I have just over 24 hours to my midwife certification exam.  In my midwifery path, certification by exam is a requirement for licensing.  But when I get that certification, I will be able to be licensed to practice in any state and it will make my international work a little easier. Certification and licensing are frequent topics of discussion among my midwifery friends.  I have some on both sides of the licensing fence, and on both sides of the certification fence. Due to the crazy nature of this world, not all my friends who think licensing is good are licensed (some are in states withoutRead More →

I was talking with another nurse practitioner (yes, I am actually a nurse practitioner now!!!) about what I would do with my midwifery training.  I’ve decided to pursue a PhD, which means I am pretty sure I’ll never work as a baby catcher.  I knew this, and accepted the possibility when I applied for the PhD program. But, as I explained to her, midwifery isn’t just about catching babies because women are more than a uterus. But I also trained in family practice, which means I can help identify an illness or treat a chronic condition.  In the real world, these two disciplines overlap.  PregnantRead More →

Intervention is a tricky little word that seems to divide midwives.  Most midwives agree that midwives in general use less “intervention” then physicians. But that seems to be where the agreement ends.  What makes some midwives feel a woman can be successful at an intervention free birth in a hospital, while others believe even women giving birth with a home birth midwife receive regular interventions? The problem arises when using different meanings for the term intervention. Some midwives use the term to mean surgical or pharmaceutical techniques (cesarean, pitocin, epidural). Some midwives use the term to mean anything done to alter the natural course of labor (castor oil,Read More →

I meet a lot of wannabe midwives, and a lot of midwives.  The wannabe midwife I meet most frequently is the one who is angry with the “birth system” and plans to become a midwife to fight that system.  Usually, the plan is to become a homebirth midwife to provide for births, “the way they should be.”  I like to ask wannabe midwives two questions before I agree that is their path.  Why?  Because usually they do not realize all the ways to bring change to the system. Question #1:  What is it about the “birth system” that bothers you? While your first response mayRead More →

I wanted to share something I learned about myself recently.  I love caring for HIV+ patients.  Actually, the patients I have been seeing have AIDS.  What is the difference?  A person is HIV+ when they are infected with the virus; a person is said to have AIDS when the virus has done enough damage to their immune system that they have less than 200 CD4 cells or have an opportunistic infection. This semester, I’ve been doing clinical hours at an HIV center caring for women living with AIDS.  I truly mean living.  The women I met had all been extremely sick at one point, butRead More →

I wanted to take a minute to share a frustration I have.  When my direct entry sisters criticize nurse midwifery because it does not follow the apprenticeship model, I’m not sure they understand how nurse-midwives are trained. Nursing education is not like medical education.  There is classroom content, and there is clinical content, but these are not separated. You learn new things through reading and class, and then you go out and do them with your preceptor.  Sometimes things line up beautifully, and other times it doesn’t. When it doesn’t line up you may end up spending hours researching things you are doing in clinical beforeRead More →

Next week I will be presenting a workshop on menopause. This is to be my very time-consuming project at the end of my midwifery training. Except it isn’t the end, I still have a ways to go (combining degrees and all). It is interesting to think about how I got to this point.  Ten years ago I would never have guessed I would want to present on menopause, I was still very birth focused.  But as I learned more about women’s health, my interests widened.  I never would have thought I’d like working with women to treat and prevent STIs, but I do.  Dealing withRead More →

I just received an email update from a woman I almost know–a social networking friend also involved in birth activities in Sub-Saharan Africa.  I had to laugh at the end of her email.  She never thought she would pursue a midwifery registration in her home country, but that is exactly what she is doing. Why laugh?  Because her story mirrors mine. My goal was never to be a midwife by vocation, but to improve the health of women in resource poor areas.  Yet here I am with a BSN and enrolled in a major university midwifery program. At the same time, I have friends whoRead More →

I read an article today that said CNMs can be great, but they have been trained as nurses first so are indoctrinated to the Doctor-Nurse hierarchy, and I had to scratch my head. Hierarchy? As in the doctor is the boss and the nurse follows orders?  This is a very common misunderstanding of the doctor-nurse relationship, and if you believe it you risk not helping your clients  utilize the best services from a nurse. Each nurse is an independently licensed professional with a scope of practice that determines her role.  Nurses deal with responses to illnesses and conditions while the doctors and advanced practice nurses deal with the illness orRead More →

One of the arguments my teachers gave for the superiority of the BSN over a two year program was the way a liberal arts education gives you a well-rounded perspective of health and life. She explained the exposure to many ideas would allow us to better communicate with the wide variety of individuals who would eventually find themselves under our care. I’m not a person who would call any education “wasted.” But I am a person who can think of time or money wasted. Which is why I am glad statistics demonstrate that BSN nurses do provide better outcomes.  I doubt it is because BSN’sRead More →