New England Midwifery's Certified Nurse Midwife team, from left, Kerri Hoyt, Isabel Brewster, Kelli McKay, Christy Aberg and Jewelia Chrevalier.
This article originally appeared on Manchester InkLink.
As gynecological services shrink nationwide, Catholic Medical Center recently expanded its midwifery program to aid in hospital births at the center.
Midwives are certified medical professionals who care for women — especially pregnant women — during different phases of their lives, from adolescence to menopause. Midwifery services also include reproductive care, newborn and postpartum care, counseling on birth control and pelvic exams.
“We’re trained in caring for women throughout their lifespan,” said Isabel Brewster, a certified nurse-midwife at Manchester’s CMC.
At a time when the gap between OB-GYN providers and patients widens nationwide — including in New Hampshire, New England Midwifery offers a collaborative and personalized model that helps women with their pregnancies every step of the way.
“You’re going to get to know us, and we’re going to get to know you,” said Kerri Hoyt, another CNM at CMC, who has been affiliated with the organization for the last 22 years.
NEM, previously known as St. Mary’s Bank Pregnancy Care Center, is one of the several healthcare centers that offer midwife-attended births in New Hampshire, and was launched last month.
Earlier last month, NEM delivered its first baby, Vera, as it simultaneously announced the expansion to include inpatient and outpatient services, including 24-7 inhouse resources for coverage of midwifery services for labor, delivery and postpartum support. Every pregnant patient who comes in to receive care at CMC is automatically connected to CMC’s midwifery program.
“Luckily, it is the default right now,” Brewster said. “Most women are low-risk, so they are able to be cared for by midwives.”
NEM currently has five full-time staff members, with a hope to hire a sixth CNM as soon as possible.
Expansion of midwifery services is a trend visible nationwide, as maternal health advocacy increases, health care provider shortages exacerbate and maternity care deserts continue to emerge.
OB-GYN shortages continue to worsen in the country with almost 500 hospitals — 200 of which were in rural areas — closing their obstetrics units between 2010-2022. According to the U.S. Department of Health and Human Services, there is a projected shortage of 5,000 OB-GYN providers by 2030, with numbers reaching to 22,000 by 2050.
And midwives help address this provider shortage.
“We very much practice evidence-based care, much like our OB-GYN colleagues do,” Hoyt said.
CMC’s investment in midwifery services also comes at a time when maternal deaths in the country are rising, with the U.S. reporting the highest rate of maternal deaths among any other high-income nation in the world. In 2022, there were almost 22 maternal deaths per every 100,000 live births in America, according to the Centers for Disease Control and Prevention.
Studies say that most of these deaths, nearly 80 percent, are preventable if strong policies and proper medical support systems are provided to women.
“Skilled midwives help women trust in their bodies, their abilities, and their care,” said Ulrika Rehnstrom Loi, Midwifery expert at WHO and technical lead for the guidance.
At the same time, nationwide, interest in midwifery services is growing in the U.S., and midwife-attended births increased from 1.1 percent childbirths in the 1980s to 12 percent in 2020.
“A lot of patients now actually are looking for nurse midwives and are happy to deliver at CMC. They are looking for midwifery care. It’s back on the rise in the US,” Hoyt said.
While some midwives can assist in home births, CMC’s midwifery team exclusively operates from an in-hospital setting and works closely with the hospital’s OB-GYN physicians, Brewster said, debunking a widely-held belief that midwives only assist in traditional births.
“Most nurse midwives practice within hospital systems,” Brewster said. “There are some who run birth centers or do home birth, but most nurse midwives work in hospital settings, and so our practice is exclusively hospital based birth.”
At CMC, women travel from several New Hampshire towns to experience improved birthing experiences through NEM’s midwifery team, Hoyt shared.
“I just finished a 24 hour call shift this morning, and I had two beautiful births,” Hoyt said. “One was a first time mom. She was actually a transfer from a local birth center who just needed a little bit more hospital support.”
Hoyt’s other patient, reported having a suboptimal birthing experience previously, and decided to travel an hour to deliver her baby at CMC, she said.
“That probably would have been unusual, 10-15 years ago, for women to travel that far,” Brewster said. “I guess they come seeking these specialized services that we offer.”
With several years of nurse midwifery experience under their belts, it isn’t mere professional experience in the field that commits both Brewster and Hoyt to their jobs.
Less than a year ago Brewster delivered her now nine-month-old at CMC with the assistance of a midwife, after delivering her first born similarly. Hoyt too had midwives assist in the birth of all her three children, she said.
“[Midwifery] is really extraordinary. And babies do better. Moms do better. There’s lower risk of postpartum depression,” Hoyt said.