Why is there a nurse when you have a midwife with hospital birth?

[Florence NightinFAIL]

A couple of days ago I visited my friend who was in labour at a hospital. She had a midwife but I noticed that she also had an assigned nurse. The nurse did what any labour/delivery nurse does - meds, assessments, etc. etc. But I thought what was the point of the midwife except to catch the baby? The nurse was also doing almost all the pt teaching. Is there a policy that you must have a nurse assigned to you?

I thought I might have a midwife when I gave birth but I'm not so sure anymore. I think more than one health professional with a laboring woman at the same time is too much.

This was in BC, Canada by the way.

[Silverdragon102, BSN]

I guess each country will do things their way. I know in the UK the midwife does everything and is generally the only nurse in the room unless they have students working with them. Only time a Dr is involved is if there is a problem with the delivery or the mother is a high risk delivery or C-section is required

[themoreyouknow]

Our midwives only come to catch the baby.

We do all the teaching/support.

[SandBetweenMyToes, BSN, RN]

In Canada, midwives are not nurses. They complete a 4 year baccalaureate leading to a Bachelor of Health Sciences degree. They are a regulated profession, but have a defined scope of practice, just as an RN does, though it is not the same scope. For further information:

Canadian Association of Midwives | CAM

Association of Ontario Midwives | Welcome to aom.on.ca

[withwomen]

Coming from an out of hospital background, it makes sense to have two assistants at a birth. Most of the midwives I know (CNM or DEM) have someone else in the room to assist with the births, or in the case of an emergency whether that person is an RN or in a home birth, a student or other midwife. Also, sometimes you need an extra hand for support or organizing the delivery area (moving sheets around, handing instruments). I do realize your question was referring to hospital births, where help is a button or call away but the local freestanding birth center we had in our city always had one midwife and an RN at each birth. And from what I saw it made a lot of sense. It sounds like in the case you refer to the RN was more of the teacher and hands on with the patient, which is usually the midwife's job. Just my humble observation. :)

[RootedRedwood]

Fromthesea- there is no hospital that I know of that allows non-nurse midwives to have hospital privileges- I am a direct entry midwife (not practicing) and I have never been allowed to deliver when my patients have to transfer, and that is true across the country.

This is why I am back in school for my CNM license!

Not totally on topic to the OP but just an FYI, I worked for a small community hospital in N. California that did give privileges to a non-nurse midwife to deliver in the hospital. This midwife is a CPM and has never gone to nursing school. I think it is up to the hospital and the MDs that would be backing you up, and there just aren't many that go the non-nurse midwife route here in the US. Rare but not non-existent.

To the OP, it sounds like it really varies a lot geographically. The two places I have worked the midwives always have an RN assigned to their patients to do much of the patient care (meds, fetal monitoring, vitals, assessments, labor coaching, education, waitressing, etc). The main difference for us as RNs if we have a midwife patient vs an MD patient is that the midwives tend to spend more time labor sitting and pushing with the patients and do most of the cervix checks/placement of internal monitors if needed. When I have an MD patient, I do everything except AROM and catching the baby (unless they don't get there in time :).

Safest for mom and baby to have a few sets of eyes and minds watching as labor progresses and definitely best practice to have two people with skills to resuscitate the infant if needed - hospital or at home.

[CEG]

I believe that non nurse midwives in Oregon are able to get hospital priveliges if they choose to get licensed. I have definitely heard of some practicing in hospital there but not sure about the exact rules.

[snazzy-jazzy, BSN, RN]

Different system in Australia, I think our scope is based along the same lines as the UK. We only have Midwives in the labour and Delivery wards, Both direct entry and RN Midwives. At the time of birth there are always 2 midwives in the room, one for the mum and one for the baby just incase there are complications.

[tntrn, ASN, RN]

All patients where I work will have a labor nurse, and a baby nurse when the birth occurs. We are all NRP certified, and thus anybody can be the "baby catcher." Of course, the real catcher is the OB, family practice doc, or a midwife....when we had them. We no longer have any nurse midwives.

Code pink for us is baby abduction.