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AIMS AND OBJECTIVES: To describe the nature and scope of nurse-midwifery practice in Texas and to determine legislative priorities and practice barriers. BACKGROUND: Across the globe, midwives are the largest group of maternity care providers despite little known about midwifery practice. With a looming shortage of midwives, there is a pressing need to understand midwives' work environment and scope of practice. DESIGN: Mixed methods research utilising prospective descriptive survey and interview. METHODS: An online survey was administered to nurse-midwives practicing in the state of Texas (N = 449) with a subset (n = 10) telephone interviewed. Descriptive and inferential statistics and content analysis was performed. RESULTS: The survey was completed by 141 midwives with eight interviewed. Most were older, Caucasian and held a master's degree. A majority worked full-time, were in clinical practice in larger urban areas and were employed by a hospital or physician group. Care was most commonly provided for Hispanic and White women; approximately a quarter could care for greater numbers of patients. Most did not clinically teach midwifery students. Physician practice agreements were believed unnecessary and prescriptive authority requirements restrictive. Legislative issues were typically followed through the professional organisation or social media sites; most felt a lack of competence to influence health policy decisions. While most were satisfied with current clinical practice, a majority planned a change in the next 3 to 5 years. CONCLUSIONS: An ageing midwifery workforce, not representative of the race/ethnicity of the populations served, is underutilised with practice requirements that limit provision of services. Health policy changes are needed to ensure unrestricted practice. RELEVANCE TO CLINICAL PRACTICE: Robust midwifery workforce data are needed as well as a midwifery board which tracks availability and accessibility of midwives. Educators should consider training models promoting long-term service in underserved areas, and development of skills crucial for impacting health policy change.
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Enfermeras Obstetrices , Rol de la Enfermera , Práctica Profesional , Adulto , Anciano , Empleo/economía , Empleo/estadística & datos numéricos , Femenino , Humanos , Persona de Mediana Edad , Enfermeras Obstetrices/legislación & jurisprudencia , Enfermeras Obstetrices/organización & administración , Enfermeras Obstetrices/estadística & datos numéricos , Embarazo , Estudios Prospectivos , Investigación Cualitativa , Encuestas y Cuestionarios , Texas , Salud de la MujerRESUMEN
This year marks the 25th year of publication for Nursing for Women's Health.
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Salud de la Mujer , HumanosRESUMEN
In her final editorial, Nursing for Women's Health editor Mary Brucker has some wishes for readers.
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Salud de la Mujer , Femenino , HumanosRESUMEN
The massive upheaval that the COVID-19 pandemic has brought to all our lives has caused many of us to think long and hard about what kind of future we want and need.
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COVID-19 , Enfermería , Humanos , SARS-CoV-2RESUMEN
Change is a defining characteristic of the times we are living in.
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Ansiedad , COVID-19 , Resiliencia Psicológica , Depresión , HumanosRESUMEN
Images have the power to inform us, surprise us, and move us.
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Enfermería , Fotograbar , Humanos , Fotograbar/éticaRESUMEN
This year has brought challenges many of us never imagined, but the importance of nursing care for women, newborns, and families remains constant.
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The SARS-CoV-2 pandemic may have many of us feeling distraught, but there are still reasons to be hopeful about the future of health care.
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Infecciones por Coronavirus/enfermería , Atención a la Salud/organización & administración , Enfermeras y Enfermeros/psicología , Pandemias , Neumonía Viral/enfermería , COVID-19 , Infecciones por Coronavirus/epidemiología , Atención a la Salud/tendencias , Predicción , Humanos , Neumonía Viral/epidemiologíaRESUMEN
Novel viruses and zoonotic infections pose global health risks.
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Viaje/tendencias , Zoonosis/complicaciones , Animales , Humanos , Zoonosis/fisiopatologíaRESUMEN
Nurses are at the forefront of the COVID-19 pandemic.
