Nurse-midwives address obstetrician shortage at Wisconsin hospital

A new collaborative model puts certified nurse-midwives at the helm of care teams, which can help hospitals facing a shortage of obstetricians, according to a study published in Mayo Clinic Proceedings: Innovations, Quality & Outcomes.

The American Congress of Obstetricians and Gynecologists projected that there will be a shortage of up to nearly 9000 obstetricians and gynecologist (OB/GYN) by 2020, which will grow to a shortage of up to 22,000 by 2050, according to a 2019 Doximity report.

To address the looming shortage, Mayo Clinic Health System-Franciscan Healthcare in La Crosse, Wis., created a care model of certified nurse-midwives leading care teams.

Per the model, the nurse-midwives provide around-the-clock care for obstetric patients who are at low to moderate risk, with generalist obstetricians on call, as needed. Patients can choose whether to participate in the care model. The model was implemented in July 2014.

After the model was implemented, the primary cesarean section birth rate and vaginal operative deliveries at the hospital declined, while rate of vaginal births after C-sections increased. Admissions to the neonatal intensive care unit decreased from 14.9 percent in 2012 to 10.9 percent in 2017.

"Across the country, hospital delivery units are facing a shortage of obstetricians due to a change in the workforce and increasing demands," said Gokhan Anil, MD, an obstetrics and gynecology physician at Mayo Clinic Health System and first author of the report. "Innovative approaches to staffing are needed to serve the needs of the patient, increase collaboration and improve patient safety."

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