UCSF Interested in Nursing and Midwifery Program Amidst Maternal Care Issues – California Health Care Foundation

One of California’s two nursing and midwifery training programs has stopped accepting students while it revamps its curriculum to offer only medical degrees, a move that has drawn protests from alumni. health policy experts and higher education faculty accuse the University of California of profiteering. above public health needs.

UC-San Francisco’s renowned nursing school will graduate its final class of registered nurses next year. Then the university will cancel its two-year master’s in nurse-midwifery program, along with other nursing courses, in favor of a three-year associate’s degree in nursing, or DNP. The change will freeze UCSF’s nearly five decades of nursing training until at least 2025 and will more than double the cost to students.

State Assemblywoman Mia Bonta, who chairs the health committee, said she was “disappointed” to learn that UCSF is ending its nurse-midwifery program and fears that the additional time and cost to find medical certificate will prevent potential applicants. “Instead of increasing barriers, we need to build and expand the pipeline of cultural and ethnic providers to support improved birth outcomes, especially for Black and Latina births,” he said in an email.

The medical education reform is part of a national movement to require all advanced practice registered nurses, including nurses and nurse practitioners, to obtain a doctorate, said Kristen Bole, a UCSF spokeswoman, in response to questions from written. Medical training will have more leadership and quality improvement teams.

But the organization, which began in 2004, has not caught on the way the American Association of Colleges of Nursing envisioned when it called for a doctorate-level education to be required for advanced nursing practice. in 2015. That deadline came. Now, the strong demand for obstetricians has some universities moving in the opposite direction.

Renewal of Some Master’s Programs for Nurse-Midwives

This year, Rutgers University brought back the master’s degree in nursing that it had discontinued in 2016. The University of Alabama-Birmingham also restarted its nursing degree program in 2022 after a 25-year hiatus. in addition, George Washington University in Washington, DC, Loyola University in New Orleans, and the University of Nevada-Las Vegas have added master’s training in midwifery.

UCSF estimates that tuition and fees will cost $152,000 for a three-year doctorate in midwifery, compared to $65,000 for a two-year master’s. Studies show that 71% of nursing students and 74% of nursing students rely on student loans, and nurses with medical degrees earn little or no money than nurses with degrees. master’s degrees.

Kim Q. Dau, who directed UCSF’s midwifery program for a decade, resigned in June because he was uncomfortable with the elimination of master’s degrees for medical necessity, he said, which contradicts government employee needs and unnecessary. for clinical practice.

He said: “They will be prepared in the same clinical way but at a greater cost to the student and with a greater investment of time.

Nurse-midwives are registered nurses with multiple nursing-midwifery certifications. Licensed in all 50 states, they work primarily in hospitals and are able to perform abortions and administer medications, although they are also trained to manage labor pain through showers, massage and other natural methods. Registered midwives, on the other hand, study midwifery at the graduate level outside of nursing schools and are licensed in other areas. Certified midwives visit births outside of hospitals.

The California Nurses-Midwives Association also criticized the change to the UCSF program, which comes amid a national maternal mortality crisis, a severe shortage of midwifery providers, and growing confidence of midwives. According to the 2022 “White House Blueprint for Confronting the Maternal Health Crisis”, the US has the highest maternal mortality rate of any developed country and it takes thousands more midwives and other women’s health providers to close the swelling gap.

‘Problems in the Good Life’

Ginger Breedlove, founder and CEO of Grow Midwives, a national consulting firm, likened UCSF’s transition from master’s to medical training to an “earthquake.”

“Why are we delaying the entry of critical care providers by making them attend an extra year of school, which adds nothing to their clinical preparation or their safety to serve the public?” asked Breedlove, past president of the American College of Nurse-Midwives. Why they chose this during the worst labor shortage and the worst maternal health crisis we’ve had in 50 years is beyond me.”

A 2020 report published in Nursing Outlook failed to find that senior registered nurses with doctorates have more clinical knowledge than those with master’s degrees. “Unfortunately, so far, the data is limited,” it concluded.

The American College of Nurse-Midwives also criticized the medical requirement, as did the trade associations for midwives and midwives, saying “the lack of scientific evidence that … medical-level education is benefit to patients, physicians or society.”

There is no evidence that nurse practitioners will provide better care, Breedlove said.

“This is more of a profit than a project,” he added.

UCSF: Preparing Students for the Developing World

Bole disputed Breedlove’s claim of a profit motive. When asked about the reasons for this change, he gave broad statements: “The decision to improve our program was made to ensure that our students are prepared for the challenges that they will face in the future. first.”

Like Breedlove, Liz Donnelly, vice chair of the health policy committee for the California Nurse-Midwifery Association, worries that UCSF’s move to a medical degree will exacerbate two maternal mortality problems. and the reduction of maternity workers across California and the country.

On average, 10 to 12 nurses have graduated from UCSF’s master’s program each year for the past decade, Bole said. California’s remaining master’s program in nurse-midwifery is at California State University in Fullerton, south of Los Angeles, and graduated eight nurses last year and 11 this year.

More than half of rural US counties lacked prenatal care in 2018, according to a report by the Government Accountability Office.

In some parts of California, expectant mothers have to drive two hours for care, said Bethany Sasaki, who runs Midtown Nurs Midwives, a Sacramento birth center. It has to stop accepting new clients because it cannot find midwives.

Concerns About Loss of Diversity Efforts

Donnelly predicted the closing of UCSF’s midwifery program would significantly reduce the number of nurses entering the workforce and would prevent those with limited resources from attending the program. “In particular, I think it’s going to reduce people of color, people from rural areas, people from poor communities,” he said.

The change at UCSF may also reduce efforts to train providers of diverse backgrounds.

Natasha, a 37-year-old Afro-Puerto Rican mother of two, spent ten years preparing to train as a nurse so she could help women like her during pregnancy and childbirth. He asked to be identified only by his first name for fear of reducing his chances of being accepted into the school.

The interruption of the UCSF program, along with the added time and expense of obtaining a doctorate, derailed his career path.

“The master’s program was the perfect program,” said Natasha, who lives in the Bay Area and was unable to travel to the other end of the country to attend CSU-Fullerton. “I’m confused, and I feel hopeless. Now I have to find another way of work. “

This article was produced by KFF Health News and published on August 26, 2024, by California Healthline. KFF Health News is a national newsroom that produces in-depth journalism on health issues and is one of the main operating programs at KFF – an independent source of health policy research, elections and the media. Learn more about KFF.

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