As a Certified Nurse-Midwife (CNM) at Kaiser Permanente Hawaii's Waipio Clinic, Brenda Jackson witnesses miracles every day. She admires the strength of women facing the challenges of pregnancy, watches families bond as they await their newest member and sheds tears of joy when she hears what, to her, is the most beautiful sound in the world: the cry of a healthy, newborn baby.
“I've been a CNM for nine years, and I can't think of a job that would be more rewarding and inspiring,” Jackson says.
Jackson is one of five CNMs in Kaiser Permanente Hawaii's new Midwifery Program, which started last September as an option for expectant parents. Its goal is to provide mothers-to-be with safe, holistic, family-centered pregnancies and birthing experiences.
The CNMs have master's degrees in nursing, American College of Nurse-Midwives certification and Hawaii state Advanced Practice Registered Nurse licenses. “The CNMs are highly trained medical professionals who round out our team of Ob/Gyn physicians and other specialists,” says Dr. Keith Ogasawara, Chief of Kaiser Permanente Hawaii's Obstetrics/Gynecology Department. While they can deliver babies without a doctor, there's always an Ob/Gyn physician at the Moanalua clinic ready to assist if complications arise.
Ogasawara was instrumental in developing the program, modeled on successful programs in Kaiser Permanente's Northern and Southern California regions and at university hospitals such as Johns Hopkins, USC and UCSF Medical Center. Kaiser Permanente is the only healthcare system in Hawaii that provides fully integrated midwifery services.
Personalized approach
The CNMs talk with expectant mothers about everything from nutrition to breastfeeding. They provide comfort and encouragement, and take the lead in managing care for low-risk pregnancies, doing prenatal and postpartum checkups.
Key is listening to patients and respecting their choices, including pain management during labor. “Some women want as natural a delivery as possible,” Jackson says. “If, however, a patient wants pain medication, I'll prescribe it for her. If she wants an epidural, I'll order it. My responsibility is to provide patients with information and reassurance and to allow them to make informed decisions.”
Team Effort
The CNMs work closely with physicians on high-risk cases. Jackson recalls a patient diagnosed with a potentially life-threatening illness during her eighth month of pregnancy. Her doctor and pediatrician agreed the baby needed to be delivered immediately so she could receive treatment. Jackson is pleased to report both mother and baby are fine. No matter how often we have seen it, she says, “the birth of a healthy baby always makes us smile.”
Visit kp.org/midwife/hi for more information.
