More than catching babies

New Midtown Midwife clinic focuses on ‘well-woman care’

Oklahoma State University Medical Center has positioned itself as the unlikely leader in expanding midwifery care for women in Tulsa. The hospital, a training ground for new physicians, opened a midwifery clinic in midtown in March, employing three certified nurse midwives, two of whom double as women’s health nurse practitioners.

Shaun Baranowski, who, along with Jessica Cotton, opened the practice in March (Lori Edwards joined in July), said OSU obstetricians Corey Babb and Lance Frye led the charge in encouraging OSUMC to incorporate midwifery care into its women’s health offerings. 

“Dr. Frye and Dr. Babb were both advocates of midwives,” Baranowski said. “They had worked with midwives in the past and they recommended it to OSU.” The hospital’s administration latched onto the idea and approached Baranowski and Cotton last August. 

The Midtown Midwife clinic, at 3345 S. Harvard Ave., is a private practice specializing in women’s health. Baranowski hopes to dispel the myth that midwives only catch babies.

“In addition to prenatal care, we do well-woman care,” Baranowski said. “We’re comfortable seeing ages 15-70, and we do the full gamut of well-woman care and basic (gynecologic) needs.” 

The clinic’s obstetric patients—low-risk, healthy pregnant women—receive their prenatal care from the midwives and are guaranteed to have a midwife attend their birth at OSU Medical Center, which renovated its labor and delivery floor in 2015.

Prior to this, only one certified nurse midwife was regularly catching babies in the hospital setting—Kim Kmita at Hillcrest Hospital South. Nurse-midwives at OU Physicians on the campus of the University of Oklahoma-Tulsa mostly worked in the clinic, and only caught babies on Friday mornings, covering OU residents while they attended lectures. 

“We didn’t have our own practice; we were mainly there to do the clinic setting,” said Baranowski, who practiced there before opening the Midtown Midwife clinic. “We were not able to take on private patients, and that was the hole we felt like we were missing as midwives. That’s something we love to do is make connections with our patients and see that through to fruition. That’s why we’re happy to be here.”

The partnership provides laboring women access to low-intervention obstetric care within a setting designed to accommodate any emergency that may arise. And patients who are deemed too high-risk for the midwives to care for—those with gestational diabetes or chronic hypertension, for example—are often referred to OSU for obstetric care.

While Baranowski recognizes that midwifery care may not be the right fit for every patient, she said it’s still a good place for many women to start with regards to their obstetric care.

“There’s still so many women who are very healthy, low risk,” she said. “Midwifery is used in about 70 percent of the world. We’re kind of the oddball out here in the U.S. And it is financially beneficial to start with a midwife if you can, as a low-risk patient.” 

A recent study in the journal PLOS One found that states that integrated midwifery care into their health systems saw improved quality of maternal care and fewer maternal and neonatal deaths.

States with the most integration of midwifery care and “improved access to midwives in all settings, were associated with significantly higher rates of spontaneous vaginal delivery, vaginal birth after cesarean (VBAC), and breastfeeding at birth and at six months; and significantly lower rates of cesarean section (CS), preterm (PTB), and low birth weight (LBW) infants,” the study found. 

Baranowski said the midwifery model of care focuses on listening to the patient and her desires for her birth and letting those guide the plan of care, as well as health promotion, education and prevention.

“The way the medical system is going, there’s a lot more pressure to do more, see more, get more done in a shorter amount of time, so it becomes really hard to sit on your hands and be hands off,” Baranowski said. “But that is how we were trained as midwives, that birth is a normal thing unless proven otherwise. And that’s our job, to monitor and watch and be hands off unless we need to intervene. I really like that we’re trained initially in that. In obstetrics, they’re trained to treat and to heal. That’s why they have surgical skills, too.”
    And sometimes, those surgical skills become a necessary intervention, which is why Baranowski appreciates being able to care for women in the hospital setting. OSUMC’s recently remodeled labor and delivery suites are spacious and homey, with soft colors and dark wooden cabinets hiding most of the medical equipment—equipment that can become quickly available when needed.

“You know, things happen, no matter how healthy you are or how low-risk your situation is,” Baranowski said. “We’ve seen some things where you need to get somewhere within three minutes—you need to get to a C-section. So it’s so nice to be in that comfort of a homey environment where you can do your thing but know that you can be near a C-section if you need it to save your baby’s life. I do think it’s a beautiful place and that women are truly looking for that.”