Volume 17, No. 3, Summer 2009
Something old is something new at Cape Cod Hospital.
Midwives, whether called Auntie or Grandma, have existed, in practice anyway, as long as there have been babies. As Janice DiGioia, a Certified Nurse-Midwife at Cape Cod Hospital, recalls hearing tales about the first midwives as trained professionals heading up to the hill country to deliver babies when she working on her master’s degree at the University of Kentucky.
“But now we don’t go out to the homes any more,” she explained recently, “These days we work in hospitals.”
And that’s the story.
Midwifery has been practiced at Cape Cod Hospital in the past as a pilot program. But, since January, the Family Birthplace at Cape Cod Hospital has been established as a formal team practice, with three Certified Nurse-Midwives on regular staff and a Laborist, Dr. Luisa Kontoules, a board-certified obstetrician, working exclusively with patients in labor two weekends a month when the midwives are off.
The three nurse-midwives all have impressive academic and professional credentials.
Ms. DiGioia earned her Master of Science degree in Nurse-Midwifery at the University of Kentucky. She worked as the first C.N.M. at Cape Cod Hospital from 1985 through 1991 in private practice. She has also maintained an OB/GYN practice on the South Shore. She has a bachelor’s degree in nursing from Alfred University, followed by a year on a Navajo Indian reservation in Arizona with the United States Indian Health Service.
Jeanette R. King earned her Master of Science in Nursing at the University of Rochester in New York. She has served as an obstetrical R.N. in New York, and, beginning in 1996 as a Certified Nurse-Midwife in Maryland and Massachusetts.
Jodi Belson earned her Master of Arts in Nurse-Midwifery at New York University. In her career, she has served as an R.N. and a Labor and Delivery Nurse in New York and as a Nurse-Midwife in both New York and Massachusetts.
Ms. DiGioia, 52, lives in Chatham and has no children of her own. But, overall, she estimates she has given birth, so to speak, to 3,000 babies in a 25-year career. (Only one was ever named after her, “but they gave it the French spelling, Jeanice,” she adds with a laugh.)
“This is almost like a calling for me,” she says. “I always felt I wanted to deal with mothers, but after seeing my first baby born, I knew that was it for me.”
Since joining the Family Birthplace team in January, Ms. DiGioia estimates she has delivered about 50 babies, including five in one day. (Her all-time one-day record is 11 at Broward County Hospital in Fort Lauderdale, Florida, and none of them involved multiple births. “Actually, we’re only allowed to perform low-risk deliveries and multiple births are considered high-risk,” Ms. DiGioia explains.)
“What we do is evaluate patients, watch out for risk factors and then, if there are any complications, we call a physician. There’s always an obstetrician readily available,” she says. “It’s up to the parents if they want this program, but I think the women are really keen for this.”
Two OB/GYN specialists who practice in Hyannis agree.
According to Dr. Bill Agel, the midwives provide “better and safer care because they’re in the room all the time and if there’s an issue, we’re called right away.”
And Dr. Rich Angelo agrees that “speaking for all of us physicians, we’re delighted to have them as a part of our healthcare team. And the patients are very receptive to the midwife program.”
The certification of professional-level nurse-midwives is part of a growing trend in healthcare, known as Physician Extenders such as Nurse Practitioners and Physician Assistants. They have more training than Registered Nurses and can relieve physicians of some of their more mundane tasks.
Doctors obviously appreciate the way the extenders ease their burden. And according to Dian Birch, Director of Women and Children Services at Cape Cod Hospital, there is no resentment from the nurses. “They work together in collaboration and the nurses are glad they have a go-to person right there,” she says. “Our mission is to provide the highest level of care possible for parents and their new babies and these new staff members help us achieve this mission.