PURPOSE:
To demonstrate how broad-scope midwifery care and education presents unique opportunities for the delivery and impact of midwifery model health care in a variety of settings that would otherwise lack this holistic perspective.

DISCUSSION:
The University of Michigan (UM) Nurse-Midwifery group was established in 1983 with two members and has since grown in both number (47) and scope. A tertiary care, hospital-based practice encompassing midwifery, nursing, OB/GYN resident and medical student clinical care and education, the UM midwife group has expanded from traditional midwifery continuity of care practice to include a unique range of in- and out-of-hospital collaborations with other health care professionals. These collaborations and practice settings include pediatric, generalist, and high risk OB disciplines and have become essential to the operation of the OB/GYN department. Inpatient, these roles include the Midwife Laborist supporting physician labor and birth care and education, Midwife Postpartum Rounder, Midwife Labor and Delivery Triage Coordinator, and Maternal-Fetal Medicine Antepartum Midwife Rounder. Outpatient, midwives provide high risk prenatal care with MFM specialists, and the Virtual OB Triage team staffs a video-visit clinic seven days a week managing postpartum hypertensive disorders and seeing urgent pregnancy and postpartum concerns. Our Early to Home program provides care to patients discharged as early as six hours postpartum, including one to two home visits by a midwife for mother and baby. Midwives in our Sexual Assault Nurse Examiner program provide care to people who have experienced sexual assault and present to the Emergency Room, and provide Trauma Informed Care education to department members.

EVIDENCE WHERE RELEVANT:
Research shows that women who feel safe, accompanied, and supported throughout their childbearing journey have better outcomes through midwifery.

KEY MESSAGE:
The UM model of midwifery care integrated across multiple and varied spaces demonstrates positive impact on systems and quality of care, expanding access and improving outcomes. Poster session 1 (Group A)