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.