A Nashville midwife has a different approach to pregnancy and birth than the standard OB/GYN. A nashville midwife works with low risk women and is able to attend births at home, in a freestanding birth center or in the hospital.
Typically, midwives have longer prenatal visits with their clients and stay with them during labor and delivery. They also are trained in emergency skills, such as neonatal resuscitation. The Nashville hospital credentialing and medical staff voting bodies began permitting midwives ten years ago. This enables expectant moms to get personalized care from a nurse-midwife and keep her in a hospital setting should an emergency occur.
A nashville midwife must have a nursing degree and complete a masters in nurse-midwifery. Those who have this degree are certified by the Council of Certified Professional Midwives (CPM). Nashville midwives can be found at private practices, hospitals and community centers. They are also licensed by the state of Tennessee. The certification process includes testing, education and experience. The CPM requires that a midwife complete 200 births and maintains ongoing training and clinical practice.
Nurse-midwifery is a specialty and requires students to be in the Nashville area for classes and clinicals. During their specialty year, nurse-midwifery students attend classes at Vanderbilt University and use local clinical sites. The students and faculty work in partnership to develop their knowledge of obstetrics, family planning, nutrition and health maintenance.
When the nashville midwifery students are in their final semester of the program, they begin applying for hospital privileges. The nursing school has a special agreement with Baptist Hospital and Vanderbilt to allow their student nurses access to the two largest maternity services in Nashville. The school’s faculty and administration felt that it would be in the best interest of its student nurses to have close relationships with these two major maternity facilities.
One of the main obstacles for these students was the fact that Vanderbilt has a relationship with the TMA and the hospital had a policy against granting privileges to CNMs. The school asked Vanderbilt to allow the nurse-midwifery students to be granted privileges at the facility, and it agreed to do so if the midwives signed a contract that stated that they would only do normal obstetrics and that they would work closely with OB/GYNs.
In the end, it was the OB/GYNs who prevailed in this case. The ad hoc committee, which included Dr. George Andrews, chairman of SHH’s obstetric department, and three other doctors, was concerned about the financial relationship between the nurse midwives and Dr. Martin and about the manner in which they were practicing. The committee never reviewed the specific midwifery protocol that was submitted by plaintiffs or discussed the ways in which it differed from OB/GYN practice. Consequently, the ad hoc committee recommended that SVMIC cancel midwifery coverage. The decision was upheld by a Board of Directors, including Dr. Hibbett, who voted against the renewal of coverage. SVMIC has not appealed the decision.