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Call the Midwife: What midwifery can teach us about patient-centered care

October is Patient Centered Care Awareness Month

We live in a consumer-centric age. The five-star rating system of companies like Amazon and Yelp, streaming services like Netflix and Spotify, curated subscription packages from HelloFresh, Birchbox, StitchFix, and Blue Apron — these have given us access to products and experiences that are completely tailored to our preferences. We’ve come to expect a fully personalized experience in every aspect of our lives.

Healthcare is no exception — and why should it be? The path to health and wellness looks different for every patient, and the delivery of care should not be limited by a one-size-fits-all approach. Take pregnancy care, a space with one of the most diverse groups of patients: new moms, working moms, single moms, moms with kids at home, moms with a complicated medical history, moms with high socioeconomic risk. For female patients, the need for personalized care is felt most acutely here, during pregnancy, and many women have their first introduction to healthcare at the obstetrician’s office.

So what does patient-centered care look like in the pregnancy space? For providers committed to personalizing care for mothers, the first step should be looking to a tradition of care that extends back to the dawn of time — midwifery.

This model of care provides the perfect template for a personalized experience of care for mothers. Midwifery is

  • Female-centric, empowering women to make decisions and manage their own care, and ensuring consideration of their cultural traditions and individual values

  • Focused on developing a care relationship that is based in trust and honesty

  • Holistic, addressing the physical, psychological, and social well-being of the woman

  • Comprehensive, extending past the prenatal time to provide care in the weeks following birth

  • Personalized, providing targeted education and counseling.

The midwifery model of care focuses on prevention and early intervention. It also involves a woman’s designated family members, in as much as is desired, in all health care experiences throughout the care journey. Additionally, this model is extraordinarily successful with identifying and referring patients to other practitioners, creating deep-rooted collaborations and maintaining continuity of care when there is need for a transition.

It has gained plenty of attention over the past few years for its demonstrated ability to produce better outcomes at lower costs for low-risk women. Among other key outcomes, perhaps the most significant is a reduction in preterm birth (birth before 37 weeks of pregnancy), the single leading cost for Medicaid, but more importantly, the leading cause of infant mortality and morbidity. With the midwifery model of care, women are at a lower risk of losing a baby.

As care providers transition to patient-centric models across the pregnancy space, they would do well to pay attention to the strengths that midwives have brought to the table for centuries, such as

  • Frequent interactions with the patient (also known as high-touch care)

  • Active listening to make a patient feel heard and validated in their concerns and needs

  • Acknowledgment of a patient’s life experiences and knowledge as a part of the data that leads to care decisions and treatment plans

  • Invitations that empower the patient to be an integral part of the decision-making team

  • Consultation, collaboration and referral to other members of the healthcare team

It is my belief that our healthcare system at large would benefit if all specialties adopted the unique characteristics of the midwifery model of care. For healthcare providers who are not trained in this model, listening carefully to patients is the first step to getting started while in the confines of the office.

At a time when physicians are overworked and overextended, and providing this level of personal care seems like an impossible task, they can take a page from the business marketplace, utilizing technology to provide connected care and extend their reach outside the four walls of the office.

Technology can make personalized healthcare education, risk-stratified remote monitoring, bi-directional chat, and real-time virtual triage as readily accessible as the smartphone in our back pockets. Meeting the patient where they are, and creating ease of communication in a way that meets their expectations, is one way that providers can turn toward patient-centered care. In the digital age, we can use technology to amplify the patient experience, while remaining deeply-rooted in the traditions of the original patient centered care model — the midwifery model of care.

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