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A Midwifery-Led In-Hospital Birth Center Within an Academic Medical Center: Successes and Challenges

Perdion, Karen MSN, CNM; Lesser, Rebecca MSN, CNM; Hirsch, Jennifer MS, CNM; Barger, Mary PhD, CNM; Kelly, Thomas F. MD; Moore, Thomas R. MD; Lacoursiere, D. Yvette MD, MPH

The Journal of Perinatal & Neonatal Nursing: October/December 2013 - Volume 27 - Issue 4 - p 302–310
doi: 10.1097/JPN.0b013e3182a3cd42
Feature Articles

ABSTRACT The University of California San Diego Community Women's Health Program (CWHP) has emerged as a successful and sustainable coexistence model of women's healthcare. The cornerstone of this midwifery practice is California's only in-hospital birth center. Located within the medical center, this unique and physically separate birth center has been the site for more than 4000 births. With 10% cesarean delivery and 98% breast-feeding rates, it is an exceptional example of low-intervention care. Integrating this previously freestanding birth center into an academic center has brought trials of mistrust and ineffectual communication. Education, consistent leadership, and development of multidisciplinary guidelines aided in overcoming these challenges. This collaborative model provides a structure in which residents learn to be respectful consultants and appreciate differences in medical practice. The CWHP and its Birth Center illustrates that through persistence and flexibility a collaborative model of maternity services can flourish and not only positively influence new families but also future generations of providers.

Department of Reproductive Medicine, University of California San Diego, La Jolla, California (Mss Perdion, Lesser, and Hirsch, and Drs Kelly, Moore, and LaCoursiere) and Hahn School of Nursing and Health Science, University of San Diego, San Diego, California (Dr Barger). Ms Lesser is currently at Kaiser Permanente Walnut Creek, California.

Corresponding Authors: Karen Perdion, CNM, 200 W Arbor Dr MC8612, San Diego, CA 92103 (

Disclosure: The authors have disclosed that they have no significant relationships with, or financial interest in, any commercial companies pertaining to this article.

Submitted for publication: December 10, 2012; accepted for publication: July 5, 2013.

© 2013 by Wolters Kluwer Health | Lippincott Williams & Wilkins.