DiversityNursing Blog

It's encouraging to see the growing recognition of the "fourth trimester", the crucial postpartum period extending from birth to three months or even a year after delivery. For too long, the focus in maternal care has primarily been on pregnancy and childbirth, often leaving new mothers to navigate the complex physical, emotional, and social changes of postpartum on their own. However, a powerful movement is changing this narrative, with health systems nationwide stepping up to provide comprehensive and much-needed support during this vital phase.

One such leader is AdventHealth, which is actively responding to this movement by striving to care for women across their entire lifetime. Their innovative Fourth Trimester Program offers 12 weeks of dedicated postpartum care, a significant expansion from the traditional six-week check-up.

This program goes beyond just medical follow-ups, providing assistance with medications, blood pressure monitoring, and weekly visits. It also addresses the broader determinants of health by helping with insurance, paperwork, supplies for milk, transportation, and even financial and housing assistance.

The impact is already evident. According to Becker's Hospital Review, since its late 2024 launch, the program has achieved a remarkable 20% reduction in readmissions for Black mothers who had a C-section, a testament to its holistic approach and focus on health equity. AdventHealth is further expanding its commitment to women's services with two new locations opening in 2026.

Beyond AdventHealth, other health systems and organizations are also pioneering comprehensive fourth-trimester care:

• Partnership for Proactive Health champions a team-based approach to fourth-trimester care, emphasizing "Healthcare as a Team Sport." Their model proactively builds trusting relationships during pregnancy and extends support into the postpartum period, focusing on five key areas: team and support, food and nutrition, movement and exercise, rest and recovery, and joy and mindset.
• Kahn Health offers a dedicated "4th Trimester Care Package" that includes in-home check-ups for both mother and baby, specialized lactation and breastfeeding advice, and support for common newborn issues. This personalized, integrative primary care model provides crucial support in the comfort of the family's home.
• UW Medicine in Washington is leading the "Maternal Mental Health Access" effort. This initiative, funded by the Washington Department of Health, aims to enhance perinatal behavioral health care capacity across the state. It focuses on screening for suicide risk, developing risk-mitigation plans, and providing team-based care and training for healthcare providers. The Washington State Legislature has also extended Medicaid benefits for mothers from six weeks to a year postpartum, recognizing the increased risk of maternal mortality for those without benefits.
• Cherokee Health Systems in Tennessee has implemented the NURTURE model of care. This integrated approach combines OB/GYN, pediatric, and behavioral health care for new parents and their babies, ensuring comprehensive support during and after pregnancy. Their behavioral health specialists are even trained in basic lactation to address feeding-related stress.
• NewYork-Presbyterian emphasizes "mother-baby" care on their postpartum units, where one nurse is trained to care for both the mother and newborn. They provide support for physical changes, coping with "baby blues," medication management, and daily workshops on breastfeeding and discharge.
• UMass Memorial Health has introduced a "Hospital at Home for Postpartum Care" program for eligible patients who have had cesarean births. This innovative model allows mothers to recover in the comfort of their homes while still receiving high-quality, hospital-level services, including daily virtual doctor visits and 24/7 monitoring.

These pioneering programs represent a vital shift in healthcare, recognizing the postpartum period is not just about the baby, but also about the health and well-being of the birthing parent. By extending care, integrating services, and embracing new technologies, these health systems are not only improving individual maternal health outcomes but also contributing to a healthier society as a whole.

As Nurses, we are at the forefront of this movement, advocating for and delivering the compassionate, comprehensive care that new mothers truly deserve during their fourth trimester and beyond.

Certified Nurse Midwives (CNMs) are becoming more common for women and mothers across the nation.

Overall employment of Nurse Midwives is projected to grow 45% from 2020 to 2030, much faster than the average for all occupations.

If you're interested in this career path,  it's beneficial to understand what CNMs do and their role in health care.

Nurse Midwives are primary health care providers for women of all ages and provide all types of gynecological, prenatal, and post-pregnancy care.

