Midwives preferred, study says

New research found pregnant women communicate better with midwives than physicians.

Jessie Bekker

When Katharine Blanchet found out she was pregnant in 2013, she didn’t consider consulting a physician.

Instead, the University of Minnesota history professor shared her pregnancy with midwives — who can serve as an alternative option to a doctor during pregnancy.

Pregnant women like Blanchet are reporting better communication with midwives than other types of providers, according to a School of Public Health study published earlier this month. The results may point to a bigger trend: As health care costs increase, doctors are expected to meet with more patients, giving them limited time with each person.

Researchers analyzed the results of a national online survey that asked 2,400 recent mothers a series of questions concerning their prenatal and labor experiences for their own study.

Katy Kozhimannil, a health policy and management assistant professor and lead on the study, said their analysis of responses showed that pregnant women experienced issues communicating with their providers, whether they were a midwife or a physician.

Despite their findings, she said, patients reported better connections with midwives.

Overall, patients felt more comfortable asking questions and didn’t feel rushed under midwifery care, Kozhimannil said.

Elena Kehoe, a retired certified nurse midwife, said people tend to work as midwives because of the high level of communication in their profession.

“Midwifery really understands the combination of both the science and physical progress of labor,” she said, “along with the psycho-emotional process and needs of pregnancy and birth.”

Dr. Carrie Terrell, division director for general obstetrics and gynecology at the University’s Medical School, said she makes a sincere effort in her own practice to fight against these communication issues.

But stringent health care and insurance policies reduce time with each patient in order to increase revenue, forcing doctors to cut appointment times short.

“You don’t have the time that it takes to communicate well and get to know patients,” she said.

Midwives haven’t felt these constraints as severely as physicians, Terrell said.

As a Medical School instructor, Terrell teaches her students about communicating more quickly while still ensuring that patients feel respected.

“Physicians have this feeling that they don’t have time to allow patients to talk,” she said, although on average, a patient only takes about 90 seconds to speak.

While Kozhimannil said no single health care provider is delivering a poor level of care, the recent study’s results demonstrate room for improvement and a new direction for patient care.

“This [study] shows there are some models of care that are more conducive to better communication,” she said, “and midwifery may be one of those models.”

Kehoe now spends her retirement in the dermatology field. She said she recently ran into a patient who remembered her from 25 years ago when Kehoe cared for her.

“We, as midwives, bond with our patients,” she said. “The quality of that experience stays with a woman forever.”