As hospitals are held increasingly accountable for health outcomes and satisfaction of childbearing families and the maternity care workforce shortage grows each year, it has never been more critical to reconfigure hospital staffing models. Of key importance is to understand and successfully integrate all available roles and providers into birthing facilities with them practicing to the full scope of their education, certification and licensure.
Decades of research and data from countries that spend far less on maternity care with better outcomes, demonstrate successful integration of Midwives. ACOG continues to endorse advancing Midwives in team-based models of care by providing the right provider, for the right patient at the right time.
Grow Midwives brings over 70 years of combined experience integrating midwifery-led models as Chief Midwives and Service Directors in community-based and academic teaching centers. Our goal is to facilitate the role of Midwives in hospital settings whose mission is to provide quality care that improves the health and well-being of childbearing families.
How Can We Create a Midwifery Led or Alongside Birth Facility for Low Risk Patients
One of the challenging questions that the midwifery profession is still trying to figure out is, “How do we look attractive in a collaborative relationship? Perhaps it is with a privately owned obstetric group. Maybe it’s 5 obstetricians and 4 midwives. Maybe it’s a hospital based service where physicians are collaborating through mutual employment models. There are many possibilities to fit a variety of situations for different birthing facilities.
How do you figure out your income and expenses in a collaboration? How do you ensure that all parties make some profit margin that’s respective to the body of work that each has done and to their degree of training? How do you measure the level of acuity of services each provides?
Midwives aren’t surgeons. Midwives primary scope of care is in working with normal, healthy people. One of the important things few midwives have thought about, or accounted for in any kind of data collection, is “How much money are they generating based on the services they provide in a given period of time?” Creating this kind of pro forma is incredibly important for Midwives, yet almost never happens today.
How Do We Open an Accredited Birthing Facility
Opening an accredited birth center would start with understanding what the American Association of Birth Centers (AABC) promotes as exemplary models of free-standing birth centers. Creating environments that emphasize family centered care for low risk maternity patients in an out-of-hospital birthing facility.
Alongside the AABC, is an accrediting body that is not affiliated with, but works in tandem to promote accreditation of freestanding birth centers, the Commission for Accreditation of Birth Centers (CABC).
Birth Centers can be owned and operated by midwives or physicians or hospitals. When you think about accrediting a birth center, again you need to go back to state regulations. About half the states in our country have state licensure regulations that are additional to an accreditation process. Some insurance companies are likely to mandate both state licensure and accreditation before reimbursing for a facility fee. Additionally, some states do not require accreditation of your birth center or have regulatory requirements.
Optimal safe practice is best provided by meeting minimum requirements of CABC accreditation. There is a cost associated with accreditation as with any oversight organization that provides recommendation of quality review. However, Grow Midwives believes this is the most rigorous process demonstrating public safety and accountability. We believe this is a requirement for safe care in all birthing facilities.
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