CNM

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A very OOC personal post or All The Things I’m Into Lately

Well, doesn’t this look familiar? I’ve had the good fortune of a snow day, no work and no school, so I thought it might be time to update tumblr. All of these things connect somehow in my brain, so bear with me:

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anonymous asked:

What school did you go to to become a midwife? If I became an abortion doula, would I go through the same schooling? Thanks!!!

There are 3 different types of midwifery:

  • Certified Nurse Midwives (CNMs) – start as Registered Nurses and get a 2 year masters degree in Advanced Practice Nursing that specializes in midwifery.  They can prescribe medications, diagnose, and perform procedures.  CNMs work in hospitals, birth centers, and homes.
  • Certified Professional Midwives (CPMs) – undergo a 2-3 year training at a midwifery institution.  They can work in some birth centers and homes.
  • Lay Midwives – train as an apprentice under another midwife for many years, with no formal education.

Doulas do no medical care, whether they are abortion or birth doulas.  Doulas provide informational, emotional, and physical support during trying experiences such as birth, abortion, the postpartum period, certain medical procedures, and in some cases death.

If you train to be an abortion doula you will go through a 1 or 2 day workshop where you will learn vital skills in supporting patients throughout their experience.  That might mean good language to use, pressure points or massage points, tactful ways to counsel patients, ways to empower patients to ask the questions they need to hear the answer to.

I am a Certified Nurse Midwife, which means that I went through a 4 year Bachelors, then I attended Yale School of Nursing for an 11 month long accelerated nursing program after which I became a Registered Nurse, and then a 2 year Masters in Midwifery (also at Yale).  I am a Licensed Independent Provider, which means that I am solely responsible for my patients.  I work with MDs in certain circumstances, but the patients are entirely under my jurisdiction.

Today, even where it is available, some employers may specifically exclude midwife care from their list of covered benefits; insurers may make little effort to include midwives in their networks, since they tend to focus on negotiations with large physician groups.

That is likely to change. The Affordable Care Act added birth centers and midwife care as mandatory Medicaid services, for example. Many health experts are recommending an expanded use of birthing centers as a cost-saving measure as well as in response to women’s demand.

Childbirth, Midwifery, Home Birth Reading List!

Ina May’s Guide to Childbirth

I loved this book. Ina May Gaskin is an incredibly well known midwife who works on “The Farm” in Tennesee. Reading this book made me want to go there to have all of my babies. This book is part guide to childbirth (as the name implies) covering all kinds of FAQ’s about childbirth in general and home birth in particular. There are also a good number of personal birth stories that Ina May attended including some at “The Farm”.

Recommended for: women planning home births, anyone interested in childbirth/homebirth, midwives, future midwives, anyone interested in the natural birth movement (I’m pretty sure I got some weird looks reading this book on the airplane home from spring break since i look about 12 and was obviously not pregnant)

Baby Catcher: Chronicles of a Modern Midwife

This is the memoir of a California Midwife. She chronicles the many births she’s witnessed and assisted in her time. She has quite a few unique stories and provides great information on what its like to be a midwife in the United States.

Recommended for: midwives, midwives to be, nursing students, anyone interested in chidbirth/homebirths

Labor of Love: a Midwife’s Memoir

This is the memory from the midwife Cara Muhlhahn who is featured in the documentary film The Business of Being Born that I watched in my Women’s Health Issues class (its a really great film by the way!). She talks about her years as a labor and delivery nurse and her years as a home birth midwife in New York City.

Recommended for: midwives, midwives to be, anyone interested in childbirth/homebirths, nursing students

 Nursing Mother’s Companion

Wonderful and practical guide to breastfeeding. It includes lots of information about feeding, when, how much, what to do if you feel your baby isn’t gaining weight, underfeeding, etc. All of it is presented in a very easy to understand format. 

Recommended for: parents, moms to be, midwives, nurses, nursing students, lactation consultants 

A Midwife’s Story

This is a memoir of a nurse midwife who trained in the UK and eventually became a midwife for the Amish in Pennsylvania.

Recommended for: Midwives, midwifery students, nurses, nursing students, anyone interested in midwives

anonymous asked:

I've recently been thinking about becoming a midwife. Could you describe what your average day is like and what your job really is? Also anything you could tell me about schooling would be appreciated! I'm really not sure where to start! Thanks!!

I work full time as a midwife in a hospital clinic, which means that I do two days of Labor and Delivery every week and two days of working in the out patient clinic every week.

