I’ve made a decision that I need to have a real working knowledge of treating women with HIV. How I could pretend it doesn’t matter to my learning for so long amazes me. Perhaps I should have done more thinking about the experiences I really need to work in developing countries, in areas where the health status is very different from what I see here in the US.
Unfortunately, I let myself believe that training at the birth center was enough because I wouldn’t be in areas where there were many medical options anyway. But to think that way minimizes women’s health. Do I really believe the high rates of maternal mortality are because the traditional birth attendants don’t know how to manage normal, healthy women? If I assume the problem is simply that there are not enough midwives (and the WHO backs me up in saying there are definitely not enough midwives), then working with the normal would be enough.
In the US with its ever growing overweight and obesity, the issues related to obesity seem to be some of the leading problems with pregnancies. But to what extent will that translate to countries where mothers are malnourished? How will my experiences with obesity help me work in areas where malaria, HIV or other issues are the common health problems? It’s time for me to get real about where I am going and what my goal really is as a midwife. I need to learn how to treat infections beyond BV and Chlamydia.
I have been reading a book about HIV because it was assigned for my public health school. I am half way through the book and I still don’t have any large desire to know more about this particular illness. But I’ve decided that it isn’t all about what I like the best. My training cannot only be in the subjects I am most drawn to. So today I asked my program director if I could do clinical time at the HIV clinic for women. She liked the idea and will check to see if the NP will take a student — and she suspects the NP works with pregnant HIV patients as well.
Honestly, the more I think about the possibility the more excited I get. I assume I will learn different ways to see a patient and different ways to think about the issues of pregnancy and birth. And I assume by learning this new perspective I will be in a better position to understand WHO recommendations for treatment and I will be better prepared to work with populations with high rates of HIV. Coincidentally, Georgia has one of the highest rates of HIV prevalence in the US (after Florida, Louisiana and DC). Another reason to it is perfect to be training here. I’m really hoping this works out.