Collaborative Practice Between Obstetricians and Midwives

Abstract

Richard N. Waldman, MDHolly Powell Kennedy, CNM, PhDCollaborative practice has been defined as the provision of health care by an interdisciplinary team of professionals who collaborate to accomplish a common goal, and is associated with increased efficiency, improved clinical outcomes, and enhanced provider satisfaction. There are many collaborative practices across this country in which certified nurse–midwives and certified midwives partner with fellows from the American College of Obstetricians and Gynecologists (the College) and provide outstanding health care. Although collaborative practice models are gaining increased attention from the Joint Commission and safety organizations, there are few articles that demonstrate successful models in action. The College and the American College of Nurse-Midwives (ACNM) have committed to the importance of a strong collaborative relationship evidenced in their recent joint statement on practice relations, which states, “…to provide highest quality and seamless care, ob-gyns and CNMs/CMs should have access to a system of care that fosters collaboration among licensed, independent providers.”).1 There are many different collaborative models of care that work well. The leadership of the College and ACNM decided to work together to create a project that would showcase collaborative models that work. The College President traditionally chooses an “issue of the year” to highlight a subject that is important and current in women's health. We turned that issue into a collaborative effort to showcase these successful models. A joint committee was formed between the two organizations that outlined the framework and criteria for the project. Papers were solicited from College and ACNM members to describe their collaborative practice. The papers had to be written jointly by an obstetrician and midwife. The committee maintained a nonhierarchical structure, both organizations had equal say in the decision process, and all decisions were made jointly. This was a truly collaborative effort from beginning to end. We were thrilled with the response. More than 60 papers were submitted, evaluated, and rated. Two papers from community and two from academic settings were selected and submitted for publication in Obstetrics & Gynecology (see pp. 663, 673, 678, and 683).2–5 The College and ACNM contributed $13,000 to a stipend fund that was distributed to the winners. The awards were announced at both organizations' annual clinical meetings with the presidents of both organizations and the co-chairs present. In our estimation, collaborative practice will be very important to the future of maternity care. Integrated practice models can reflect many forms and financial intricacies. It was our intent to showcase models that work so that others can learn from their success. Collaborative practice is a deep and thoughtful process and when it works well it is very rewarding. It is obvious that we tapped into a wealth of support throughout the United States.