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MIDWIFERY CARE FOR WOMEN WITH HUMAN IMMUNODEFICIENCY VIRUS DISEASE IN PREGNANCY

A Demonstration Project at the Johns Hopkins Hospital

Authors

  • Emily De Ferrari CNM,

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    • Emily De Ferrari, CNM, was graduated from the University of Mississippi Nurse-Midwifery Education Program and currently practices with the Johns Hopkins Nurse-Midwifery Service. She is the primary nurse-midwife for HIV-infected women attending the Johns Hopkins obstetric clinic. She served on the ACNM Ad-Hoc Committee on AIDS.

  • Lisa L. Paine CNM, DrPH, FAAN,

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    • Lisa L. Paine, CNM, DrPH, FAAN, is Associate Professor of Maternal–Child Health at the Boston University School of Public Health and is Director of the Nurse-Midwifery Education Program and the Maternal and Child Health Program in the School of Public Health. Dr. Paine is the former Director of Nurse-Midwifery Services at the Johns Hopkins Hospital, where she and Dr. Anderson developed the model of nurse-midwifery care for women with HIV disease described in this paper.

  • Carolyn L. Gegor CNM, MS,

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    • Carolyn L. Gegor, CNM, MS, RDMS, a graduate of the Georgetown University Nurse-Midwifery Program, is Director of Nurse-Midwifery and Instructor of Gynecology and Obstetrics at the Johns Hopkins University School of Medicine, and Clinical Director of the Fetal Assessment Center at the Johns Hopkins Hospital, Baltimore, Maryland.

  • Lisa Summers CNM, MSN,

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    • Lisa Summers, CNM, MSN, a graduate of the Yale University Nurse-Midwifery Program, is Instructor of Gynecology and Obstetrics at the Johns Hopkins University School of Medicine and the Nurse-Midwifery Research Coordinator. She is completing doctoral studies at Columbia University School of Public Health.

  • Jean R. Anderson MD

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    • Jean R. Anderson, MD, a graduate of Vanderbilt University Medical School, is Assistant Professor of Gynecology and Obstetrics at the Johns Hopkins University School of Medicine and Director of the Obstetrical HIV Clinic.


6Johns Hopkins University, 600 North Wolfe Street, Houck 228, Baltimore, MD 21287–1228.

ABSTRACT

Nurse-midwives at the Johns Hopkins Hospital, in conjunction with their colleagues in obstetrics, pediatrics, and infectious disease, are participating in a demonstration project designed to provide continuity of care for women with HIV disease in pregnancy. In the past 19 months, 73 women have been enrolled in the project. This article describes how the midwifery model of care has been integrated into the existing system of routine obstetric care and specialized HIV-related care at the institution. This project could serve as a model for others who are redesigning health care delivery systems to include more nurse-midwives, especially those who are trying to adapt to an ever-increasing number of women experiencing some phase of HIV disease during their pregnancy. A companion article explains the midwifery and medical protocols used in the project and discusses other clinically relevant issues.

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