About Certified Nurse-Midwives & Our Staff
Certified Nurse Midwives
Certified nurse-midwives (CNMs) are all Registered Nurses that have also graduated from an accredited nurse-midwife education program and passed a rigorous national certification exam. Because of the high standards established for education and certification, CNMs are licensed in all 50 states and the District of Columbia. They are experts held to the standards of practice set by the American College of Nurse-Midwives (ACNM) and by state licensing organizations. They are endorsed by the American College of Obstetricians and Gynecologists because of their excellence and proven safety records. In addition, CNMs attend continuing education programs offered by hospitals, universities, and the ACNM. They are held in high regard by health professionals and the Department of Public Health and work in hospitals, birth centers, government agencies, universities and attend homebirths.
Their education includes newborn care, well-woman gynecology, general health and wellness and pharmacology.
CNMs want you to take an active role in making the right decisions for you and your family. Nurse-Midwives educate you and your family to make the important decisions that will effect your health. The nurse-midwifery philosophy of care is holistic and involves the whole person on all levels- physically, nutritionally, emotionally, psychologically, socially and spiritually. The family is actively involved and care is individualized for cultural values and personal preferences.
Gynecological and p rimary health care is also provided to women. CNMs emphasize wellness, health promotion, education, and disease prevention. With health education as a primary focus, CNMs help prevent problems and assist women in developing and maintaining good health habits. Referrals to specialists are made as needed.
Certified Nurse-Midwives Provide Quality Care
- "The quality of CNM care is equivalent to physicians' care within their area of competence, according to a 1986 study by the Office of Technology Assessment. Further, they are better than physicians at providing services which depend on communication with patients and preventive action."
- The Medical University of South Carolina Twin Clinic study demonstrated a lower rate of very early pre-term births, very low birthweight infants, neonatal intensive care admissions, and perinatal mortality in a CNM directed clinic where CNM care is given when compared to a MD directed team where MD care is given. This demonstrated that the contribution of CNMs to high-risk prenatal care can be considerable.
- CNMs "hands on approach" have been shown to decrease the Ceasarean Section Rate.
- Based on the information on birth certificates- Apgar scores and birthweights, mothers and babies have distinctly better than average outcomes when births are attended by midwives, either in or out of hospitals.
- The American College of Obstetricians and Gynecologists support the use of CNMs. More and more health care providers are realizing that nurse-midwives can help decrease costs and decrease infant death rates.
- CNMs are an enormous advantage to families who expect a normal birth.
- In studies comparing healthy women with healthy pregnancies randomized to physician and midwife care midwives had similar outcomes with much less use of interventions.
Certified Nurse-Midwives Are Cost-Effective
- If only 50% of 4,060,000 births were attended in freestanding birth centers, not only would access to care be greatly improved, but savings would be almost $4 billion annually.
- A study at two Kaiser Permanente Medical Centers in California showed a 13% or $292,000 reduction in payroll costs at one center and a 7% or $2 million reduction at another center when CNMs were added to the obstetric team.
Certified Nurse-Midwives Increase Access and Improve Outcomes
- The State Advisory Committee to Florida's Healthy Start Program recommends that Florida work toward the goal of having 50% of normal pregnancies be cared for by midwives by the year 2000. This is part of the State of Florida's plan to decrease infant mortality and the rate of low birth weight infants. Other states have implemented similar plans.
The U. S. government's top scientific organization, the Institute of Medicine, has recommended "more reliance be placed on certified nurse-midwives" in delivering primary health care.
More information:
American College of Nurse Midwives,
www.midwife.org
Midwifery Today,
midwiferytoday.com
Our Staff
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Our Primary Assistant
Alice Giuffreda, Labor/Birth R.N., Doula
I have been drawn to the art of traditional midwifery since I was 9 years old when I read a book about the first nurse-midwife practice in the country that was established by a famous midwife in the early 1900's. I love attending home births! I find midwifery care to be very satisfying since we know our clients so much more deeply and can individualize their care.
Vanita and I met through a couple's group in Grass Valley. A friendship developed and we began working together doing homebirths in early 2005. In February 2007 I became the primary birth assistant.
I have 20 years of experience as a labor/birth/newborn care registered nurse working in low and high risk settings. I gave birth to my second child with a Nurse-Midwife. I previously worked full-time at Sutter Auburn Faith Hospital and at Sutter Memorial Hospital in Sacramento. I have specialized in teen pregnancy and fertility nursing in the past and I am currently studying to be an interfaith minister. I am a very dedicated, practical and yet fun-loving person. I love music and am learning to play the bass guitar. I love gardening, hiking and soaking in hot springs.
I live with my husband, Ralph and our "pound puppy" Bridget that we adopted in 2006. Our home is in Nevada City. My two children are grown-my daughter lives in Sacramento and my son currently lives in Austin, Texas.
You will probably meet me in the office during the interview or at some of your prenatal visits as I am often in the office assisting with general matters. I will attend your 36 week prenatal home visit in preparation for your birth. I will be at your labor and birth and remain for an average of 3-4 hours after the birth caring for the new family. I also do the postbirth and newborn care home visits. I plan to begin my nurse-midwifery training after I graduate from my ministerial training. |
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Back-Up Birth Assistants
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Naomi Ross, RN, ND Specializing in Labor/ Birth/ Newborn Care
I have been a labor and delivery nurse for 18 years, have two years education as a Nurse-Midwife though I didn’t complete the training and have a Nursing Doctorate. I have worked in many different places and I love attending home births with Vanita. I strongly believe in offering a variety of safe settings for people to give birth so that each family can begin in a way that is the best fit for them. I speak a pretty good Spanish and am trying to learn Russian. I have one daughter who is 7. I am honored to be at every birth. I also do prenatal visits and postbirth and newborn care home visits when Vanita needs help. |
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Cindy Pond, Certified Doula, EMT
In 1990 I became an EMT. During the eight years I worked on the ambulance, the most amazing thing to me, always, was the birth of a baby. It is so incredible to think that this little body is growing and developing inside a woman, and that this body will have to eventually find its way out. It is so empowering to know that a woman gets to experience this awesome event.
I discovered information about Doula’s, and knew right away this was the career for me. Along with all this new knowledge came the discovery of Birth Assistants, and this is how I met Vanita. How wonderful it is to have a baby in the comfort of your own home and baby gets to be born in quiet loving surroundings without unnecessary medical interventions.
I do not have any children of my own, but I have two awesome nephews. I just absolutely love babies, especially newborns, and am grateful for the opportunity to be with you when you deliver your new baby. |
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Mary Yates, RN Specializing in Newborn Care
Mary attended her first homebirth in August of 2006 and loved it! She is a nurse that has specialized in newborn and pediatric care for many years. She does home new mother/baby visits when Vanita is busy. She currently works at Sutter Auburn Faith Hospital in their Maternity Unit. She is the owner of a plant nursery also. Mary loves babies whether they are human or plant babies! |
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Our Helpful Office Staff |
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Carol Knarr, office assistant
I have a graduate degree from the American School of International Management in Phoenix, Az. I have traveled to 60 countries, lived in 5 countries on 4 continents including Africa as well as having been to all our states except North Dakota. I have 4 children, 7 grandchildren and 7 great grandchildren including my great grandchild, Nick, shown with me in the photo. I love art in any form, gardening, hiking, reading, painting, and philosophy. If homebirth had been an option when I had my children I would have chosen that way. I find midwifery care safer for baby and mother and much more appealing. |
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About CNMs & Our Staff