Midwifery Care And Services

QI Plan Part 1: Midwifery Plan and Services

The American College of Nurse-Midwives is one of the oldest organizations in the practice of women's health care in the U.S. It is a professional association, dating back to 1929 and represents Certified Midwives and Certified Nurses-Midwives. According to ACNM (2010), ACNM provides research, administers and promotes continuing education programs, establishes clinical practice standards, creates liaisons with state and federal agencies and members of Congress (About ACNM, para. 1).

Mission and Type of Care and QI Goals

The mission of ACNM is to promote the health and well-being of women and infants within their families and communities through the development and support of the profession of midwifery as practiced by certified nurse-midwives, and certified midwives. The philosophy inherent in the profession states that nurse-midwives believe every individual has the right to safe, satisfying health care with respect for human dignity and cultural variations (About ACNM, para. 2). The profession of midwifery needs to have a high degree of promotional as well as increases in the delivery of care. All practicing midwives need to participate in all areas of quality management, quality improvement, quality assurance, and peer review. In order to improve outcomes of care, QI modifies the process of providing care. Patient satisfaction, population specific care, clinical outcomes, access to care and the appropriate use of resources and technology help in measuring the parameters that the modifiers are based on.

Role of the Consumer

The involvement of patients and their families helps in the care and referral process for midwifery services. Making sure that they are informed and actively involved in the birthing process is imperative in providing safe outcomes. The credentialing, regulation, education, and licensing of midwives are some of the major concerns to consumers, because they identify whether or not women of childbearing age will be able to receive the kind of midwifery care they are seeking and need.

External Indicators and Consumer Use in Quality Improvement

Citizens for Midwifery is a non-profit, volunteer, grassroots organization. Founded by several mothers in 1996, it is the only national consumer-based group promoting the Midwives Model of Care (Citizen's for Midwifery, n.d.).

A grassroots organization means a large number of people implementing a coordinated strategy to achieve change. The goal of Citizens for Midwifery is to see that the Midwives Model of Care is available to all childbearing women and universally recognized as the best kind of care for pregnancy and birth. Citizens for Midwifery also endorse the Mother-Friendly Childbirth Initiative (Citizen's for Midwifery, n.d.).

Medscape Today in their article Science and Sensibility: Choice of Birth Place in the United States: Qualified Home-Birth Providers states "Fortunately for the American public, evaluations that compare professional competencies and practices among maternity provider groups have found more similarities than differences in the basic skills and components of care that are offered to healthy women across birth settings (Rosenblatt, Dobie, & Hart, 1997) (Wachdorf, 2003).The degree of practice and educational pathways to licensure and certification can be different among certified midwives (CM), certified professional midwives (CPM), certified nurse-midwives (CNM), obstetricians and family physicians, but similar standardized competency assessment, quality assurance, and professional accountability measures are in place for each credential. (Medscape Today, 2010) (Vedam, Janssen, & Litchman, 2010, para. 12) (Friends of Midwives, 2010).

Women and families that are interested in determining whether or not to use a midwife in childbirth processes should do as much research as possible. Talking to other families about their experience with a midwife and use of the internet to search for resources providing choices in the type of services that are available are good ways to start. One of the resources available to educate both the consumer and persons interested in becoming a midwife is The Midwifery Education Accreditation Council (MEAC.) According to MEAC (2010), The purpose of

...