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The Duke University Medical Center Archives is happy to announce that the Duke Midwifery Service Records are processed and open for research. The collection includes but is not limited to the administrative records, birth logs, bilingual (English and Spanish) curriculum materials for classes on pregnancy and parenting, and ephemera related to the patient-centered care of Certified Nurse Midwives. Major subjects include nurse midwives, high-risk pregnancies, and community health outreach in Durham County, North Carolina, documenting the work of the Duke Midwifery Service and professional activities of former director Amy MacDonald.
The Duke Midwifery Service (DMS) was initiated in 1999 to provide services to low-risk pregnant women and education to Ob/GYN and Community and Family Medicine first-year residents, medical students, physician assistant students, midwifery students, and nursing students. The service was first organized within the Division of Maternal Fetal Medicine under the Department of Obstetrics and Gynecology. In 2014, the name changed to Duke Women’s Health Services Teams when the DMS integrated with Nurse Practitioner/Physician Assistant Services to create the Advance Practice Provider Service (APPS) under the Divisions of Maternal-Fetal Medicine and Gynecology.
As the service expanded, it employed certified nurse-midwifes (CNM) across regional inpatient and outpatients clinics. The CNM’s practice was supervised by Phil Heine MD, Director of Maternal of Fetal Medicine. At the Duke Medical Center, CNMs provided daytime triage, labor, and delivery inpatient care in the Duke University Hospital Birthing Center. At Birth Place at Duke Regional Hospital, CNMs provided triage and intrapartum inpatient care for patients from Durham County Health Department (DCHD), Franklin County Health Department (FCDP), and Person County Health Department (PCHD). Outpatient care was provided at the Duke Maternal Fetal Medicine (MFM) Clinic and the Duke Resident Postpartum Clinic. DMS was contracted in 2001 to provide prenatal cares services at DCHD Prenatal Clinic at Lincoln Community Health Center, and, in 2004, the first site of Centering Pregnancy, a model program for group prenatal care. Later, in 2009, an award from the North Carolina Healthy Start Grant created a clinic and expanded the Centering program to Spanish speaking women at El Centro Hispano, a center for Latino advocacy in Durham, North Carolina. As of 2012, the service had attended to approximately 3000 births.
The materials were collected by Amy MacDonald, CNM, former DMS Director, from 1999 to 2014. She was the first CNM to be hired and remained on staff program until she left her position in November 2021. MacDonald received a Bachelor of Arts in Biological Science from Antioch College in 1984, and her Nursing Diploma and Master of Science in Nursing with a certificate in midwifery from Yale University School of Nursing in 1991. She began her career as a nurse midwife by opening a freestanding birth center affiliated with a community health center in rural West Virginia. MacDonald later worked for a private practice in Boston, where she was involved in the education of midwifery and medical students, as well as family practice residents. Upon moving to North Carolina in 1996, MacDonald provided prenatal care at Lincoln Community Health Center in Durham, North Carolina. She then developed a collaborative OB/GYN/Midwifery service at Kaiser Permanente in Chapel Hill, where she attended births at UNC hospital and Durham Regional Hospital.
MacDonald received numerous awards including the Kaiser Permanente Excellence in Patient Care Award in 1999, the Duke Friends of Nursing Award for Excellence in Women’s Health, and The North Carolina Great 100 Nurses Award in 2011. She joined the Faculty for the Duke School of Nursing as a Clinical Instructor in 2003. She later joined the Duke School of Medicine Practice Course Faculty from 2014 to 2016. Since 2008, MacDonald has been a faculty member of the Centering Healthcare Institute, leading Centering Pregnancy and Centering Parenting trainings nationally and internationally in Malawi, Africa and Rio de Janeiro, Brazil.
This collection includes administrative records, birth logs, grant information, correspondence, curriculum materials, clinic forms and handouts for patients in English and Spanish, photographs, digital files, and a lab coat. The collection contains many unusual artifacts documenting the lesser-known stories involved in the care work of nurse midwives and their advocacy for patients. Bumper stickers with small pin holes once hung in the work environment advocate “Midwifery-It’s All In the Hands…” and “Breastfed is Bestfed.” A cigar, still wrapped in cellophane, pronouncing “It’s a boy!”, which was presented to MacDonald by a parent on the celebratory occasion of a successful birth. A copy of the Centering Pregnancy notebook that served as a resource for current information and logbook for tracking vital prenatal care of participants, which contributed to outcomes of decreased preterm births and increased patient satisfaction in Durham, North Carolina. These are only a few highlighted items that capture the activities of the DMS.
This collection should be of note to researchers interested in birth work, the proliferation of midwifery, and the impact of patient centered care for pregnant women within marginalized communities of color in Durham, North Carolina.
This blog post was contributed by Archives Intern Carter Hulinsky.