Doing the hands-on examinations were about a dozen nurses studying online and on the ECU campus to advance their primary care skills by becoming certified nurse midwives, the only program of its kind in North Carolina.
The students — and their patient-facilitators — were there because of their passionate wish to share the birth experience fully and get life off to a healthy start for babies, they said.
Chesna Barrett of Winterville lay on a bed, 29 weeks pregnant, patiently watching four students have their way with her daughter, Amelia, who was tucked safely away inside.
“This is a different experience than my first birth. I wanted to try something different this time. It’s pretty good,” Barrett said. “I get to share this.”
Erin Kitchin was unique among the pregnant mothers, all nurses, who were helping their fellow nurses get trained at nurse midwifery. Her husband, Benjamin, is the first man accepted into the ECU program.
“Midwives take a lot more time, they’re more down to earth and don’t push you so much to get the delivery done,” Kitchin said. “They want to know how you feel and are more comfortable to be with. I love them.”
Second-year nurse midwifery student Cherese Infinito, a mother of four, is convinced she was made for the program.
“After I had my first baby, program leaders called me and said this is what I was supposed to do” Infinito said. “I agreed, but I wasn’t even a nurse then, so I quit my job as a recreation supervisor and went to nursing school, and now am going for my master’s degree in nurse midwifery.”
The mother and student said she feels passionate about women and women’s health choices and needs to be part of the midwifery experience.
“Birth doesn’t have to happen (in a strict medical setting). You can listen to and trust your body,” Infinito said.
There are some misunderstandings among the general population about what certified nurse midwives do, according to educators in the program.
“A lot of people use the term ‘nurse midwife’ incorrectly,” said Becky Bagley, a clinical associate professor of nursing and director of ECU’s nurse midwifery program. Certified nurse midwives are registered nurses with advanced level degrees, training and preparation in miwifery. They provide primary care to women.
Only 11 of the state’s 250 nurse midwives actually deliver babies in a home setting, Bagley said. They work mostly in large hospitals and medical centers like Vidant and others, as part of a care delivery team. Many are delivery room nurses in addition to being midwives, she said.
Nurse midwives are able to provide health care to women throughout their lives, not just during pregnancy and birth, but right into the menopause years, said Pamela Reis, a doctoral assistant professor of nursing and nurse midwifery at ECU and a board certified nurse practitioner.
The numbers surrounding women’s gynecological and obstetrical health care underscore the need for more of them, Reis said.
Of North Carolina’s 100 counties, 31 have no access to an obstetrics and gynecology provider, with 11 more having only one or two such providers, and 47 counties have no access to nurse midwives, she said. Nurse midwives currently attend about 12 percent of all vaginal births in North Carolina.
“That’s not nearly enough to meet women’s needs,” Reis said. “The shockingly high infant mortality rates in eastern North Carolina while the rest of the state is showing decreases indicates that there is a huge need here,” she said.
Nurse midwifery is beginning to make inroads toward national recognition as effective quality primary care through programs like the one at ECU. They fit into the larger role nursing is called to play in health care reform, Reis said.
One of four key findings of a 2010 report by the Robert Wood Johnson Foundation and the Institute of Medicine called for full partnership among nurses, physicians and other health care professionals in redesigning health care in the United States.
“We’re now demonstrating that the quality of outcomes in patient care is better when there is a collaborative effort in designing care,” Reis said.
The American College of Obstetrics and Gynecology supports nurse midwives becoming their primary care partners in caring for women, she said, and collaboration among professionals is the ideal way to combine resources while health care reformers are trying to figure out how to increase access to quality health care in a the most cost-efficient way possible.
The ECU nurse midwifery program has its program online in hope of reaching potential students in the more rural areas of the state who can stay in those areas and provide services to the population with which they are familiar, Bagley said.
Nurse midwives can operate as self-sufficient businesses, and the ECU program tries to help in that area by offering an online “mini-business institute,” teaching them how to develop either an independent practice or work within a physician practice.