When you do research on the benefits of working with a midwife, you will probably see the phrase “collaborative model” or “collaborative care” multiple times. And there is a good reason for this. Midwives, like the ones at City of Oaks Midwifery, pride themselves on the successful outcomes they achieve through collaborative pregnancy care. But what does it mean when we talk about the collaborative model and collaborative pregnancy care?
What Is the Definition of Collaborative Pregnancy Care and Who is Involved?
As the name implies, collaborative care is the collaboration of multiple healthcare providers on one woman’s care plan. This relationship between providers must be built on an understanding and respect between disciplines with the goal of optimal outcomes for the woman, the newborn(s), and the family.
Each provider brings a unique skillset to the table, and those skillsets complement each other and open up new possibilities for a woman’s care plan. The providers involved in collaborative pregnancy care can include:
- Family Physicians
- Nurse Practitioners
Depending on the specific needs and preferences of the woman and her baby, other health professionals that may be part of her care team include physical therapists, dieticians, anesthesiologists, pediatricians, and/or neonatologists. Lactation consultants, social workers and doulas may also be involved.
What are the Principles that Guide the Collaborative Model?
The Boston Medical Center has laid out a collaborative model that has ten basic principles that the members of the care team must keep in mind at all times. This is important for doctors and midwives to stay on top of, but as a patient, you do not need to know every single one. Still, when you see what the healthcare providers are striving for, you might have a better understanding of what the goal is in regards to your care.
- Team Focused: Responsibility for the care of women in triage, during labor and delivery, and during the postpartum stay, rests with a team of professionals rather than one provider.
- Clarity of Responsibility: Supervising providers and responsible parties for each case should be clear to all personnel at all times.
- Citizenship: Interactions between care partners will be respectful and constructive. Communication should focus on excellence in patient care.
- Acceptable Case Load: Safe patient care is possible only if providers are responsible for a reasonable number of women in labor and personnel are well rested.
- Maximizing Continuity: If possible, the first option for the care provider group on labor and delivery should be the one with whom the woman has an established relationship.
- Frequent Communication: Frequent communication is key for providing safe care. Regular interdisciplinary board rounds and updates can promote this.
- Good Documentation: Clear and consistent documentation is necessary for all care delivered. All co-management or transfer of care should be written in the chart.
- High Efficiency: Healthcare providers should make the most of their skills by caring for the women whose needs match their highest level of training.
- Evidence-Based Care: Care will be based on the most current evidence that has been standardized from one provider to another.
- Excellence in Education: At teaching hospitals, all members of the care team should help educate residents and students.
What are the Desired Positive Outcomes of Collaborative Pregnancy Care?
One of the most important, if not the most important, goals of collaborative pregnancy care is that the woman has the ability to make informed decisions about her own care. The collaboration should not just be between the healthcare providers, but between the providers and the patient as well. The aim is for prenatal care, labor and delivery, and postpartum care to be as safe, positive, and comfortable as possible for mother, baby, and the rest of the family.
This model of care falls right in line with the mission of the American College of Nurse-Midwives (ACNM), which champions midwifery as a way to achieve optimal health for women. This includes well-woman care, gynecological care, prenatal care, labor and delivery care, postpartum care, and newborn care.
So, when midwives are included in collaborative pregnancy care, they get a chance to make that positive impact while involving healthcare providers in other disciplines. Overall, collaborative care between midwives and physicians has proven to positively impact outcomes. The specific benefits of these collaborations include:
- Decreased risk of preterm birth
- Decreased infant mortality rates
- Lower costs of birth for patients and insurers
- Increased satisfaction with quality of care
If you are ready to start your journey into collaborative pregnancy care, or just want to talk to someone about your options, call City of Oaks Midwifery at (919) 351-8253 to make an appointment. We have three convenient locations in North Carolina to serve you: in Raleigh, Clayton, and Cary.