MU Women's and Children's Hospital is Listening to Moms

Amber O'Keefe

When providers at University of Missouri Women’s and Children’s Hospital launched the Low-Intervention Birth Program, they knew there was demand for natural childbirth services in a hospital setting. 

And, oh baby, were they right.

In the first year of the program, more than 100 babies were delivered using few or no medical interventions. The hospital’s certified nurse midwives delivered more than 70 of those babies. The low-intervention program is the only one of its kind in central Missouri. It allows women who meet low-risk pregnancy guidelines to choose between receiving prenatal and delivery care from a certified nurse midwife or a physician specializing in obstetrics and gynecology.

Approximately 70 expectant mothers with low-risk pregnancies participate in the program at any given time. The popularity of the program seems to be driven by a simple concept — choice. Women can bring their own doulas, or birth coaches, to be part of the delivery team, and their birthing choices, often spelled out in birth plans, are respected by the hospital staff. They can experience a natural childbirth while having the security of delivering in a hospital.

“We have so many people who have transferred their care from other hospitals or who have delivered here in the past, and they go on and on about how different it is this time,” said Lori Anderson, certified nurse midwife. “Previously, they felt like they were told how their experience was going to be. Now they feel like they’re going to have a say. We’re putting the control back in their hands.”

A new approach to caring for moms and babies

The change in philosophy began when providers at Women’s and Children’s Hospital started working toward the Baby-Friendly® designation. Conferred by the World Health Organization (WHO) and the United Nations International Children’s Emergency Fund (UNICEF), the designation requires hospitals to promote best practices for mother and baby care. When the Baby Friendly® effort started, the focus on promoting breastfeeding and keeping moms and babies together from birth (not whisking them away to a nursery) laid the groundwork for the low-intervention program by changing the way staff delivered care to mothers and babies. Adding the low-intervention program built upon that shift.

“It was a definite change for staff — just the thought process of backing off and letting physiological labor be the boss and not being so hands-on,” Anderson said of the low-intervention model. “As health care providers, we want to help, and we want to do as much as we can. Sometimes that’s the hardest thing to do is sit back and let nature do its thing.”

Midwives specialize in low-risk pregnancies. Although they are integral to the success of the low intervention program, they are also happy to work with women who choose to have some interventions, including epidurals for pain relief.

“We specialize in low-risk, not only low intervention,” Anderson says.

‘She cared about the birthing experience’

When Amber O’Keefe, 26, and her husband, Nolan, moved to Columbia in December 2015, Amber was seven weeks pregnant. She began looking for a provider right away. 

“I knew I wanted to be with a midwife,” O’Keefe said. “When I started looking around, Lori Anderson was the only midwife in the area who was offered through a hospital system. My only other options were to have a home birth or go out of town.” 

O’Keefe said the experience exceeded her expectations.

“It’s just so amazing that there’s that option for women who still want to give birth in a hospital,” O’Keefe said.

There are many benefits to partnering with a midwife, O’Keefe says. Anderson took her time during appointments, with many lasting half an hour.

“She would talk to me about whatever I wanted,” O’Keefe said. “I knew she cared about the birthing experience.”

“Previously, they felt like they were told how their experience was going to be. Now they feel like they’re going to have a say. We’re putting the control back in their hands.” Lori Anderson, certified nurse midwife

For O’Keefe, the primary benefit was knowing her provider was on board with her birth plan.

“I could have my pregnancy and birthing experience without her wanting to intervene at every stage,” she said.

O’Keefe also looked forward to using the low-intervention birth suites.

“It was nice having that really large bed because my husband could be there with me,” she said. “It felt so homey. It was like, ‘I can relax in here.’ It’s a totally different vibe than a hospital room.”

“I thought it was amazing giving birth in there,” she added.

To learn more about our midwives and Low-Intervention Birth Program, please contact Missouri OB/GYN Associates by calling 573-499-6084. Missouri OB/GYN Associates is located at 402 Keene St. 3rd Floor Columbia, MO 65201.