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Infecciones por Coronavirus/epidemiología , Infecciones por Coronavirus/enfermería , Pandemias , Neumonía Viral/epidemiología , Neumonía Viral/enfermería , COVID-19 , HumanosRESUMEN
People's experiences of the COVID-19 pandemic vary widely, with some groups suffering disproportionately.
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Infecciones por Coronavirus/epidemiología , Disparidades en el Estado de Salud , Pandemias , Neumonía Viral/epidemiología , COVID-19 , Infecciones por Coronavirus/enfermería , Etnicidad/estadística & datos numéricos , Femenino , Humanos , Grupos Minoritarios/estadística & datos numéricos , Enfermeras y Enfermeros/psicología , Neumonía Viral/enfermería , Determinantes Sociales de la Salud , Factores SocioeconómicosRESUMEN
This year has been officially proclaimed by the World Health Organization as the Year of the Nurse and the Midwife.
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Aniversarios y Eventos Especiales , Salud Global/tendencias , Humanos , Organización Mundial de la Salud/organización & administraciónRESUMEN
Nurses have a vital role to play regarding environmental issues and associated health implications.
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Salud Ambiental , Promoción de la Salud , Enfermería/métodos , Planeta Tierra , Fenómenos Ecológicos y Ambientales , Contaminación Ambiental/prevención & control , Humanos , Rol de la Enfermera , Factores de RiesgoRESUMEN
The etiology of maternal mortality is multifactorial and requires a concerted and comprehensive effort to address the problem.
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Mortalidad Materna , Medicina Preventiva/tendencias , HumanosRESUMEN
We strive to put evidence into action to promote optimal nursing care, regardless of whether those care practices are brand new or decades old.
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Enfermería Basada en la Evidencia/normas , HumanosRESUMEN
Typifying all members of a particular age group as having specific characteristics is as deleterious as doing it with members of any other population, such as racial, ethnic, gender, and geographic groups.
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Factores de Edad , Relaciones Intergeneracionales , Movilidad Laboral , Humanos , Medios de Comunicación Sociales/tendenciasRESUMEN
Studying today's data on health trends can give us a glimpse into what the future might hold for the nursing profession.
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Predicción , Enfermeras y Enfermeros/tendencias , Humanos , Mortalidad Materna , PartoRESUMEN
Healthy hands are integral to nurses' practice.
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Mano/fisiología , Mano/anatomía & histología , Humanos , Fuerza MuscularRESUMEN
INTRODUCTION: Access to quality care is a problem in Texas, an ethnically diverse state with large birth numbers. The state has over 300 areas designated as medically underserved, and a severe lack of obstetricians and midwives. Minimal data exist on midwifery's contribution, and no known study compares the work environment and clinical practice of the 2 state-recognized midwifery paths, licensed midwives (LMs) and certified nurse-midwives (CNMs). The purpose of this study was to determine the differences in practice by CNMs and LMs, the latter of whom are generally certified professional midwives. The specific aims were to 1) describe the differences in demographic and employment characteristics of CNMs and LMs, 2) identify the geographic areas and population groups served by CNMs and LMs, and 3) compare the nature and scope of CNM and LM clinical practices. METHODS: Online parallel surveys of Texas LMs and CNMs were conducted in December 2015 and January 2016. The REDCap data management system housed the 123- and 125-item surveys for LMs and CNMs, respectively, addressing demographics, populations served, and clinical practice. A comparative statistical analysis, using Fisher's exact test, Pearson's chi-squared test, and Independent Samples t-tests, was performed. RESULTS: The survey response rates of LMs and CNMs were 35.4% (n = 75) and 31.9% (n = 143), respectively. Differences in demographics, employment status, workload, scope of practice, risk assessment, time-based care management, and technology use were observed. DISCUSSION: Findings represent the first attempt to describe the Texas midwifery workforce. In a large state with health care provider shortages, this step is pivotal in addressing strategies for providing services for women and infants. This groundwork can provide the foundation for including midwifery in a state health plan.