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Pharmacology, or something like it

I am in the semester of my program in which pharmacology is a main focus. Let me rephrase that, my main focus is pharmacology.  For many of my classmates it’s just another class with take-home exams. But I want to really understand why I would prescribe what I prescribe.

I keep remembering the words of a midwife friend who shared her struggles with medications when she first became a midwife. When you are the midwife, people expect you to have answers.  Women would show up in her office with a list of medications they were taking and ask, “are these safe?” She admitted to the frustration this caused her, having little familiarity with most of the medications she would see.

I can understand that now.  My midwifery clinical is very “woman problem” focused, treating vaginal infections or prescribing prenatal vitamins or birth control. Once I saw a client with PCOS, and once we diagnosed someone with rheumatoid arthritis, but most pharmacology has been the same 5 medication classes. Even my pediatric clinical was very antibiotic or antifungal focused. It’s the nature of the primary care beast, I won’t have much to do with children who are struggling with leukemia or other “big” problems.  Their care will be in the hands of specialists.

I read recently that most physicians have about 120-128 meds they know and use, and that becomes the extent of their pharmacological prescribing. I can accept that to a point, I have definitely seen that there are some meds that you just use over and over and over. But at the same time I keep hearing my friend and the frustration she has when her clients expect her to know everything about the meds they have been taking – even though they have been prescribed by someone else. I want to have a firm foundation so when this happens to me (because I fully expect it will happen to me) I can quickly find the information my clients will need.

But I have another reason for being so interested. I want to understand the way the chemicals from medications interact with the body so I can better understand the differences between a “natural” or herbal treatment  and a standard drug. No, I don’t have an extensive herb knowledge. But a girl has got to start somewhere with her learning.  This is where I am right now, so I am jumping in with both feet. I’m off to work on my take-home midterm.  Wish me luck.

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Jennifer Vanderlaan CNM MPH is the author of the BirthingNaturally.net website. She has been working with expectant families since 2000, training doulas, childbirth educators, and midwives. She has worked with midwives in Central America and Sub-Saharan Africa. Her interest in public health grew in 2010, and she is now a PhD student learning to become a producer of knowledge.

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