Labor of Love

Labor of Love

Jenna LoGiudice, PhD, CNM, RN ’06, witnessed her fair share of life-changing moments while working in Stamford Hospital’s Labor and Delivery unit during her senior year at Fairfield University. As a student nurse, she helped coach and care for mothers-to-be during a significant time in their womanhood, offering prenatal care in the examination room and a reassuring presence in the delivery room. So it seemed only fitting that the lifegiving experiences she shared inevitably gave birth to a passion all her own.

“I valued the connections I made with each patient during my time as a student in Labor and Delivery, but at the end of my 12 shifts – after these amazing clinical relationships had been formed – it was time to leave the patient, and I would never see her or her family again,” Dr. LoGiudice recalled. “The desire to keep those connections, and the idea of continuity of care during such a momentous part of a woman’s life, was why I ultimately choose a path in midwifery.”

Flash forward seven years. Dr. LoGiudice, now a certified nurse midwife (CNM) with an active practice in southern Connecticut, is back at Fairfield University and helping pave the path for future midwives as program director and track coordinator for the Marion Peckham Egan School of Nursing and Health Studies’ Doctor of Nursing Practice concentration in Midwifery (DNP-NM). The full-time, three-year doctorate program welcomed its first student cohort in the fall of last year and is poised to meet an emerging demand in midwifery care that is currently on the rise in the U.S.

“Our students are choosing an opportune time to enter the field of midwifery,” Dr. LoGiudice explained. “As the cost of OB/GYN medical malpractice insurance continues to rise, we’re seeing a decline in the number of OB/ GYNs practicing in the U.S., and it’s predicted that shortage will continue to grow as the baby boomer generation of obstetricians retires in vast numbers over the upcoming years. More than ever, midwives will be needed to fill this gap as the primary caregivers of women’s obstetric and gynecologic care.”

Although the term “midwife” can often evoke notions of a simpler time long before hospitals and maternity wards became commonplace, today’s nurse midwives serve as primary care providers certified to handle almost every aspect of women’s health, from puberty in adolescence
to menopause later in life.

“The word midwife literally means ‘with women’ and midwives are in fact with women, providing a full scope of care throughout the lifespan,” Dr. LoGuidice said. “As graduates of Fairfield’s DNP-NM program, our students not only develop the clinical and cultural competence to provide high-quality, holistic women’s healthcare, but they cultivate decision-making and leadership skills to become trailblazers in midwifery education and research.”

And they couldn’t have started at a better time. According to a December 2015 Market Scan for Nurse-Midwifery by Hanover Research, market projections for nurse-midwives indicated positive growth across the U.S. and Connecticut, and the Bureau of Labor has predicted a one-third increase in job demand for midwives by the year 2022. Yet despite these positive projections and a consistent increase in the number of CNM-attended births in the U.S. since 2005, midwifery care remains much more common in other developed nations. Each year in the U.K., more than half of all babies are delivered under the guidance of midwives, and in countries like Sweden, Norway, and France, CNMs oversee more than 75 percent of expectant mothers’ deliveries, enabling obstetricians to focus their efforts on high-risk births.

Yet in the U.S., midwives attend less than 12 percent of yearly births, a rate that began languishing over a century ago when women starting turning to doctor-led childbirth as a “safer” alternative to midwifery. Ironically, that shift in care, coupled with the subsequent over-medicalization of childbirth, has resulted in a myriad of national healthcare concerns, including cesarean rates nearly 22 percent greater than the World Health Organization’s recommendation, and the highest rate of maternal mortality among the world’s developed nations.

In an effort to change those statistics and improve women’s healthcare overall, Fairfield’s DNP-NM’s governing organization, the American College of Nurse-Midwives (ACNM), has called for ‘a midwife for every woman’ and seeks to increase the number of midwives in the U.S. to make midwifery care the standard for all women. A call that Dr. LoGiudice says Fairfield University is ready to answer.

Structured to meet the competencies for DNP-Nurse Midwifery set forth by the ACNM, Fairfield University’s midwifery concentration prepares students as expert nurse midwives for every stage and every setting in which midwifery care is delivered to patients. In addition to gaining more than a thousand hours of hands-on clinical experience providing gynecologic, antepartum, intrapartum, postpartum, newborn, and breastfeeding care under the supervision of experienced CNM faculty, students also attend a minimum of 20 births in a variety of settings, including hospitals and birthing centers.

While the program’s training is heavily focused on normal physiological birth, students are also prepared to recognize high-risk obstetric and gyne- cologic cases through life-like healthcare simulations conducted in the Egan School’s cutting-edge labor and birthing suite. Attention is also given to trauma-informed care and perinatal loss, two unique focuses of the Egan School’s DNP Nurse Midwifery program that Dr. LoGiudice believes sets it apart other from other universities.

“Trauma and loss are delicate areas that are hard for any student to feel prepared for,” she explained, “but with the training provided by our faculty under the umbrella of the Egan School’s Kanarek Center for Palliative Care Nursing Education, our students are better equipped to handle these difficult cases when encountering them for the first time in the field.”

Yet no matter how challenging or typical the case may be, Fairfield’s faculty is educating students to empower their patients to become active participants in their personal healthcare.

“A basic tenet of midwifery is empowering women to care for themselves,” explained assistant nursing professor Christa Palancia Esposito, DNP, MSN, CNM. “Many things in pregnancy and labor cannot be predicted or controlled, but a birth in which a woman’s wishes are respected, and in which she can avoid interventions she doesn’t want, is always a goal worth working toward.”

Most women choose to pursue midwifery care because they are seeking more information and support during pregnancy. As common practice, nurse-midwives tend to give women more time during visits than they might have with an OB/GYN and put a greater emphasis on answering questions and providing information. In essence, their job is to help a woman understand the changes that come with events like pregnancy and menopause and to offer reassurance throughout the process.

Dr. Esposito believes that this basic principle of midwifery, one rooted in the Jesuit ideals of “men and women for others,” is the most important lesson to impart on future midwives.

“The most rewarding part of being a mid- wife is the relationships we make with women throughout their lifespan,” she continued. “The beauty of teaching at Fairfield is that we have the opportunity to educate practitioners in the philosophy of holistic care, who will then teach their clients the same principles. When effective leaders in healthcare provide competent care to women, the ripple effect is staggering.”