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Newborn Hearing Screening Update For Midwifery Practice


  • Deborah Narrigan CNM, MSN

    1. Deborah Narrigan is a faculty member of Philadelphia University's Distance Education Masters in Midwifery Program, and former instructor for the newborn courses of the Community-Based Nurse-Midwifery Education Program, The Frontier School of Midwifery & Family Nursing.
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  • Midwifery as used herein refers to the profession as practiced in accordance with the standards set forth by the American College of Nurse-Midwives (ACNM); midwives refers to ACNM-certified nurse-midwives and midwives (CNMs/CMs).

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Neonatal identification of congenital hearing impairment allows interventions during the first 3 years, the critical period for language and speech development. Two recently developed biophysical testing methods offer simple, accurate, and relatively inexpensive means to identify the one to three in 1,000 healthy newborns with hearing loss. Universal screening for auditory system integrity is advocated, because almost half of all newborns with hearing impairment have no risk factors associated with this impairment. Critics of universal screening cite the high rate of false positive tests (up to 7%), which increases program costs from follow-up and re-testing large numbers of infants to ensure identifying the few affected infants. As of early 2000, 24 states had introduced some type of auditory screening program, and the U.S. Congress had passed legislation with appropriations mandating state-based auditory screening for all newborns. Midwives practicing in states already mandating biophysical screening need to comply with their local requirements; those in other states may voluntarily incorporate new auditory test methods into practice.

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