Return to Main Menu

Family Medicine program provides support by Heather Woolwine Public Relations Throughout history, those involved in delivering babies have traveled the spectrum from revered and honored leaders of society to misunderstood victims of a witch-burning frenzy and back again. The historical midwife possessed an air of the mystical, a community rock who knew how to care for life’s greatest natural miracle in addition to other healing ways. The modern midwife is this and more, employing great skill and understanding in the care of mothers and their children.   At MUSC Family Medicine, certified nurse midwives Donna Taylor, Blair Tiller and Amy McCurley strive to provide all of their patients with excellent care. Part of that excellence requires the ability to know when a particular patient population might need extra attention.   “We knew that we had a lot of teenage mothers coming in, and had heard of a new model for caring for women in a group setting,” Taylor said. “This model seemed to be a great fit for women here that we knew would need the extra support during pregnancy, as well as being able to take along with some of the outreach efforts at the Florence Crittenton Home for young, unwed mothers.”   That model, called centering pregnancy, was recently described in an issue of “The American Journal of Maternal /Child Nursing” as “an innovative model of prenatal care that emphasizes risk assessment, education, and support within a group setting.” Created by a nurse midwife, the model allows providers to accomplish care goals by allowing more than 20 hours of contact time throughout pregnancy with other women due to give birth around the same time.   “These girls come in here and they have a million questions, some small, some big and only a percentage of those questions do we have time to address, if they’re even brought up,” Taylor said. By placing girls with the same due date together in a group, they help each other understand the process. They become very involved by talking, taking belly measurements, blood pressures, and so on. So many of them come into the group with little support around them from those in their lives, so this is meant to increase that support to produce better outcomes for moms and babies.”   Indeed, the group sessions are not a lecture series where Taylor or her colleagues stand in front of the room and lecture about proper nutrition, fetal development, or parenting skills. The women in the group participate in self-assessment, discuss a range of topics related to pregnancy and parenthood, and even get into conversations about their personal relationships. “We talk about things they’ve heard, or things they know, and use that as a jumping-off point to give them accurate information,” Taylor added.   Centering at MUSC Family Medicine began when Taylor and her colleagues noted that, of the 100 pregnant women in the practice at that time, 14 of those women were younger than 20. “We wanted to keep them in school and give them the support they needed to become good mothers,” Taylor said.   Taylor also mentioned an important component of the program is to have the soon-to-be moms set personal goals that will help them succeed in life and stick to them. “For example, we talk about getting the GED if mom has dropped out of school. Sometimes I’ll hear, ‘Oh, I can do that later.’ My response is, ‘Why? You can do this right now. Why wait? Just because you’re pregnant doesn’t mean that you can’t set all sorts of small and big goals and head for them. Take one goal at a time and make things happen for yourself.’”   The centering model represents a long- running theme celebrated among nurse midwives; not just caring for pregnancy, but looking at the total care of mother and child to ensure a long, healthy existence. Although nurse midwives cannot perform surgery or caesarean sections, they can participate in all other aspects of birth and delivery and as is the case with MUSC nurse midwives, employ a good relationship with obstetricians in case there is an emergency.   “Our role is to help women progress through normal pregnancies, and once the baby arrives, care for mother and child in all aspects and throughout life,” Taylor said.   The long term goals for the program involve getting more young women into the program, as well as continuing to expand outward into the community so other women who need the program might have access to it. Already, McCurley is using the centering model with young women in the Florence Crittenton Home, and has noticed changes. There, the group visits offer a forum to invalidate old wives' tales and discuss correct information. “It seems that since she began the centering program there, there have been fewer false alarm visits to the ER and the girls are getting some much needed love and support from one another,” Taylor said.   Tiller, via a College of Nursing grant, has been working in the Sea Island community with the Hispanic population there to bring prenatal care to those who need it most. A bilingual addition to the team in July, Taylor said, “She really loves her patients out there and is so committed to giving them the best care possible,” she said.   Taylor and her group are also heavily involved with educating patients about STDs and HIV/AIDS, domestic violence, and the Reach Out and Read program.   For information about the program or other nurse midwifery topics, contact Taylor at taylordo@musc.edu. Friday, Nov. 17, 2006 Catalyst Online is published weekly, updated as needed and improved from time to time by the MUSC Office of Public Relations for the faculty, employees and students of the Medical University of South Carolina. Catalyst Online editor, Kim Draughn, can be reached at 792-4107 or by email, catalyst@musc.edu. Editorial copy can be submitted to Catalyst Online and to The Catalyst in print by fax, 792-6723, or by email to catalyst@musc.edu. To place an ad in The Catalyst hardcopy, call Island Publications at 849-1778, ext. 201.