A Survey on the Scope of Practice for Certified Nurse Midwives in Georgia Open Access

Mudoh, Comfort (Spring 2019)

Permanent URL: https://etd.library.emory.edu/concern/etds/sn009z63q?locale=en


Introduction: Georgia has one of the worst maternal mortality rates in the nation. It is also in the midst of a maternity services workforce shortage. Allowing Certified Nurse Midwives (CNMs) to practice to the full extent of their education and training is one solution to not only combat the maternal health crisis in Georgia, but it could also alleviate the maternity workforce shortage; yet, Georgia remains one of the states with the most restrictive scope of practice laws for Certified Nurse Midwives. The aim of this study to assess how the current restrictive scope of practice policies influences the ability Certified Nurse Midwives of Georgia to deliver full scope midwifery services to patients.

Methodology: A survey was developed after extensive review of the literature and consult with experts in Midwifery. Convenience and snowball sampling were used to recruit participants. A survey was deployed online and through mail to CNMs practicing in Georgia. Descriptive statistics was used to analyze the data obtained from the survey.

Results: 45% of respondents were not allowed to order screening mammograms independently without physician signature. Most respondents (68%) answered that their practice agreement does not allow them to provide newborn care beyond resuscitation and breastfeeding support. At the hospital or birth center where they deliver, 60% of respondents answered that they are not aware of leadership positions midwives have at the hospital or birth center where they delivered. 44% of respondents were satisfied with their current practice agreement/protocol. Of those who were not “very satisfied” with their current practice or agreement, 51% responded that being able to offer more care options for low risk women will make them change their response to “very satisfied.”

Discussion: The results of this study show that CNMs practice agreement varies across practices and what services CNMs are able to offer patient varies based on these agreements. Future research on scope of practice should include in-depth interviews with CNMs to further understanding the practice agreements CNMs work under and CNMs perspective on such practice agreements impact their patients.



Table of Contents

Table of Contents

Chapter 1: Introduction. 1

Introduction and Rationale. 1

Problem Statement: 2

Need Statement: 5

Purpose Statement 6

Significance Statement 6

Definitions 6

Chapter 2: Comprehensive Review of Literature. 8

Introduction. 8

Maternal Mortality in the United States 8

Maternal Mortality in Georgia. 9

Georgia’s Medical Provider Shortage. 16

Scope of Practice (SOP) Issues 19

Conclusion. 26

Chapter 3: Methodology. 27

Introduction: 27

Population and Sample: 27

Procedures: 28

Instrument: 29

Limitations and Delimitation: 30

Ethical Consideration: 31

Chapter 4: Results. 31

Introduction: 31

Findings: 31

Other Findings 35

Chapter 5: Discussion/Conclusion. 35

Chapter 6: Recommendation/Implication. 39

References. 41


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