A Profile of Colorado Nurse—Midwives

Abstract

Nurse-midwives provide significant health care to underserved and vulnerable women, yet there is limited information about the nature of nurse-midwifery practices and compensation for services. This study reports the results of a Colorado statewide survey of nurse-midwives (N = 217). Electronic survey was utilized to detail practice in seven areas: demographics, type of practice, compensation, leadership, legislative priorities,teaching involvement, and practice satisfaction. Responses (N = 114) were analyzed using SPSS 13.0. Results found wide variation in compensation and practice types. Respondents largely worked in urban settings, cared for low to moderate risk patients, and were generally older and White. Restriction from medical staff membership, prescriptive authority constraints, and liability issues were practice limitations. While teaching a wide variety of learners, nurse-midwives do limited mentoring of nurse-midwifery students, a finding which is concerning given the decreasing numbers of nurse-midwives. Findings are compared to known national data, with implications for the provision of health care services detailed.

Trends in Practice Patterns and Perspectives of Colorado Certified Nurse-Midwives

“…This research, however, saw an increase in the number of respondents reporting primary employment in solo or group midwifery practices at 13.7%, a number higher than the 7.3% reported nationally (Schuiling et al, 2013) and higher than the 4.8% reported in 2009 (Hastings-Tolsma et al, 2009). This increase likely reflects greater emphasis on out-of-hospital birth and a desire for less physician supervision.…”

“…Fewer than 10% planned to seek employment in education (n ¼ 7, 6.7%). For CNMs currently in clinical practice, the average satisfaction rating on a scale of 1 to 10 (least to most satisfied) was 7.66 (SD ¼ 1.69)-a rating unchanged from a 2009 survey of Colorado CNMs (Hastings-Tolsma et al, 2009). …”

“…A prior survey of Colorado CNMs found most respondents aged 46 to 55 years (Hastings-Tolsma et al, 2009) and given retirement projections, findings are of concern. Similarly, there were virtually no improvements in ethnic/racial diversity despite the majority of respondents caring for ethnically and racially diverse patients.…”

“…A survey tool developed for use in this study was originally developed in 2001 and adapted for use in 2008 and again for this research (Hastings-Tolsma et al, 2009). Items were reviewed by the current team of investigators with items deemed irrelevant deleted and additional items added to more appropriately meet the objectives of this study.…”

“…Membership in the American College of Nurse Midwives (ACNM) was 76.9% (n ¼ 80), a number largely unchanged from the 2009 survey (Hastings-Tolsma et al, 2009). Colorado CNMs who were in full-scope practice were more likely to be members of ACNM (84.2%) than those who were not in full-scope practice (61.6%).…”