Teamwork and Collaborative Leadership Lesson

Florence's Story

Florence is a 29-year-old pregnant person.

She and her partner, Tom, are thrilled to be expecting their second child this September. They have a 3-year-old daughter together. One year ago, Florence experienced a spontaneous miscarriage at 11 weeks gestation. The couple was surprised but delighted to be pregnant again. Florence is healthy, with no significant medical or surgical history.

During her first pregnancy, Florence and Tom were very concerned about giving birth in the hospital, since it is tradition in Florence’s family for all the female relatives – including aunts, sisters, cousins, grandmothers – to be present during a birth. Hospitals near her typically restrict the number of relatives allowed in the labor room. Florence also worried that she might experience an illness or complications that necessitate hospital birth and not being able to have her whole family with her.

Thankfully, Florence had an uncomplicated first pregnancy and she was able to have a planned home birth with a midwife. Now, with her current pregnancy, Florence hopes to deliver at home again with her midwife.

Tasmin's Story

In Arizona, both physicians and midwives provide perinatal care.

Florence and Tom currently receive all of their medical care from Tasmin, a midwife who has practiced for many years. Florence has spent a lot of time reflecting on her experience of her last pregnancy and birth and she has some different expectations this time.

Tasmin carries her own caseload that includes both pregnant and non-obstetric clients. She enjoys being able to provide care to women that extends beyond 6 weeks postpartum, including an expanded scope of care to babies and well-woman care. Because of the lower number of maternity cases in her community and to maintain her competency,  she occasionally has to travel for continuing education or short-term practice opportunities in high-volume settings.

Riann's Story

Everytime Florence sees Tasmin, she is reminded about how she works with other providers in the community.

In this community, when a doctor or midwife has to be away – for continuing education, an emergency, or vacation, for instance – another provider assumes the caseload and covers call for the traveling provider during that time.

Tasmin has an arrangement with Riann, a family practice physician, who carries her own obstetric caseload and attends births in the hospital. She has lived in the community for two years. When they are taking responsibility for each other's caseload, Tasmin and Riann discuss every patient and the birth plan. They have this arrangement to keep each other in the loop, to support team functioning, and to help ensure people's safety and satisfaction.