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My Thesis

I’ve had my thesis approved!  This means I can begin working on it.  So what amazing topic did I decide to pursue?  Actually its quite simple, and I’m a bit ashamed of our health care system that it has never been looked at before.

I’m doing a population based cross-sectional study to compare patient to provider ratios to see if there are differences in outcomes at either end of the scale.  I’ll take existing public health data on the numbers of physicians per county, and cross that with the vital statistics data for birth by county.  I did a similar project during my BSN up in New York, and the results were used by the Licensed Midwives Association to help remove the written practice agreement from the Midwifery Act.  Why?

It is simple public health policy, really.  When you show that there is a lack of providers in an area, and that willing providers cannot get into the area because of a bad policy, the policy can be removed.  Public health policy is rarely moved by the effect to the individual, and once we accept that we can start to do more population based studies on midwifery care.  Law makers do not care that women who use midwives have less cesareans, until they know that districts that integrate midwives have lower costs due to decreased cesareans.

So, that is the basic and the reason why.  It will be a lot of work, and I’ve pretty much decided I need to stay for an extra semester to make up clinical time and finish my thesis – which pushes my graduation to 2013 instead of December 2012.  But at some point I need to sleep, so I’m almost OK with the extra months.

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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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