A pioneering program at the University of Vermont Medical Center to offer women the option of receiving care from certified nurse-midwives is marking its 50th year, making it the second-oldest hospital-based midwifery program in the nation. Since 1968, the Midwifery Service has managed 13,000 births and grown to the point of having certified nurse-midwives (CNMs) attend nearly 20% of deliveries, a rate more than double the national average.
“The high rate is meaningful because studies show better outcomes are associated with deliveries attended by nurse-midwives, including lower rates of emergency caesarean sections, fewer inductions and greater success with breastfeeding,” said Marti Churchill, CNM, who leads the hospital’s program.
Churchill, a 25-year veteran at UVM Medical Center, says women actively seek out midwives for those reasons, and because of their holistic approach. “No pregnancy happens in a vacuum. We attend to the mother’s psychosocial and emotional health and assess how she takes care of herself, her access to healthy food, how is she treated in her workplace, her housing situation – everything that can have an impact on a positive outcome.”
Nurse-midwives are trained to help women maintain healthy pregnancies and have optimal births and recoveries through education, counseling, prenatal care, hands-on assistance during labor and delivery, and postpartum support. They typically offer their patients a variety of options and seek to eliminate or minimize unnecessary medical interventions.
The UVM Medical Center Midwifery Service was initiated by Dr. John Maeck, chair of the Obstetrics and Gynecology Department at what was then known as the Medical Center Hospital of Vermont. Maeck’s familiarity with midwifery, gained during a medical training tour in England, led him to believe the involvement of midwives in a team approach with physicians would provide a high quality of care.
He connected with Claire Lintilhac, a Stowe resident and retired nurse who trained as a midwife in England. She encouraged and supported Dr. Maeck’s efforts to launch the program, which started with just one practitioner. She also began providing financial support to the program in 1978 when it expanded to become a 24/7 full scope practice. Her son and his wife, Phil and Crea Lintilhac, have carried on that legacy.
“Phil and I have loved getting to know the nurse-midwives who have continued the success of the program,” said Crea Lintilhac. “We believe nurse-midwives are the gatekeepers for low-risk births.”
Largely due to the constant support of the Lintilhac Foundation, the Service evolved to include research sabbaticals, a lactation clinic, a professional education program, and most recently a perinatal mental health service.
“I was introduced to the benefits of midwifery first-hand as an OBGYN resident here 37 years ago, and believe the mutual respect and partnership between physicians and midwives that has developed over the years provides tremendous benefit to our patients and families,” said John Brumsted, MD, CEO of the UVM Medical Center and president and CEO of the UVM Health Network. “The unwavering support of the Lintilhacs has advanced the profession of midwifery and allowed us to expand and improve the care we provide. We cannot thank them enough for their remarkable commitment.”
“We honor and bear witness to Claire Lintilhac’s vision and philanthropic legacy every day,” said Churchill.
One pioneering aspect of the program is a weekly Maternal Fetal Medicine clinic, staffed jointly by physicians and midwives, which allows women with high-risk, or more complicated pregnancies, to benefit from being cared for by both types of providers.
“I’m not aware of any other clinic like it in the country,” said Kelley McLean, MD, medical director of the Midwifery Service. “It is great to see these patients benefitting from a range of expertise in an integrated fashion.”
“It’s interesting to note that Vermont is transitioning to an approach to health care that essentially borrows from the orientation midwives have always had,” said Ira Bernstein, MD, Women’s Health Care Service Leader at the UVM Medical Center and chair of the department of Obstetrics, Gynecology and Reproductive Sciences at the Larner College of Medicine. “Their philosophy of looking at the whole patient to identify barriers to better health, and making wise choices about medical interventions will fuel continued improvement in our midwifery services and obstetrical care.”
About the University of Vermont Medical Center
The University of Vermont Medical Center is a 447-bed tertiary care regional referral center providing advanced care to approximately 1 million residents in Vermont and northern New York. Together with our partners at the Larner College of Medicine at the University of Vermont and the College of Nursing and Health Sciences, we are Vermont’s academic medical center. The University of Vermont Medical Center also serves as a community hospital for approximately 150,000 residents in Chittenden and Grand Isle counties.
The University of Vermont Medical Center is a member of The University of Vermont Health Network, an integrated system established to deliver high quality academic medicine to every community we serve.
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