Characteristics and Outcomes of Postgraduate Midwifery Fellowship Programs in the United States

Abstract

Navigating the period of transition from a student to a clinician can be challenging for new graduate midwives and advanced practice providers. With exponential growth in these professions coupled with a complex American healthcare system, there has been increased desire for fellowships for advanced practice providers. This sentiment has been echoed by midwifery students. While there is an increasing body of evidence for the benefits of postgraduate fellowship programs for nurse practitioners, studies regarding midwifery specific fellowships are limited. This project gathered information regarding the characteristics and outcomes of postgraduate midwifery fellowship programs in the United States. A mixed methods design used a program demographic survey and interviews with the program directors. With both a quantitative and qualitative approach, a thorough description of US postgraduate midwifery fellowship programs as perceived by the program directors was completed. Seventeen postgraduate midwifery fellowship programs were identified through an environmental scan and snowball sampling. Thirteen program directors completed the survey (76.5% response rate, n=13) and 11 completed the Zoom interviews (64.7%, n=11). The findings allowed for identification of program characteristics including location, structure, funding, and educational offerings of midwifery fellowship programs. The thematic analysis revealed the emergence of three themes highlighting the creation of support for midwives in transition, including new graduates and practicing midwives returning to practice after a hiatus or shifting to specialty practice: 1) Stepping-stones; 2) Empowered and equipped; and 3) Innovative future. This project provided new information as it relates to postgraduate midwifery fellowship programs in the U.S. There is no call for mandatory midwifery fellowships or residencies, but rather, as a valuable option that selected midwives and practices may find useful. The findings of this project validate the unique qualities of these programs in creating a bridge for midwives transitioning into practice, returning to practice, and changing clinical settings. Disseminating information about these programs, bringing them together in a coalition within midwifery professional associations, and joining forces with other fellowships in advance practice specialties can create opportunities to advocate for systemic legislative and funding support, similar to that of medicine, for advance practice providers and midwives.