The Midwifery Pearls of Physiologic Birth are a cornerstone of midwifery practice. They were developed by Whitney Pinger, CNM, MSN, FACNM, an expert in evidence-based maternity care, natural childbirth, optimal nutrition and exercise during pregnancy, primary cesarean prevention, vaginal birth after cesarean (VBAC), health disparities, and collaborative practice. She is committed to and passionate about educating the next generation of physicians, midwives, and nurses so they can help women optimize their chances of a normal birth. She is also a fierce advocate for normal birth and collaborative practice, and this passion infuses her teaching and midwifery practice.
Pinger has worked closely with the GW Nursing MSN in Nurse-Midwifery leadership and has spent many years as the director of the GW Midwifery service at GW Hospital.
“Since 2010, GW Midwifery ’Practices by The Pearls’, and uses innovative labor management strategies, including ‘The Pinger Patterns of Labor’ and strong collaboration with our physician partners to mark a cesarean delivery rate of 6%, a natural childbirth rate of 94%, and a VBAC success rate of 90%,” says Pinger on her website. “GW Midwifery consistently scores highly in nationally benchmarked outcome data, including low cesarean delivery and high VBAC rates for a practice of its size. In 2019, I transitioned out of the leadership at GW Midwifery, and we marked our 5,000th GW Midwifery delivery, which I was honored to catch.”
The Midwifery Pearls:
• Culturally safe environments improve outcomes
• Eating and drinking in labor is encouraged
• Routine intravenous fluids are avoided
• Intermittent auscultation of the FHR is the standard of care
• Ambulation and freedom of movement are encouraged
• Hydrotherapy is safe and effective and is the standard of care
• Continuous labor support is the standard of care
• Routine rupture of the membranes is avoided
• Passive descent and self-directed pushing are encouraged
• Individualized, gentle perineal support prevents lacerations and episiotomy
• Delayed cord clamping improves neonatal outcomes and is the standard of care
• Immediate skin-to-skin contact, bonding, and breastfeeding are facilitated
• Trial of labor after cesarean is the standard of care
• Planned vaginal breech birth is a safe option in a collaborative model of care
• Inter-professional education, collaboration, and team-based care promote optimal outcomes