Why would an OB want to sign a practice agreement with a CNM?

[SiennaGreen]

I am hoping to apply to Frontier in the next 2-3 years, and my husband wants to move to rural Ohio for grad school with an intent to stay and teach there. Lots of choices for him in places that are midwifery friendly (Yale, Ann Arbor..., but nooooo) he really likes this school and faculty.

I'm trying to envision what the benefits are to a local OB, who has worked hard for his/her practice, to want to sign an agreement with a CNM to practice? What are some real world experiances? What does the OB gain in this relationship? What are the qualities in an OB to look for that would make them a good candidate for a practice agreement? Likewise, some warning signs?

Thanks for the insight. I'm always thinking, formulating, strategizing. It's exhausting!

[Bobbkat]

I don't have an answer to your question, unfortuanatly, but I just had to chime in that I think it's amusing the two cities that you picked. I'm from Ann Arbor originally, and just moved east of New Haven, CT. I'm also planning on applying to CNM school within the next few years. I guess our environments really do shape us, lol!

[CEG]

I think there are kind of two schools of thought. One is that there are many doctors who support the midwifery model of care and believe in childbirth choices so they agree to sign collaborative agreements. The other is that there is money to be made in it- some midwives will pay a doc a fee for each patient. Many backup docs require a consultation with all the patients so they make money that way. Referals for patients who become high risk, require external version, scheduled section, etc. And in many cases it is cheaper to employ a midwife in an established practice than take on a partner or hire another doctor.

[strelitzia]

Hi,

My best friend is an OBGYN who employs a midwife, and her reason is to attract clients who are more into the natural birthing movement. She covers if the patient experiences complications, and her office has the benefit of billing for procedures/tests required over-and-above the midwife's services. Also, the midwife shares the 'on call' duties, relieving my friend of having to take call 24/7. It is also easier to find an MD to cover her practice when she takes leave, if the covering MD knows there is a midwife in the practice handling the run-of-the-mill stuff. So the MD benefits by attracting into her practice clients that would not normally come to her, as well as having someone share call duties. The midwife benefits by having an MD she is familiar with covering her tail if there are complications, and providing the physical setting in which to practice.

Male obgyn's often hire midwives to attract clients into the practice who prefer a woman practitioner, eg Muslims, Indians, lesbians (yes, they have babies too) etc.

Hope this helps!

[peytonsmom]

I live in the boondocks in NW Ohio (near the Toledo area). The OB that delivered me had a midwife in his practice and I saw both of them during my pregnancy. He was a DO that really believed in the practice of midwifery. He was def not your typical "labor on your back in the stirrups" kind of OB. Aside from that though it was good business for him to hire her. She brought in a lot of pt's for him that were looking specifically for a midwife and then due to complications needed to see an OB. There were also a lot of woman that specifically were looking for a woman to do their physicals and then would end up using him as their OB during a pregnancy if they were set on an OB vs midwife after meeting him. She also took turns w/ him doing on call as a lot of pt's didn't care which one of them delivered them.