Integrated Obstetric Care at Mayo Clinic

Mayo Clinic obstetric care utilizes an integrated care model that includes a multidisciplinary team of physicians, nurse-midwives, nurse practitioners, nurses, and allied health staff. Certified nurse-midwives provide care for obstetric patients who are at low to moderate risk as part of a team model described in Mayo Clinic Proceedings: Innovations, Quality & Outcomes. Physicians manage care of high-risk patients and provide ongoing emergency support for all patients when needed.

Gokhan Anil, M.D. shared his experience working within this practice model at Mayo Clinic La Crosse:

"Across the country, hospital delivery units are facing a shortage of obstetricians due to a change in the workforce and increasing demands," says Dr. Anil. "Innovative approaches to staffing are needed to serve the needs of the patient, increase collaboration and improve patient safety."

This collaborative care model has had several positive outcomes since it was implemented in July 2014 in Mayo Clinic La Crosse. The primary cesarean section birth rate has declined, as have vaginal operative deliveries. The rate of vaginal births after C-section has increased. Admissions to the neonatal ICU decreased from 14.9% in 2012 ― before the care model was offered ― to 10.9% in 2017.

"Based on previous research and our experience, women who receive midwife-led continuity of care are less likely to need an intervention and are more likely to be satisfied with their care," said Costa Sousou, M.D., chair of the Department of Obstetrics and Gynecology at Franciscan Healthcare. "This team approach allows us to continue to provide high-quality care with a more sustainable and cost-effective staffing model. We think it's a model that other institutions may find worth exploring."

“The midwifery team in La Crosse is able to work at the top of their licensure to not only see low to moderate risk patients independently, but to collaborate with our physicians to help care for high-risk pregnancies as well.  This, as well as delivering the vast majority of labor patients, allows us to bring the personal touch of midwifery care to patients who might otherwise not have had the opportunity to experience it,” states Jennifer Meyers, certified nurse-midwife (CNM) at MCHS in La Crosse.

The integrated care team model is available in Rochester and many sites in the Mayo Clinic Health System.

Read the full story about the integrated care model at Mayo Clinic La Crosse. 

Learn more about the Midwife Laborist Model in a Collaborative Community Practice article in the Mayo Clinic Proceedings.