FARGO - When Sanford Health moved into its new hospital off Interstate 94 and Veterans Boulevard here in the summer of 2017, it was already on pace for a record number of births.
Cyndy Skorick, Sanford Women's executive director, said that was one factor in the recent move to add certified nurse-midwives to the staff.
The second factor: requests from patients.
"We know that there are women really wanting that low-intervention birth," Skorick said.
Sanford hired three certified nurse-midwives in March to focus on helping women through labor and delivery.
For now, the midwives are working in the hospital only, but plans are underway to incorporate them into the clinic setting as well, to be involved early in a patient's pregnancy and follow them through childbirth and beyond.
To do so, Sanford is planning to hire about six more CMN's over the next year or so.
Certified nurse-midwives typically have a four-year nursing degree and either a master's or doctorate degree in midwifery. Universities in more than two dozen states offer nursing-midwifery programs, the closest being the University of Minnesota, Twin Cities.
Kayla Quinn is one of Sanford's new certified nurse-midwives.
She said a CNM provides some of the same support that a doula or childbirth coach does, such as helping women in labor position themselves, but also delivers babies, which a doula can't do.
Unlike obstetricians, CNM's don't do surgery or work with high-risk patients, so they can be "a lot more present" than a physician can during labor and delivery, Quinn said.
Sanford's chief competitor, Essentia Health, has had at least one certified nurse-midwife on staff for 30 years.
Denise Powell, a CMN at Essentia, is one of five midwives practicing full-scope midwifery there, which means they care for women as young as 10, up to age 90.
Those visits can include well-woman care, annual checkups and obstetrics and gynecologic exams. Some of her patients have only seen a midwife through their entire medical care experience, she said.
Powell said if a pregnant woman chooses to see a midwife, all of her prenatal visits will be with one of the midwives on the team.
During labor and delivery, the midwife is with the patient at the hospital the entire time.
"I think midwives really offer a personal touch," she said.
For patients who don't want medication, a CNM can help manage labor pain with techniques including hydrotherapy and massage. They also support women who want pain meds, including an epidural.
If a complication develops, the midwife will coordinate care with an obstetrician. In case of a Caesarean section, a patient can still have a midwife involved in the birth.
Quinn said midwives look at labor and childbirth as a normal process, not a medical one.
"You know, women have been doing it forever and so it's our job to support them," she said.
Doula: A person trained to provide information and support to a woman before, during and after childbirth
Certified Nurse-Midwife: A registered nurse with additional training as a midwife who delivers babies, provides prenatal and postpartum care, newborn care and some routine care, including gynecological exams
Obstetrician: A physician specializing in pregnancy, childbirth and the postpartum period