August 17, 2007

Nurse midwives delivering babies at Nashville General

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Nurse midwife Melissa Davis examines patient Shannon Adkines at the Vine Hill Community Clinic. (photo by Neil Brake)

Nurse midwives delivering babies at Nashville General

Vanderbilt University School of Nursing nurse midwives, who typically help birth more than 700 babies each year, have begun delivering babies at Nashville General Hospital (NGH).

Five babies were born at the facility in July and 20 more are expected to be delivered this month. The agreement, which went into effect July 1, is aimed at helping ease capacity issues in Vanderbilt's labor and delivery service as well as providing assistance to the underserved.

Rather than offering prenatal and women's care exclusively at the West End Women's Health Center (WEWHC), the nurse midwives have split their practice and also offer care at the Vine Hill Community Clinic (VHCC). WEWHC clients deliver at Vanderbilt while VHCC clients deliver at Nashville General Hospital.

“The hospital is very supportive and the staff is very receptive to working with midwives,” said Tonia Moore-Davis, M.S.N., C.N.M., clinical practice manager for VUSM's Nurse-Midwifery Faculty Practice. “A lot of people who work at General remember the Meharry midwifery program from several years ago, so we have been able to develop great working relationships so far.”

The VUSN nurse-midwifery team of 13 is divided between the two clinics and two hospitals in order to offer continuity of care for patients. There is some cross-coverage, and everyone is trained for deliveries at both locations. In case of emergency C-sections or operative deliveries, Meharry physicians serve as backup at the Nashville General Hospital site.

Most importantly, the patients are having positive birthing experiences, citing the smaller environment and family atmosphere at Nashville General. Many are self-pay patients and realize greater financial savings as well. Offering prenatal care at Vine Hill and deliveries at NGH will hopefully result in healthier babies, as many economically disadvantaged women do not seek care until early in the third trimester because of financial reasons or in some cases, language barriers.

NGH's labor and delivery department is about one-third the size of Vanderbilt's, but the new midwifery practice is helping drive renovation and expansion plans, scheduled to start this fall. The nurse-midwifery practice expects to deliver nearly 300 babies at Nashville General Hospital within the next 12 months.

Adding Nashville General Hospital to the midwifery service also helps with nursing student placements and preceptorships. VUSN is able to double the number of students per clinical rotation and give students a more hands-on labor experience in a low-intervention birth model.

“We are really hopeful that we can bring in volume to help jumpstart the renovation and expansion,” said Moore. “This has been a good move and offers future opportunities as well.”