Certified Nurse Midwives’ Lived Experience with Certified Nurse Midwife-Nurse Collaboration to Provide Patient Care in the Hospital Setting

Background This study examines the working relationship between certified nurse-midwives (CNMs) and intrapartum nurses in a hospital setting from the CNM's perspective. Certified Nurse-Midwives play a vital role in maternal healthcare in the United States. The role and success of CNMs on a unit depends on the professional relationship they have with the healthcare team. The relationship between CNMs and intrapartum nurses is unique and has not been thoroughly examined. Methods We employed a qualitative, exploratory approach to capture participants' experiences working with intrapartum nurses in various hospital settings. Semi-structured interviews were conducted with 13 CNMs from February to April 2023. Participants were recruited through known practices and snowballing, and eligibility criteria included working with intrapartum nurses in a hospital and having attended at least 10 births since becoming a CNM. Thematic analysis and coding were done utilizing Braun and Clarke’s process. Results Five themes emerged: (1) birth philosophy, (2) transition in role to CNM, (3) interpersonal dynamics, (4) experience and exposure to midwifery , and (5) quality of patient care, with several subthemes identified. Conclusions Findings from this study indicate that CNMs perceive a generally positive working relationship with intrapartum nurses. Barriers to this relationship can exist and affect patient care when present. Certified Nurse-Midwives and intrapartum nurses have a unique relationship because of their shared educational background and potentially overlapping roles in patient care. Creating a positive working relationship requires a midwife-positive culture, mutual respect for knowledge and experience, education for nurses regarding midwifery care, and support for those CNMs transitioning to an advanced practice role.