With a shortage of obstetricians at rural hospitals, the answer may be: Call the midwife

Midwives could save rural hospitals struggling with the challenge of being prepared 24/7 to deliver babies, a new Mayo Clinic study found.

Mayo's hospital in La Crosse, Wis., reported fewer surgical deliveries and birth complications requiring neonatal intensive care under a system in which seven certified nurse midwives provided round-the-clock staffing and coordinated with obstetricians on prenatal care for expecting mothers and their baby deliveries.

The benefits of using CNMs as hospital laborists "could be because someone was readily in-house at all times" to prevent or identify birth complications, said Theresa Hagen, a La Crosse hospital CNM.

Rural hospitals have struggled to retain enough obstetricians so that one is at least on call. That has left the remaining physicians overworked, and hastened their departure from practice, said Dr. Gokhan Anil, a Mayo obstetrician and lead author of a report on the La Crosse experiment.

The new approach "was partly necessity and partly using each other's strengths to care for patients," he said.

An increase in training programs means CNMs will be in greater supply to partner with rural obstetricians and ease hospital shortages. In La Crosse, birth outcomes improved even as CNMs were assigned more responsibilties such as consulting on high-risk cases and leading or performing moderate-risk deliveries.