Kristin Rardin is a board-certified nurse midwife with Baptist Medical Group – Ladies First OBGYN in Pensacola. She practices at Baptist Health Care’s new $700-million hospital.
Q: What does a midwife actually do to help the patient during childbirth?
A: In the actual prenatal process, we focus on things that prepare the body for birth. During the birthing process, a patient might have 10 minutes with an OB-GYN physician who’s making sure the baby’s got a good heartbeat, that the mother’s blood pressure is okay and she’s not having any other symptoms that you’re concerned about. In our prenatal preparations, what we’re doing with these women is talking about nutrition, we’re working on teaching them how to carry their bodies that allow their babies to be positioned in a way to best navigate the birth canal. We’re preparing them for the intensity of what their labor will be like so, when they are experiencing it, they’re not immediately wanting to start this cascade of high-priced procedures. Midwifery care is really about building relationships, and through those relationships you establish the basis of trust both with the person you're caring for and also with their entire family.
Q: Does the participation of midwives before, during and after childbirth actually help lower the cost of health care?
A: Absolutely. Over and over the research proves that, even when you think about the statistically lower rates of typical high-priced procedures such as epidurals, anesthesia, episiotomies. With midwives’ involvement in childbirth, you also have lower rates of breech births and C-sections. And that naturally lowers the length of stay and the costs associated with a newborn that otherwise may have to remain in a neonatal intensive care unit for an extended period.
Q: Describe the working relationship between OB-GYNs and midwives.
A: OB-GYNs and midwives bring unique and valuable skills to women’s health. OBGYNs are highly trained surgeons who are experts in high-risk pregnancy and birth. They approach women‘s health through the lens of medical management and provide the skills to deal with and fix complex health issues associated with childbirth. Midwives, on the other hand, are also highly trained and are experts in low-risk pregnancies. They approach women’s health with a focus on relationship building. Midwives spend a great deal of time at appointments and emphasize education and listening. Many midwives also are exceptionally well versed in natural approaches to health and childbirth.
Midwifery, By the Numbers
There were 29,917 midwife-attended births in Florida in 2022 — slightly more than 13% of all births that year, reports the American College of Nurse-Midwives. The organization counted 869 board-certified midwives in the state that year. Florida has no midwifery education programs. A state survey of 133 licensed Florida midwives reported the following activity for 2022-23:
- 6,262 total initial OB visits
- 5,779 maternity clients accepted in a midwife’s care
- 1,275 water births
- 168 licensed midwife students were assigned to midwives
- 403 maternity clients were transferred to the hospital during their pregnancy (prior to labor and delivery), another 409 were transferred during labor and delivery, and 58 (as well as 39 newborns) were transferred after delivery. There were four fetal deaths reported and no maternal deaths.
Sources: American College of Nurse-Midwives; Annual Report of Midwifery Practice, Florida Department of Health, Division of Medical Quality Assurance