{"id":34686,"date":"2020-09-29T11:26:25","date_gmt":"2020-09-29T17:26:25","guid":{"rendered":"https:\/\/www.uchealth.org\/today\/?p=34686"},"modified":"2023-06-23T11:47:14","modified_gmt":"2023-06-23T17:47:14","slug":"certified-nurse-midwife-assisted-birth-creates-presonalized-care","status":"publish","type":"post","link":"https:\/\/www.uchealth.org\/today\/certified-nurse-midwife-assisted-birth-creates-presonalized-care\/","title":{"rendered":"Certified nurse midwives help moms create their own birth experience"},"content":{"rendered":"
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\"Abby
Abby Zamora’s third child gazes lovingly at her little brother. Abby Zamora has loved having nurse midwife-assisted births. Photo courtesy of Abby Zamora.<\/figcaption><\/figure>\n

When she reflects on her experience having kids, Abby Zamora chuckles and admits many women, and even traditionally minded men, probably think she\u2019s crazy.<\/p>\n

\u201cI love pregnancy, labor and delivery,\u201d she says. \u201cIf you love something, you do it.\u201d<\/p>\n

She\u2019s had ample opportunity to test that love. Zamora, 36, and husband Steven have three children of their own \u2013 daughters 7 and 4, and a son, 5. She\u2019s also been a gestational surrogate for intended parents. She delivered a baby boy for a couple in January 2019, and is now in the fourth month of a second \u201cgestational surrogacy journey\u201d for another couple.<\/p>\n

\u201cBeing able to give the gift of a child to someone is beyond words,\u201d Zamora said.<\/p>\n

\"Abby
Abby Zamora, husband Steven and their three children, who all had certified nurse midwife-assisted births at UCHealth. Photo courtesy of Abby Zamora and Kristi Williams Photography.<\/figcaption><\/figure>\n

Not that she romanticizes pregnancy. Zamora was in labor for 48 hours with her boy, one of her three \u201ckeepers,\u201d as she put it, and finally chose an epidural to manage the pain only in the last two hours. She had little pain with her first daughter, but was in labor for 36 hours and delivered after three hours of pushing. Those kids both arrived past their due dates. She jokingly calls her youngest \u201cher favorite\u201d because she arrived three days early \u2013 the other two were past due \u2013 after \u201conly\u201d 10 hours of labor.<\/p>\n

Insisting on a nurse midwife-assisted birth<\/strong><\/h3>\n
\"Abby
Abby Zamora has loved having nurse midwife-assisted births. Here, her third child hugs her belly when she was pregant for the first time as a surrogate. Photo courtesy of Abby Zamora.<\/figcaption><\/figure>\n

Aside from the unswerving supportive presence of Steven, one factor unites Zamora\u2019s deliveries. They all happened under the care of certified nurse-midwives at UCHealth University of Colorado Hospital<\/a> on the Anschutz Medical Campus<\/a>. These midwives are part of the UCHealth Center for Midwifery<\/a>, which along with other sites provides care from certified nurse-midwives across the metro area (see box).<\/p>\n

When the attorneys for the couple whose unborn child Zamora now carries told her they wanted her to deliver with an obstetrician, she, in turn, delivered a simple message. \u201cI said, \u2018It\u2019s my midwives or I\u2019m walking,\u2019\u201d she recalled, and held her ground successfully.<\/p>\n

The mini-confrontation begs a couple of questions. Just who are these nurse-midwives and why should there be resistance to them? It\u2019s an especially opportune time to pose the questions. October 4 marks the start of National Midwifery Week<\/a>. In addition, the World Health Organization has declared 2020 the Year of the Nurse and the Midwife.<\/p>\n

Specific training and roles<\/strong><\/h3>\n
\"Abby
Abby Zamora is approaching her fifth birth assisted by certified nurse midwives at the UCHealth Center for Midwifery. Photo courtesy of Abby Zamora.<\/figcaption><\/figure>\n

As to what they are: Certified nurse-midwives are registered nurses who complete master\u2019s-level midwife education programs approved by the national Accreditation Commission for Midwifery Education<\/a>. They receive certification after passing an exam through the American Midwifery Certification Board<\/a>.<\/p>\n

Certified nurse midwives assist during childbirth, but they provide a range of services encompassing women\u2019s health<\/a> before, during and after pregnancy. In so doing, they \u201caugment\u201d the care provided by maternal and fetal medicine specialists, obstetricians, and family medicine physicians, said Jessica Anderson<\/a>, director of Midwifery Services\u00a0and associate professor of Clinical Practice at the University of Colorado College of Nursing<\/a> (CU Nursing). Anderson noted that 2020 marks the 40th<\/sup> year of the midwife education program at CU Nursing<\/a>, which was recently named one of the top\u00a0 midwifery programs in the country.<\/p>\n

\u201cWe are a unique profession and serve different purposes,\u201d said Anderson, who delivered Zamora\u2019s third keeper. For example, nurse-midwives refer their high-risk pregnancy patients to physician specialists, but physicians also refer low-risk patients to midwives.<\/p>\n

\u201cPatients want options to choose what is best for them,\u201d Anderson said. \u201cThey also have the ability to move around the spectrum of care based on their health care needs. We augment each other rather than compete.\u201d<\/p>\n

Setting aside stereotypes<\/strong><\/h3>\n

The reality of midwives stands in stark contrast to stereotypes Zamora says some people still cling to.<\/p>\n

\"Jessica
Jessica Anderson, director of Midwifery Services at the UCHealth Center for Midwifery. Photo by UCHealth.<\/figcaption><\/figure>\n

\u201cWhen you mention nurse-midwives, people may think of a hippie chick coming to your door, giving everyone a shot of vodka and you have a baby in your living room,\u201d she chuckled. But she admits her decision in 2012 to have a nurse-midwife assist in her delivery concerned even husband Steven at first. \u201cEverybody\u2019s stigma is that you\u2019ll have a home birth, unmedicated, with someone with no medical training,\u201d Zamora said.<\/p>\n

That\u2019s far from the reality. All women who receive care from nurse-midwives at UCHealth and the University of Colorado deliver at University of Colorado Hospital, where higher-level care is readily available if it\u2019s needed. (About 94% of certified nurse midwife-assisted births nationwide occur in hospitals.) That fact, and a few visits with Abby\u2019s nurse-midwives, quickly allayed Steven\u2019s fears and, later, the concerns of the attorneys for the intended parents of her current surrogacy.<\/p>\n

Why choose a certified nurse midwife-assisted birth rather than an obstetrician? It\u2019s still a relatively uncommon choice, representing only about 9% of births in the United States. Anderson said midwives use their nursing and midwifery skills to create a \u201cpersonalized\u201d experience for women that focuses on meeting their individual needs and expectations for childbirth and their health as a whole.<\/p>\n

Individualized approach<\/strong><\/h3>\n

Zamora said she appreciated the \u201cquiet strength\u201d that her nurse-midwives projected during each of her births. They stood ready to call in additional medical care if a problem arose, like the baby\u2019s heart rate decelerating with contractions. With her second biological child, her prolonged labor led her midwife to warn she might need induced labor or a C-section instead of the natural birth she wanted. But after she agreed to medications to help her sleep, she emerged \u201cre-energized\u201d to get through the rest of her labor. She asked for an epidural, her midwife checked her progress and approved, and Zamora delivered her baby about two hours later.<\/p>\n

<\/strong><\/p>\n

Sites for midwifery services in the UCHealth\/University of Colorado system:<\/p>\n