St. Pat’s opens nurse midwifery program in Missoula

By Martin Kidston/MISSOULA CURRENT

There was a time not long ago when Brenda DeGrazio considered quitting her practice as a nurse midwife. She was working alone, always on call and the hours were grueling.

But one day at a local restaurant, she met a man who looked strangely familiar.

“He actually got down on one knee like he was going to propose, took my hand and said his son was graduating from high school this year,” DeGrazio said. “He told me he'd never forget the birth of his son and how I had included him. He said it's been such an incredible memory for all these years.”

DeGrazio sits in her newly painted office at the Garden City Medical building on the Providence St. Patrick Hospital campus with fellow nurse midwife Wendy Flansburg. The two CNM's are on the ground floor of the hospital's new midwifery program, one that compliments the recently opened Family Maternity Center.

While the midwifery program is new at St. Patrick Hospital, it's not new in concept. The term translates to “with woman,” and the practice is steeped in history, dating back to its first mention in Genesis, when Rachel gave birth to Benjamin as they traveled away from Bethel.

“Nurse midwifery incorporates that incredible richness of the art of midwifery, the traditions of nursing and the science of medicine,” DeGrazio said. “The thing that's really exciting to me about this practice is that it's an all-women office, it's nurse run, and it's just the best of all worlds for women's care.”

The two nurse midwives made their way to St. Patrick Hospital through disparate paths. Flansburg earned her master's degree from Case Western Reserve University in Cleveland before receiving her midwifery certification from the Frontier School of Nursing and Midwifery in Kentucky.

In the early days of her career, Flansburg set out to become a labor and delivery nurse. While a career as a midwife didn't seem possible at the time, she pursued it anyway and hasn't regretted the decision, saying the bonds she forms with new and expecting mothers is richly rewarding.

“I was with women at the point of labor when I was a labor and delivery nurse, but I though it would be cool to have that bond throughout the whole nine months of their pregnancy,” said Flansburg. “You create an incredible bond with your patients. You don't get that anywhere else.”

As for DeGrazio, she traces her career as a nurse midwife back to dumb luck. She initially practiced in male urology, though it didn't suit her. So she joined the Air Force to attend the women's health nurse practitioner program.

At the time, DeGrazio said, she didn't know what a midwife was, though she was persuaded to apply to become one.

“I applied, got accepted, didn't know what a nurse midwife was, didn't know what it did, didn't know why anyone would want one,” DeGrazio said. “But I was there, they were paying for it and life was good. It was just one of those things in life that you don't know why it happened, but you knew it was good.”

That was back in the 1980s and it marked the beginning of a long career as a nurse midwife. DeGrazio would later became the first midwife to earn hospital privileges in Missoula in 1995. She was the first nurse midwife to deliver a baby at Community Medical Center.

DeGrazio repeated the task just last week at 4 a.m., becoming the first midwife to deliver a baby at St. Patrick Hospital. It was a boy.

“We can practice autonomously, but the best case scenario is to have a very good working relationship with a physician who understand nurse midwifery and is willing to offer their medical expertise,” DeGrazio said. “This new program is reproducing that. The doctors have been very welcoming and supportive. You get the best of the time we have and the best medical expertise they have.”

In an adjoining room, Brianna Lipke sits for a morning visit. The expecting mother is 24 weeks into her first pregnancy. She's due on July 24 and is understandably nervous. But DeGrazio has been through this many times before and encourages Lipke through the process.

Lipke, who seeks to have a natural childbirth, found DeGrazio through research and the recommendation of friends. The two have already formed a strong bond.

“I've wanted to take the more natural approach to motherhood,” Lipke said. “I don't really want to be filled up with medication. Bodies have been doing this for thousands of years. If they can do it, I can do it, too. I've interacted with (DeGrazio) more than I've interacted with the nurses.”

Outside the room, Flansburg says nurse midwives are often misunderstood, though their role in women's reproductive health is far reaching. They conduct obstetrics and gynecological exams, perform paps-meres, and help women maintain a healthy a pregnancy.

During labor, they can provide massage therapy and water therapy. They serve as coaches, help with counseling, and provide general support and friendship.

“When they're in active labor, we go in and be with them until they deliver,” said Flansburg. “They don't have as much of that fear factor, especially with that first baby. It's being with them throughout the process and when they're in labor, too. It's a whole continuum of care.”

In many cases, the children they bring into the world become future patients.

“For me, it hasn't been unusual to take care of young women long before they became an OB patient, and they just grew into that role over time,” said DeGrazio. “And when they graduate through their post child-bearing years, I follow them through that as well.”

Flansburg agreed.

“What's really neat is when patients come back and have their second baby,” she said. “They go off into post and start sending their children to you for care and to have a baby. It ends up being a family experience. You just all get to know each other.”

To find out more or to schedule and appointment, call 329-7300.