According to Mayo Clinic College of Medicine and Science, common tasks and duties include:

• Confirming and dating pregnancy
• Providing prenatal and postpartum care
• Caring for women during childbirth including monitoring the mother and fetus during labor, assessing labor progress, managing complications, assisting with pain management, performing episiotomies if needed, and delivering the newborn and placenta
• Providing education for new parents on infant care
• Supporting new mothers that are breastfeeding with education and training
• Preparing pregnant women for what to expect during the birthing process
• Performing preventive health screenings and tests
• Diagnosing and treating gynecological disorders such as sexually transmitted diseases and infertility

There are many different paths in the Midwifery field. According to Western Governors University, various roles include:

• CNM: Certified Nurse-Midwives are Registered Nurses who have additional certification as a Midwife. That double licensure gives them additional opportunity and training in the medical field. Specific Midwifery education is the same for a CNM and CM.

• CM: A Certified Midwife is someone who is certified as a Midwife, but doesn’t have a Registered Nursing license as well. The certification is identical for a CM and CNM, the only difference is the Registered Nursing license.

• CPM: A Certified Professional Midwife is certified and must have particular experience in home-birth or out-of-hospital settings. The certification requirements are much less than that of a CM or CNM. A Midwifery program may still be involved, but often it is less detailed and intense.

• Doula: Doulas are not maternity care providers, but provide informational and emotional support for a mother during childbirth. Doulas provide services to mothers while they are pregnant, during their labor and delivery, as well as after the baby is born. Some Doulas work directly for birth centers or hospitals, while others are hired directly by expecting mothers. Because Doulas don’t provide medical support, there aren’t direct legal requirements regarding their practice. Some doulas get formal training, though it’s not required.

The average CNM salary in the United States is $116,574, as reported by Salary.com.

If you’re truly interested in becoming a Nurse Midwife, start with your BSN then find a Nursing school like Frontier Nursing University (FNU) to help get you started on your journey.

FNU graduates make up nearly 40% of the nation's Midwives!  

National Midwifery Week is the first week of October, and Frontier Nursing University (FNU) is celebrating by hosting a virtual event from Oct. 5-8, called Empower 2020: Year of the Nurse and the Midwife. 

The event features four free sessions, including two continuing education opportunities, presented by FNU faculty, students, and alumni on the latest practices and topics influencing nurse-midwifery care:

• It’s the Year of the Nurse and the Midwife: Get the 411 on Becoming a Nurse-Midwife, presented by Dr. Jeneen Lomax and Dr. Tonya Nicholson - Oct. 5 at 5 p.m. ET
• Midwifery Pearls of Telehealth, a Free CE Session presented by Dr. Tanya Belcheff, Dr. Cassie Belzer, Dr. Judith Butler, Martha Harvey, Dr. Audrey Perry and Heidi Loomis - Oct. 6 at 5 p.m. ET
• Hot Topics in the Management of Perimenopause & Menopause: A Conventional & Integrative Approach, a Free CE Session presented by Dr. Ruth Ellen Elsasser and Dr. Ana Verzone - Oct. 7 at 5 p.m. ET
• Racial Disparities in Maternity Care: Where Do We Go From Here?, presented by Dr. Heather Clarke and Dr. Susan Stone - Oct. 8 at 5 p.m. ET

It’s the Year of the Nurse and the Midwife: Get the 411 on Becoming a Nurse-Midwife is for midwifery students or anyone who is considering becoming a nurse-midwife. Participants will hear from current midwifery students about their experiences and have the opportunity to ask questions during this live session.

Midwifery Pearls of Telehealth will provide an overview of telehealth from a midwifery perspective with special emphasis on the areas of patient engagement, group care, provider satisfaction and best practices for meeting compliance requirements.

Hot Topics in the Management of Perimenopause & Menopause: A Conventional & Integrative Approach will provide a review of the most common conventional and evidence-based integrative medicine interventions used during perimenopause and menopause.

Maternal and infant mortality affects black and indigenous women at a much higher rate than other races. In Racial Disparities in Maternity Care: Where Do We Go From Here?, FNU Assistant Professor Dr. Heather Clarke and FNU President Dr. Susan Stone will review the issues related to health care disparities and discuss how midwives can engage in meaningful strategies for change.

