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Noteworthy: Mat-Su Midwifery & Family Health

front entrance to mat-su midwifery

We had the opportunity to sit down  with Jessica Sawyer to talk about Mat Su Midwifery & Family Health and how they are responding to community needs through interprofessional collaboration and a unique care model. Jessica has been with Mat-Su Midwifery since 2002, when she began a 3-year apprenticeship there. The birth center  opened in 1993 as an expansion of Judi  Davidson’s home birth practice. They have been CABC-accredited since 2006.

Their client population comes from the  surrounding area as well as from the  bush communities, often several hours away and fairly inaccessible during the  winter. Those clients have 3-4 in-person prenatal visits and the rest virtually. They stay in the area starting at about  36-weeks and for a short time postpartum.

What exciting things are happening in your practice? 

In 2021, we moved into a new building with space to accommodate both  the birth center and the growing primary care practice, and with totally  separate spaces for the office and birth center.

In 2022, we added 3 OB/GYN physicians to our staff. They joined our group of interprofessional providers that includes  CPM/CDMs, CNMs, and FNPs with a variety of specialties, including functional medicine, women’s and men’s health, and pediatric care.

Our innovative model arose from our  response to the question, “What does our community need?” This is reminiscent of  the first of Ruth Lubic’s Principles for a Successful Professional Life – “Begin with the needs of the people you serve.”

The addition of OB/GYN physicians allows our practice to provide collaborative care when indicated and to care for clients  who are high-risk and thus ineligible for independent midwifery and birth center care, but they can benefit from the birth  center philosophy and group prenatal care. “This model gives our clients the  best of both worlds.”

What advice do you have for some one who wants to replicate your collaborative practice? 

Cultivate friendships with professionals in your community. Find common ground in the commitment to providing care that is  compassionate, comprehensive, individualized, and respectful. Our team uses shared decision making to develop a plan of care that is based on research as well  as the traditions and values of our clients.

It has taken many years to build our team. We have found that finding and retaining  the right people, those who are passion ate about providing excellent service for our community, is more important than filling positions with qualified applicants. We have found that finding and retaining the right people, those who are passion

ate about providing excellent service for our community, is more important than filling positions with qualified applicants. If we find someone who shares our vision, we try to find a way to incorporate them onto the team. This approach requires taking a long view.

Why do you think it is important  for your Birth Center to be CABC accredited? 

Seeking CABC-accreditation made us  think about our systems of checks and  balances and to set up systems that  work. Reviewing cases and events is  helpful. There are things we do be

cause of CABC that are important but that we might not take the time to do if we weren’t accredited. It is also good to feel we are part of a community of  birth centers that are committed to  quality and safety.

Tell us about the CPM/CNM Model  in Your Practice.

In our model it is important to respect  the strong points of each provider— both types of midwives as well as physicians and nurse practitioners. We see that the advantages of working closely together go in all directions. Everyone benefits, especially the clients.

We find that new CNMs who have not  had community birth experience need a  longer orientation and more mentoring  than CPMs, who have had 3-years of  community birth experience during  their training. One challenging concept that is best learned in a community  birth setting is “anticipatory management.”

Having CNMs in the practice allows us  to keep clients who are just a bit out side the usual CPM scope of practice and everyone learns from the collaboration.

Everyone learns from the other providers who all have different backgrounds  and training, and different ways of  seeing the world.

Clients can be educated about their  choices in care and choose options  across the spectrum of possible interventions what is best for them

What is Your Birth Center’s Greatest  Challenge? 

“Keeping enough support staff and  maintaining intra-team communication to be sure nothing falls through  the cracks.” With a total staff of 31  people, maintaining consistent team communication is essential. It is important to retain enough staff so that  everyone has adequate training and  mentoring, and no one is overworked.

What Inspires You?  

Jessica was inspired to become a mid wife partly by her first two high intervention hospital births. She thought, “There has to be a better way” and found it in midwifery and community birth.

She credits both of her grandmothers  for the confidence and motivation to pursue a career in midwifery. One grandmother was an architect who was  the only woman in her college classes. Jessica designed the home in which she and her family live. She finds that  her talent for 3-D visualization helps her picture how the baby is coming through the birth canal and is an important skill in her midwifery practice.

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