The Nurse-Midwifery Service within Mountain Area Health Education Centers Regional OB/GYN Specialists was the first nurse-midwifery service to operate in a tertiary hospital in the state of North Carolina. Our service was also the first to operate within an OB/GYN residency in the state and as such serves as a model for other residency programs wishing to teach true collaborative practice. The service began with one CNM in 1988 who served as coordinator for the practice’s state funded high-risk clinic, which became the foundation for the OB/GYN residency. Indeed, the development of the ACNM position statement on the role of CNMs with high risk maternity care and the use of technology was instigated and authored by the practices first CNM.

All Certified Nurse-Midwives in the service are members of the American College of Nurse-Midwives.

Our service has always been a leader in innovative programs and has worked hard to bring needed services to our region. In the practice’s beginnings, a CNM and MFM team traveled to outlying counties to enable high risk care to reach the rural and isolated areas of our 17 county region. As the residency program assumed some of these roles, the CNMs adapted their service to provide new OB triage in a county where access to care was limited. In addition, one of the CNMs worked with the team that wrote and developed the original grant of the Mountain Area Perinatal Substance Abuse Program in 1989. This is a model program for the state which offers case management services for pregnant women and prenatal and delivery care through our residency program. This program prompted the community work and multi-agency cooperation that established the Mary Benson House as a residence for women and their children while they were in treatment for their addictions. One of our CNMs was also instrumental in developing a teen practice that enables pregnant teens in school to obtain all their care and services after school hours thus enabling completion of education requirements. One of our CNMs has served on the Student Health Advisory Board of the Asheville/Buncombe County Health Center which has been instrumental in the development of school clinics. CNMs have developed with our residents the Smoking Cessation Program in our practice, and were instrumental in highlighting the need for translation services for our Hispanic and Russian populations. Providing speakers for regional Birth Conferences, the Annual Addictions Focus on Women Conference, and planning an working to bring the ALSO course to the regional obstetrical providers are just a few of the activties where we have lent our expertise.

The mission of the Area Health Education Centers is education. North Carolina has truly developed this concept into a model for the nation. To that end the nurse-midwives have always enjoyed the role of teaching; whether it is nursing students, nurse practitioner students, medical students, residents or participating in the summer shadow program for middle and high school students. Further, we are highly committed to the education of nurse-midwives. We feel that our program offers a unique opportunity to train the disciplines together. We have been privileged to work with students from Community-Based Nurse-Midwifery Education Program, East Carolina University, the University of Kentucky, the Institute of Midwifery and State University of New York. We have even had a strident from the University of Colorado. We have provided this service since the programs beginnings, even serving as preceptor for one of our current midwives through her integration experience.

We can say that our CNM’s do put the “heart of Midwifery” into practice even in our high-risk population because we believe that every woman no matter what her risk deserves the midwifery touch. To be with these women and their families is our ultimate gift.

We are proud of the longevity of this practice. We have achieved this when midwifery was phased out of the private community practices relocating the practice within MAHEC and adapting to the changing needs of the evolving residency program. We believe that our work models the benefits for collaborative practice for future consultants to nurse-midwives. Our dedication to our community is evident by the services we have been instrumental in creating and our ability to preserve midwifery care of the women we serve.