The World Health Organization (WHO) designated 2020 as the “Year of the Nurse and the Midwife” in honor of the 200th anniversary of Florence Nightingale’s birth. The designation brings awareness to the importance of nurses and midwives in the health and care of populations across the globe. According to the WHO, the world needs nine million more nurses and midwives to achieve universal health coverage by 2030.

Southern Cross Insurance Solutions is sponsoring the 2020 virtual event. National Midwifery Week was created by the American College of Nurse-Midwives (ACNM) to celebrate and recognize midwives and midwife-led care. ACNM and its 7,000+ midwife members, physicians and women’s health organizations observe National Midwifery Week each year. Dr. Cathy Collins-Fulea, FNU course faculty member and DNP graduate, is currently serving as president of the ACNM Board of Directors.

Frontier Nursing University is the birthplace of nurse-midwifery in the United States and has 80 years of experience in delivering graduate nursing and midwifery programs. This is the sixth consecutive year FNU has hosted a virtual event in support of National Midwifery Week.

Register for the Empower 2020: Year of the Nurse and the Midwife virtual event and learn more at Frontier.edu/MidwiferyWeek. 

VERSAILLES, Ky.—National Midwifery Week is the first week of October, and Frontier Nursing University (FNU) is celebrating by hosting a virtual event dedicated to nurse-midwifery. Featured topics include healthcare team communication and perinatal mental health. Nurse-midwives, prospective midwives and others can participate online at Frontier.edu/MidwiferyWeek. 

From September 29 to October 5, the Empower 2019 FNU Virtual Event: Nurse-Midwives Improving Patient Care Through Teamwork will bring together leaders in nurse-midwifery to present the following sessions:

·         Celebrating National Midwifery Week - Susan Stone, CNM, DNSc, FACNM, FAAN, President, Frontier Nursing University and President, American College of Nurse-Midwives (ACNM)

·         It’s a Beautiful Day in the Neighborhood: A Community-Based Approach to Improving Perinatal Mental Health - Kalena Lanuza, DNP, MSN, APRN, FNP-C, PHN, CLCI 

·         We’re All in It Together - Midwives, Nurses and Physicians: A Team Solution for a Team Problem - Cathy Collins-Fulea, DNP, CNM, FACNM, Faculty Member, Frontier Nursing University

·         Maybe there is an “I” in TEAM: IPECS - Audrey Perry DNP, CNM, Clinical Director, Women’s Health Care Nurse Practitioner and Nurse-Midwifery programs, Frontier Nursing University and Mark B. Woodland, MS, MD, Chair, Department of OBGYN, Reading Hospital 

·         I Wanna Be Part of the Team! Becoming a Nurse-Midwife - Tonya Nicholson, DNP, CNM, WHNP-BC, CNE, FACNM, Associate Dean of Midwifery and Women’s Health, Frontier Nursing University

Dr. Collins-Fulea will present a certified nurse-midwife-designed quality improvement project aimed at decreasing the length of stay in an obstetrical triage unit. She will discuss how improved team communication and patient engagement and the use of nurse-driven orders decreased patient time in triage and increased client and staff satisfaction. 

Dr. Lanuza’s session will explore how empowering women through a shared decision-making process, coupled with community collaboration, can improve the implementation of effective perinatal mental health practices in the obstetric setting and society at large. Perinatal Mood and Anxiety Disorders (PMADs) can occur in up to 20 percent of women during the perinatal period and are among the leading cause of complications associated with childbearing.

The 2019 virtual event is sponsored by Southern Cross Insurance Solutions. National Midwifery Week was created by the American College of Nurse-Midwives (ACNM) to celebrate and recognize midwives and midwife-led care. ACNM and its 7,000+ midwife members, physicians and women’s health organizations observe National Midwifery Week each year. FNU President Dr. Susan Stone is currently serving as president of the ACNM Board of Directors. 

Frontier Nursing University is the birthplace of nurse-midwifery in the United States and has 80 years of experience in delivering graduate nursing and midwifery programs. This is the fifth consecutive year FNU has hosted a virtual event in support of National Midwifery Week. 

Register for the virtual event and learn more at Frontier.edu/MidwiferyWeek.