Hospitalist Midwife

[imenid37]

Does anyone know how common this role has become? This type of work would be very appealing to me. I love working one on one with patients in the labour, birth, and triage settings. The "office visit" part is not for me. I have an MSN and worked with a CNM and WHNP in the clinic setting for about 200 hours total as part of my required rotations. It was so rushed. Yes the hospital can be rushed too, but I really like that type of work. Right now I have a job with almost no patient care and find myself longing for the bedside. I did M/B and L/D for many years. I felt I would like to increase my skills and considered midwifery. At the time, I was not in a position to travel and do clinicals while I had a 5 day a week job and teenagers at home. I have a CNS certificate, but mostly I am now doing admin work. If I found a CNS job where I was physically caring for patients, I would like that too. Any input would be greatly appreciated. I am turning 50 in March and have been an RN for almost 28 years. I wish I wasn't so damn restless!

[LibraSunCNM, BSN, MSN, CNM]

That is likely my biggest fear of actually becoming a midwife in a hospital setting, treading that fine line between conforming enough to policies to preserve my job yet helping to effect change. Having experienced and worked at places that encourages EBP, I fear getting emotionally worn out, especially since I suspect that most of the hospitals in my area aren't all that progressive.

To me it was worth it to work in a hospital and get a lot of experience. It can be emotionally exhausting at times, but mostly the good outweighs the bad. You try to advocate for change, and if the hospital is really really backwards, you get your experience and move on to someplace better, you know?

[queenanneslace, ADN, MSN, APRN, CNM]

There could be a big difference in being a midwife working in a hospital and being a hospitalist midwife.

Having hospital privileges and attending births in the hospital doesn't mean you can't provide evidence-based midwifery care.

Being hired on as a 'hospitalist' and working for the hospital - the midwife may have much less say in the type of care provided or how care is provided - for example, all 'undoctored' patients who met certain criteria would be routed to the midwife. The hospitalist midwife could be given the responsibility to 'manage' all the laboring patients - while the OB hospitalist performed surgeries and more complicated cases. I think the concept of a 'hospitalist midwife' is very appealing to hospitals, but not because hospitals want to necessarily increase access to midwifery care. They want to reduce the amount of money they're spending. And if hospitals can hire a provider (a midwife) who can handle a subset of the laboring population and cost less than an OB/GYN to employ, it's very appealing to their bottom line.

There are FANTASTIC midwifery practices with midwives who attend births in the hospital. Evidence-based, personalized care. Absolutely! These are midwife practices or midwife-physician practices.... very different than a hospital-employed midwife.