survey of Connecticut CNMs (Holland & Holland, 2007) that found that gynecologic care was provided by 99% and primary care by 52% of respondents. Jevitt and Beckstead's (2004) survey of Florida CNMs found 76% of respondents provided gynecologic care and 43.2% provided primary care for women.…”

“…It may also indicate the relatively scarce provision of nurse-midwifery care in rural Colorado areas-areas that have limited access to other primary care providers and specialists and where CNMs would be more likely to provide full scope care. Finally, and not surprisingly, very few (7%) nurse-midwives provided newborn care, a rate lower than the approximate 15% reported in other statewide surveys (Holland & Holland, 2007;Jevitt & Beckstead, 2004). This likely reflects the fact that 99% of all respondents attended births in the inpatient setting and were employed by hospitals or a physician group, consistent with national trends (Schuiling et al, 2005).…”

“…There have been three detailed statewide surveys of nursemidwives reported since 2001. Surveys of certified nurse-midwives in Florida (Jevitt & Beckstead, 2004) and Connecticut (Holland & Holland, 2007) detailed the use of nurse-midwives in providing health care, as well as the nature of services provided. A Washington state survey examined trends in nurse-midwifery attended births (Bussey, Bell, & LydonRochelle, 2007).…”

“…In addition, results confirmed that nurse-midwives provide care in a wide variety of settings, although largely for vulnerable populations with access and health care coverage issues. Although several of these studies (Holland & Holland, 2007;Jevitt & Beckstead, 2004;Schuiling et al, 2005) addressed income, compensation, and scope of practice of CNMs to varying degrees, none reported legislative concerns of practicing CNMs, or teaching involvement, practice leadership issues, or practice satisfaction. A full appreciation of where and how CNMs practice is central to detailing solutions that will provide access for a U.S. population with growing health care concerns.…”

The missing element: consanguinity as a component of genetic risk assessment

“…Increasingly midwives and certified nurse-midwives in many Western countries are providing a broad spectrum of maternity care, often working alongside obstetricians, general practitioners or family physicians. [27][28][29][30] Many hospitals are also encouraging midwives and certified nurse-midwives to work autonomously when providing prenatal care, a trend that has been observed internationally despite the differences in organized health care structures between different countries. 27,[31][32][33] As nothing is currently known about how midwives collect family history or their attitudes around asking about consanguinity, we have explored both current practice and attitudes toward collecting this information within an ethnically heterogeneous population.…”