When University of Vermont Health-Central Vermont Medical Center began planning to expand its midwifery program, the goal was clear: respond to community demand calling for more access to midwifery care and build a sustainable, team-based model for reproductive health. 

That vision became a reality in 2025, when Central Vermont Medical Center grew its midwifery team to four certified nurse midwives (CNMs). Together, they now provide around-the-clock coverage and care for patients with low-risk pregnancies, as well as physician-supervised support for those with moderate-risk pregnancies. 

The expansion also reflects a broader strategy: strengthening obstetrics and gynecology services in rural areas while responding to shifting demographics, including a rising need for surgical gynecology and menopause care." We are taking care of our friends, neighbors and colleagues," says Colleen Horan, MD, site director for Central Vermont Medical Center’s Department of Obstetrics and Gynecology. “It makes our commitment to quality care very personal.” 

Building Collaborative Care

Across the country, rural hospitals are facing rising challenges in obstetrical care. Central Vermont Medical Center’s investment in midwifery reflects a long-term commitment to community-rooted solutions.

"When I first came here in 2011, there wasn’t a strong relationship between physicians and midwives," says Dr. Horan. "We recognized the benefits of midwifery for low-risk pregnancies and wanted to create something collaborative." 

The program began small, with two midwives providing daytime care alongside physicians trained in team-based practice. Over time, relationships strengthened, and the program has expanded to today’s 24/7 coverage. 

Corey Gilkey, CNM, was one of the program’s early recruits. "I moved back to New England five years ago, drawn by my love for the region and the opportunity to help shape a collaborative midwife-physician practice model at CVMC," says Gilkey. "We knew that the community wanted full-time midwifery care and now we can provide it." 

The effort also attracted Callie Linehan, MD, a family medicine physician with specialized obstetrics training. Her addition has helped Central Vermont Medical Center connect pregnancy care with long-term family health.

"Pregnancy is one period in somebody's life," says Dr. Horan. "But conditions like depression, high blood pressure and diabetes need continued care afterwards." 

Comprehensive Local Care

Central Vermont Medical Center’s OB/GYN program now offers a range of services rarely available in rural communities. 

• Midwives provide care for low-risk pregnancies and births.
• OB/GYN physicians deliver specialized services, including minimally-invasive gynecologic surgery.
• Menopause and midlife care is a growing focus led by Dr. Horan, who is certified by the Menopause Society
• Mental health counseling is integrated into prenatal and postpartum care through Jennifer Auletta, MA, LCMHC, BC-DMT, a perinatal mental health counselor. 

The program also collaborates with community partners, including: 

• Home health teams
• Good Beginnings — a nonprofit that supports new parents
• The Doula Project, through Washington County Mental Health Services, which provides prenatal, labor and postpartum support.

"Low-risk obstetrics, surgical gynecology, menopause care — we have the pieces in place," says Dr. Horan. 

Contributing to Statewide Excellence

Central Vermont Medical Center’s investment in collaborative midwifery care is part of the reason Vermont continues to lead the nation in maternal health outcomes.

In 2024, Vermont was the only state to achieve an ‘A’ grade on the March of Dimes annual Report Card, which tracks maternal and infant health. Vermont had the lowest preterm birth rate in the country, and the highest rate of adequate prenatal care.

At Central Vermont Medical Center specifically, the low-risk cesarean rate dropped from 34.9% to 22.6% in 2022, according to data from the Vermont Child Health Improvement Program. Providers attribute much of that progress to the expansion of midwifery care, which emphasizes prevention and reduces unnecessary interventions.

Looking Ahead

Central Vermont Medical Center's expansion of midwifery care, paired with new gynecology services tailored to older patients, reflects a vision for sustainable, community-centered care. “It’s rooted in Vermonters wanting a more patient-centered experience that minimizes interventions,” says Rachel Long, MD, medical director of Central Vermont Medical Center's birthing unit. “Midwifery care has clear benefits — including lower interventions and fewer C-Sections. It’s not a model that is used a lot in America, but that’s hopefully where we are headed.”