National Midwifery Week is September 30 – October 6, and Tennova Healthcare is marking the occasion by sharing what it means to choose a nurse midwife for a hospital birth.

“For centuries, midwives have been attending births in cultures all over the world,” said Leonard A. Brabson, M.D., an obstetrician and gynecologist with Tennova Healthcare. “Today, there are a growing number of midwives who are registered nurses with master’s degrees. They work side-by-side with doctors to provide personalized care and counseling throughout pregnancy, labor, delivery and the postpartum period.”

While obstetricians and gynecologists are still the go-to professionals for most infant deliveries in the United States, midwife-attended births are growing in popularity. Additionally, the majority of those births now occur in hospitals.

Top photo L-R:

§ Chris Bottoms, CNM

§ Kelly Ostrowski, CNM

§ Laura Pohl, CNM

§ Sarah Key Wiklund, CNM

§ Blair Hicks Terrill, CNM

§ Adriana Matos Stiles, CNM

§ Hannah Proctor, CNM

§ Manola McCain, CNM

In the U.S., there are two categories of midwives: nurse midwives, who are trained in both nursing and midwifery; and lay midwives, who are not necessarily nurses before they train to become midwives.

Tennova Healthcare has eight certified nurse midwives (CNM) who see patients at Physicians Regional Medical Center and Turkey Creek Medical Center. Babies are delivered exclusively at The Birth Place at Physicians Regional Medical Center. Tennova’s certified nurse midwives are: Chris Bottoms, CNM; Blair Hicks Terrill, CNM; Sarah Key Wiklund, CNM; Adriana Matos Stiles, CNM; Manola McCain, CNM; Kelly Ostrowski, CNM; Laura Pohl, CNM; and Hannah Proctor, CNM. To schedule an appointment, call 865-647-3450.

A certified nurse midwife—such as those employed by Tennova—is a registered nurse who has graduated from an accredited midwifery education program and has passed a national certification examination. Lay midwives, also known as certified professional midwives (CPM), are able to assist with out-of-hospital births. They do not receive the same education or professional training as CNMs.

“The majority of CNMs earn bachelor’s degrees in nursing, work as registered nurses—often in labor and delivery units at hospitals—and then choose to go back to school for a two- or three-year master’s degree program in midwifery,” Dr. Brabson said.

Leonard A. Brabson, M.D., is an obstetrician and gynecologist with Tennova Healthcare

According to the most recent numbers from the American College of Nurse-Midwives, the majority of midwife-attended births occur in hospitals (94.2 percent), while the remaining take place in homes or freestanding birth centers. In the Knoxville area, Physicians Regional Medical Center was the first hospital to offer a midwife-attended birth.

More and more women are choosing to give birth with the support of a nurse midwife,” Dr. Brabson said. “In fact, since 1989—the first year that CNM statistics were collected—the percentage of CNM-attended births has risen annually. In 2013, for example, midwives attended approximately 8 percent of all hospital births.”

But what exactly is the role of a nurse midwife? “The term ‘midwife’ literally translates to ‘with woman,’” Dr. Brabson said. “Essentially, CNMs are trained to monitor the physical, psychological and social well-being of the mother throughout the pregnancy, labor and delivery. They provide individual prenatal care, education and counseling. They give continuous hands-on support during labor. And they also assist with postpartum mother and baby care as well as lactation assistance, if needed.”

CNMs may minimize the use of technological and drug-related interventions as well. Although many patients will ask for and get epidurals, other methods to manage pain will likely be encouraged first, such as water labor, massage or acupressure techniques. Tennova Healthcare recently introduced a patient-administered nitrous oxide and oxygen analgesia system, which is a safe and effective treatment for relief of pain and anxiety during childbirth.

At Tennova Healthcare, women can work with both midwives and doctors to ensure that the delivery is both safe and comfortable, depending on the mother’s medical history and pregnancy course. “For those who elect midwifery care, a risk assessment is done at the first prenatal visit and this process is on-going as the pregnancy progresses. If complications arise during pregnancy or childbirth, the CNMs will consult with me or another physician colleague,” Dr. Brabson said.

“Of course, not all pregnancies go as smoothly as planned,” he added. “Sometime, a C-section delivery may be indicated for the mom or baby’s health. In these cases, the midwife will accompany the woman to the operating room and remain with her for support. A CNM will resume care post-operatively to facilitate bonding and early initiation of breastfeeding.”

In addition to attending births, Tennova’s nurse midwives provide a wide range of women’s health services, such as annual exams, nutrition counseling, parenting education and reproductive health visits. Although the focus is typically on pregnancy and childbirth, the CNMs are medically trained to care for women and girls from adolescence though menopause and beyond.

For more information about midwifery services at Tennova Healthcare, call 1-855-TENNOVA (836-6682) or visit (WLAF NEWS PUBLISHED – 10/03/2018-6AM)