Newswise — Cesarean sections have reached the rate of one in three births — including births for first-time mothers — and the trend is rising, according to a study released this week by the National Institutes of Health. Critics say physicians perform them too often, needlessly exposing mothers and babies to major-surgery risks.
With a goal of eliminating unnecessary interventions, some leading nursing schools have begun offering a new educational program so that students can progress directly from a bachelor’s degree in nursing to a doctorate in nurse-midwifery, said Dr. Mary Ann Faucher, associate professor of nursing and program coordinator of the nurse-midwifery program at Baylor University Louise Herrington School of Nursing in Dallas. That nursing school is the country’s first to offer the new program.
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, Faucher said. The study was done with adjustments for medical risks and demographics and published in Obstetrics & Gynecology, journal of the American College of Obstetricians and Gynecologists.Nurse-midwives perform fewer episiotomies, fewer labor inductions and fewer births done with forceps or vacuum extractors than physicians do, Faucher said. Midwives do not perform operations but may assist and may prescribe medicine, including pain relievers.
Births attended by midwives translate to lower patient cost because of fewer cesareans, lower rates of technological intervention, shorter length of stay and lower payroll, Faucher said.
“The best practice is when midwives collaborate with obstetricians if there are complications,” she said.
Misconceptions exist about midwife-attended births — including that they usually occur in homes. In reality, more than 97 percent of the births occur in hospitals; 2 percent in freestanding birth centers; and fewer than 2 percent in homes, Faucher said.
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