Support Midwifery at Evergreen Hospital

My daughter was born at Evergreen Hospital. The staff and nurses there are exceptional. The birthing suites are well equipped. The medical technology is state-of-the-art. But I didn’t know any of that when I chose to birth my daughter at Evergreen. I chose Evergreen Hospital because that is where the Certified Nurse Midwives at the Center for Women’s Health delivered babies. Unfortunately, the future of this practice is in jeopardy.

A Certified Nurse Midwife (CNM) is a highly-trained and licensed medical practitioner, but the child-birthing philosophy of a midwife is generally different from most Obestricians (OBs).

Midwives generally schedule more time for prenatal appointments. As a nervous first time parent, this time was critical for my peace of mind as I barraged the midwives with questions generally beginning with “Is it normal when-.”

Midwives are generally on call for urgent, but non-emergency, after-hours questions and concerns. Sharon Hammond, CNM, answered my call on a December evening when I received a small, but startling jolt from the Christmas tree lights. Janice Smith, CNM answered my call on President’s Day when I stumbled off a step at the state capital. On both occasions, the midwife assessed my condition over the phone and calmed my jittery nerves.

Midwives spend significantly more time with their patients during labor. Sharon, the midwife on call during my labor, was available throughout my labor suggesting different positions to cope with the pain and, eventually, supporting my decision to get an epidural.

Most importantly, midwives have a significantly lower rate of cesarean sections than OBs. According to the Center for Disease Control, the national rate of cesarean births in 2008 (the last year for which final data is available) is a startling 32%. Preliminary data for 2009 shows a 29.2% rate of cesarean births in Washington State. Midwives have a cesarean rate approximately 30% to 50% below the national average (depending on the source of information).

During labor, Sharon determined that my daughter was in a “less than ideal” birth position. Later, while pushing, I spiked a fever. Both circumstances commonly lead to an “emergency” cesarean section. In the absence of any other indication of risk, the midwives stayed the course. Both issues resolved on their own. My daughter was born happy and healthy without incident.

In many respects, my experience with the midwives at the Center for Women’s Health is typical of midwives generally. In one respect, though, it is very different. Most midwives in this region practice in birth centers or attend home births. The combination of a hospital birth attended by a midwife is somewhat unique to Evergreen Hospital. As much as I wanted by daughter’s birth attended by a midwife, I also wanted the very best medical intervention available at a moment’s notice. I was very grateful to have this option available to me.

Unfortunately, there is an unhappy prologue to an otherwise joyous story. The Center for Women’s Health recently restructured the practice. Instead of five midwives, one of whom was always on call, there are now only two. Each one works in conjunction with two OBs. As a result, a patient of the practice will not have her labor and birth attended by a midwife if the OB is on call when she begins labor. The midwifery practice is essentially gutted.

As a patient of the Center for Women’s Health, the news is heartbreaking. But this loss is not personal to the patients of this practice. No matter what one’s preferences regarding childbirth may be, there are simply fewer options available to all future expectant families in this region. The health of our community is poorer for it. Unless, that is, we do something about it.

Recognizing the value of a true midwifery practice at Evergreen, there initially was some movement toward the hospital absorbing the practice. That plan seems to have been tabled, if not totally jettisoned. However, there is a growing movement to encourage Evergreen Hospital to reconsider that decision. If you are pregnant, hope to be in the future, or know someone who is pregnant or hopes to be, (that’s pretty much everyone, right?) your help is needed. Please write a brief letter or email to the Evergreen Hospital Board of Commissioners and “like” our Facebook page "Support Midwifery at Evergreen."

With your help we can persuade Evergreen Hospital to establish an in-house midwifery practice, encourage lower rates of cesarean sections, and maintain the wealth of healthcare options we are accustomed to in our community.