Shortage of Maternity Care Providers
The Perinatal Partnership is continuing its work to improve access to maternity care. In 2007 when the initial study on maternity providers was completed, we found that close to 86 percent of West Virginia women have adequate and timely prenatal care. However, a lack of access to maternity care services was identified as a major barrier for many women in rural areas of the state. Both the Key Informant Survey of 2006 and the data analysis reports included in the Reports on the Blueprint to Improve Perinatal Health identified many of the issues that contribute to poor access. Among these are:
- a decline in the number of hospital and birthing facilities
- the location of birthing attendants
- a change in type of maternity providers
- the cost of medical liability insurance
Wesleyan to Offer Two New Advance Practice Nursing Degrees
On Friday, July
15, 2011, officials from West Virginia Wesleyan and Shenandoah University
(pictured at left) signed a
Memorandum of Agreement creating a partnership between the institutions
allowing them to collaboratively offer two new programs leading to Master of
Science in Nursing degrees. Beginning this fall, prospective students will
be able to pursue a master’s degree with a certificate in psychiatric
mental-health nurse practitioner or a certificate of endorsement in
nurse-midwifery. After two years of full-time study, graduates will be
eligible to sit for the certification examinations in their respective field
of study. A part-time option is also available for interested students.
This agreement between the two institutions will address not only the needs of students wishing to pursue a career as a nurse practitioner or nurse-midwife, but also will benefit local communities by graduating skilled, competent and caring health care providers to work in these underserved areas. “Historically, West Virginia has suffered a shortage of health care providers, particularly in rural areas,” said Dr. Susan Leight, associate professor of nursing and director of Wesleyan’s MSN program. “This partnership allows us to help nurses gain the knowledge and skills they need to enter advanced practice, while at the same time meeting the health-care needs of their home communities.”
W. Va. Perinatal Provider Census
In
order to fulfill an unmet need in West Virginia, the Partnership is
undertaking to establish a one-source online index of in-state perinatal
health providers. We will be creating a database of
obstetrician-gynecologists, hospitals providing OB services, birthing
centers, perinatal health programs, etc.
For the last few decades there has been speculation regarding the number of obstetrical providers in West Virginia. In addition, organizations and individuals have reported that West Virginia has an obstetrical provider-shortage. Several groups reported varying estimates of the number of providers providing prenatal care and delivery services. After hearing as many as three different estimates reported by the press or members of State government, the 1992 Statewide Perinatal Task Force systematically determined an accurate number of obstetricians, family-practice physicians, and certified nurse-midwives who were routinely delivering babies and/or providing prenatal care.
Using similar methodology, the West Virginia Perinatal Partnership conducted studies of the numbers of obstetrical providers in 2006 and 2010. See 2010 WV Birth Attendant Study (rev. 3/2011). Additional research on the history of maternity facilities in WV and provider shortage areas is summarized in a PowerPoint Presentation entitled Licensed Birth Facilities and Maternity Providers in WV (rev. 9/2011).
Resources
Map showing Total W. Va. Resident Births by County 2000-2004
Marshall University to Offer MSN with emphasis in Midwifery Program
Results from a study conducted by the WV Perinatal Partnership reveal the need to increase the number of perinatal care providers in underserved counties. In 2007, the Partnership conducted a statewide study to identify private obstetrical practices in the state that might benefit from being matched to an existing Federally Qualified Health Center (FQHC) site. This designation would allow the medical professionals to have medical liability coverage under the Federal Tort Claims Act. Over the last year, the WV Primary Care Association has held quarterly meetings via WEBEX with providers in high need areas of the state. The providers have explored ways to collaborate to enhance perinatal service and share resources such as physicians.
FamilyCare has expanded their perinatal services to three new sites by scheduling an OB/GYN physician on a rotation to the various sites once a month, while a nurse midwife or nurse practitioner follows the patient locally more frequently if needed. Wirt County Health Association is expanding perinatal services in the Jackson county area using a nurse midwife who is developing practice arrangements with local physicians to support this service. The current issues surrounding expansion of perinatal care in the targeted areas rest upon the supply of skilled practitioners and a willing, available medical provider that can close the gap regarding a collaborative practice agreement. There is an extreme shortage of both professional types in the most rural areas.
To address the shortage of maternity professionals in the West Virginia, Marshall University School of Nursing is partnering with Shenandoah University in Winchester, Va., to bring midwifery to the Master of Science in Nursing Program. Midwifery students will complete 25 graduate credit hours at Marshall University. Upon completion of the Marshall courses, students will transfer to Shenandoah to complete their degree requirements. (The Shenandoah University Program is accredited by the Accreditation Commission for Midwifery Education by the American College of Nurse-Midwives.) Students will spend one week each semester at Shenandoah, then will return to West Virginia where they will be assigned clinical preceptors in rural areas of the state. The didactic portion of the Shenandoah courses will be available using multiple modalities including online via iPod, iTunes and Blackboard. Marshall will begin offering an MSN with emphasis in Midwifery this fall (09). For additional information about admission to this program contact Madonna Combs at combsm@marshall.edu
Once the MSN degree and area of emphasis requirements are completed, the student will graduate from Marshall and will receive a Certificate of Endorsement in Nurse Midwifery from Shenandoah. They will be eligible to take the national certification examination in Nurse Midwifery from the American Midwifery Certification Board.
"We are very happy to be able to offer registered nurses this opportunity to further their education through this program,” said Dr. Chuck Hossler, College of Health Professions associate dean. “The Nurse Midwifery concentration opens the door to local nurses interested in midwifery who previously were forced to travel out of state for this specialization. This program allows them to remain at home and still meet their educational objectives.”
Dr. Madonna Combs, College of Health Professions School of Nursing graduate program director, said Marshall is the first and only university in West Virginia offering nurses the opportunity to earn a master’s degree with a concentration in Nurse Midwifery.”
Information on the MSN with area of emphasis in Nurse Midwifery and the other specialty areas is available on the College of Health Professions Web site (http://www.marshall.edu/cohp) under Nursing/Prospective Students/MSN. For more information on nurse midwifery please contact Dr. Madonna Combs at (304)696-2628.
The WV Perinatal Partnership recognizes Dr. Madonna Combs of Marshall and
Dr. Julianna Fehr of Shenandoah University, and others at each of the
universities for their forward thinking and for their hard work to make this
program a reality for West Virginia nurses.