As highly trained healthcare professionals, certified nurse midwives (CMNs) are particularly valuable in rural and underserved areas where obstetric care is limited. Yet, in places they can help most – like eastern and central Washington – they’re often underutilized or not part of the birth process at all.
So what’s going on?
“Once you leave the coast, people just don’t know about us,” said Carol Neely, chief nursing officer and a CNM at Omak’s Mid-Valley Hospital. “Doctors and patients don’t have the same experience with midwives, so there’s less understanding of how they work together.”
Neely practiced in western Washington for much of her career, where CNMs are in high demand and integrated into hospitals and the obstetrics community. When she moved to Omak in 2021, job offers were sparse – a bit of a shock considering how sought after her skills remain on the other side of the Cascades.
Neely sees it as an awareness problem.
“Recruiting OB/GYNs can be difficult in rural areas where family practice providers tend to care for most of the population. We need to spread the word that CNMs are specialized OB Providers. They are cost effective, evidenced-based and patient-centered.”
In Washington State, CNMs are recognized as independent practitioners, meaning they can provide care without direct supervision from a physician. This autonomy allows them to offer personalized, patient-centered care, often in a variety of settings, including hospitals, birthing centers and even at home.
“There are OB deserts in our state and throughout the U.S.,” Neely said. “Families and doctors need to know we are here and present in communities. And any hospital with a struggling OB department should hire CNMs.”
The good news for birthing parents is Washington State has the highest integration of midwives in the United States as well as some of the best outcomes for moms and babies. Beyond childbirth, CNMs in Washington provide a wide range of services, including family planning, gynecological exams and menopause management. Their work contributes to improving maternal and infant health outcomes and plays a vital role in the state’s overall healthcare landscape. (Kelly Akers)
