Journal of midwifery & women's health
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J Midwifery Womens Health · Jul 2013
Breastfeeding rates and the relationship between breastfeeding and neonatal abstinence syndrome in women maintained on buprenorphine during pregnancy.
Although a growing body of evidence suggests that buprenorphine is a safe alternative to methadone in the treatment of opioid-dependent pregnant women, little is known about breastfeeding in this population. The first objective of this study was to describe breastfeeding rates among opioid-dependent pregnant women maintained on buprenorphine in an integrated medical and behavioral health program. The second objective was to determine whether breastfeeding is related to the duration, severity, and frequency of pharmacologic treatment for neonatal abstinence syndrome (NAS). ⋯ More than three-quarters of the opioid-dependent pregnant women in this case series chose to breastfeed after birth. Although a direct comparison of care models is not possible, the integrated model of care potentially reduced some of the barriers to breastfeeding as the women accessed all their care in a single, infant-friendly setting. Further work is needed to definitively determine whether breastfeeding mitigates NAS.
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J Midwifery Womens Health · Mar 2013
Improving satisfaction with care and reducing length of stay in an obstetric triage unit using a nurse-midwife-managed model of care.
A quality improvement project was initiated at a tertiary-care center in a suburban area of the northeastern United States to determine whether length of stay and patient satisfaction in an obstetric triage unit could be improved by using a certified nurse-midwife (CNM) to manage and organize care in the triage unit. ⋯ The findings from this project suggest that a CNM-managed obstetric triage unit can improve satisfaction with care during the triage experience and reduce length of stay in the triage unit.
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Midwives provide an integral part of health care in underserved, rural areas of the United States. To meet the health care needs of people from diverse cultures, they need to learn culturally competent care. ⋯ Culturally competent care is infused in the midwifery curriculum through self-directed inquiry and discovery approaches. Outcomes of these approaches are evident in the nurse-midwifery program, which can serve as a model for integration of culturally competent care throughout the nursing curriculum.