‘The Birthplace’: Showcasing a Collaborative Practice Model

By Sylvia Foley, AJN senior editor

Photojournalist Alice E. Proujansky reports in AJN this month on The Birthplace, a collaborative care practice model at Baystate Franklin Medical Center in Greenfield, Massachusetts, where a team of five nurse midwives, three obstetricians, and 35 nurses attend some 400 to 500 births annually. Except for preterm and other higher-risk deliveries, the nurse midwives manage all deliveries and monitor fetal and maternal health. Patients complete detailed birth plans that afford them various care options. Physicians are called in only when necessary; as one nurse midwife told the author, “There’s an awful lot that we can do on our own.”

How well does the model work? The Birthplace has lower-than-usual rates of medical interventions such as episiotomy, epidoral anesthesia, and cesarean section. The patients have greater autonomy and decision-making capabilities. And the practitioners “relish the collaborative approach,” says Proujansky, who interviewed several clinicians and patients for the article; her photographs appear alongside the text and on the December cover. Proujansky’s last piece for AJN, a photo essay on a Dominican maternity ward, appeared in our December 2008 issue; read it here.


Bookmark and Share

2016-11-21T13:14:38-05:00December 21st, 2010|Nursing, patient engagement|0 Comments

Questions of Priority, Written in Vernix and Blood: Two Poems in ‘Art of Nursing’

By Sylvia Foley, AJN senior editor

Jenna Kay Rindo’s poem “An Ode to My Certified Nurse Midwife” (Art of Nursing, August) brims with the narrator’s gratitude for the clinician who has seen her through a “gloomy complicated gestation” with great skill and compassion. (Art of Nursing poems are always free online—just click through to the PDF files.)

This is no sentimental paean, though. This ode is a gritty read, full of vernix and “unrehearsed pain,” euphoria and shame. The child, we learn, was “conceived completely out of wedlock, / in a rush of holy illicit love.” The narrator at first only wants to know how long she can hide the pregnancy. It’s the nurse midwife whose “jubilant congratulations” never seem to waver, whose “size seven hands covered in  / sterile latex” draw the infant’s wide shoulders into the world, and give the young mother courage. It’s an ode, perhaps, to something we strive for but rarely attain: a nonjudgmental attitude.

“It is lucky to live outside the target groups,” begins the narrator of Erika Dreifus’s poem “The Autumn of H1N1” (Art of Nursing, October). She is referring to those considered most at risk for the flu and thus at the top of the list for immunization.

But when she finds herself hemorrhaging and frightened, waiting to be seen by a gynecologist who minimizes her distress, she reveals far more complicated feelings about “the prioritized.” It’s an unusually frank […]

2016-11-21T13:15:31-05:00October 1st, 2010|patient engagement|1 Comment
Go to Top