Midwives: 5 Strategies for Escalation, Co-management, and Referral

Author: Ginger Breedlove, PhD, CNM, FACNM, FAAN, CEO, Founder and Principal Consultant of Grow Midwives LLC and Member, TDC Group APC Advisory Board

Let’s say my patient is in active labor, and I know this patient’s birth with her first baby included shoulder dystocia. Let’s say this patient has a high BMI, and the baby’s head is not descended in an expected manner, although she is fully dilated. In this hypothetical scenario, the timely call would include me calling the ob/gyn (or family physician) and saying, “I think I want you here in the second stage of labor, because the risk of shoulder dystocia might be elevated.”

This proactive approach promotes much better outcomes than waiting until the turtle sign to escalate.

By laying the groundwork for care escalation in advance, all practitioners and practices can promote patient safety while mitigating their own liability risks. The following are five key strategies:

https://www.thedoctors.com/articles/midwives-escalation-collaboration-comanagement-referral-strategies