A day in the clinic:

  • I’m there 9-5, but it usually goes late, because I have to see every patient that comes.  With midwifery you can never just clock out at the end of your scheduled day - you’re there until there’s nothing left to do.
  • When I first arrive I go through the test results we’ve received for all the tests we sent out the previous day.  I read through all of them and either ok them or follow up to call in the patient or prescribe medication, etc.
  • At this point I see 3 different types of patients.  I see people coming in for their first prenatal visit, people coming for return prenatal visits, and people coming for their postpartum visit.  Unfortunately my clinic isn’t set up to have midwives seeing annual visits, GYN problem visits, abortion counseling, etc.
  • As soon as patients start arriving, I am handed their chart by my medical assistant.  I review their chart - I read through the note from their last visit, I look at their history, check the ultrasound reports or test results from their last visit, and make a plan for all the things we need to go over.
  • I call the patient in and talk to them, address their issues, prescribe them medication if need be, reassure them that things are normal and healthy, make referrals for them to see specialists, talk them through appropriate exercises, etc.  Then I do a physical exam if necessary, and send them out to get any vaccines or lab tests they may need.

A day in Labor and Delivery:

  • I’m in L&D from 8:30am-8:30pm or 8:30pm-8:30am.  
  • When I first arrive I change into my scrubs and go meet with the midwife who I’m taking over for.  She tells me about the patients we have in L&D and on the Postpartum floor.
  • I care for patients in labor - assessing their progress, supporting their coping mechanisms, managing their health problems.  I do a lot of charting.
  • I also check in on patients in postpartum as necessary, and visit them at least once a day in the morning.  I do a quick physical exam and talk to them about what they need once they go home, I help with breastfeeding and show new parents how to swaddle their babies, etc.
  • When someone comes into the hospital because they think they’re in labor or their water has broken or their having some kind of issue, I see them in triage.   Depending on what they’re there for I put them on the fetal monitor for 20 minutes, I check their cervix, watch them have contractions, look at their amniotic fluid under the microscope, etc, to make a plan for them.  Sometimes I say everything is fine and send them home, other times I admit them.
  • Sometimes I’m doing all of this at once - watching the monitor for a patient in labor, running over to postpartum to check on those patients, zipping back over to assess a new patient in triage, all before I have to pop back into my laboring patient’s room.

I love it, but there are also many other ways to be a midwife.  There are birth centers and homebirth practices and private practices and all of them are hugely different.  Any other midwives want to share?

anonymous asked:

If you had the choice would you have gone to school to be a CPM rather than a CNM since it's a cheaper and quicker route? What are the benefits to being a nurse midwife instead?

Oh boy. Prepare for a ramble haha. So I actually did have the choice (don’t we all?) and ultimately decided to go for CNM. There’s a school here in my state for aspiring CPMs that I had initially considered for a few different reasons, one of which was certainly that it was cheaper and quicker. I was also afraid that nursing school and training as a nurse midwife in a clinical setting would be too far away from the traditional training that I was really seeking in midwifery. I was concerned that I would become sort of institutionalized into an interventionist, technological mindset. And yes, it seemed easier. But after some introspection and looking through the actual program and some others that are similar, I decided that it just wasn’t for me. It’s a 2-year distance education program (as many of them are), during which time you’re studying as an apprentice under an experienced midwife. The programs I was looking at just seemed strangely inadequate to me. A couple years of textbook reading at home in your kitchen and a handful of births was about all that was required for some of them. I could not fathom coming out of that as a competent healthcare provider. I am not at all saying that CPMs are incompetent, nor do I believe that to be true. I had both a CNM and a CPM at my own birth and absolutely loved and trusted them both. But I have also talked to many women who went through similar programs, who were said to be qualified midwives, but who did not feel comfortable enough in their training to even practice. That’s scary to me. I want to be 1000% comfortable and confident in the program that I pursue. And if I was being honest with myself, if I was choosing the path because it was cheaper and quicker, could I really call myself committed? Would I personally want a midwife who chose her path of training based on how quick, cheap, and easy it was? Literally hundreds of women are going to trust me enough to put their own lives and the lives of their children into my hands. I want to have training that will allow me to provide them with the care they deserve, and for me to be the midwife that I want to be. With the program offered here in my state, I can’t say for sure that I would be able to do that. (This is also kind of a PSA moment - choose a reputable, quality program if you’re pursuing a career as a midwife. Not all programs are created equal. Don’t go for what’s cheap and easy. Dedicate that which is deserved.) And when it comes down to it, I’m not going to become an OB/GYN. I’m going to be a midwife. Despite my fears of institutionalization, Nurse-Midwives still practice according to the Midwifery Code of Ethics, which still views birth as a normal physiological occurrence and which encourages natural birth and low-intervention and individualized, personal care.

As for the benefits of going the CNM route, the first that occurred to me was hospital privileges. I want to be available for the women under my care, even if they need to be transferred to an OB for whatever reason. I know women in this area who can still be cared for by their Nurse-Midwives, despite being considered high-risk, because the OB is readily available within the hospital to check in on the patient. That wouldn’t be so as a CPM because most of the time they have no hospital privileges. CNMs can also work in all birth settings (home, hospital, birth center) whereas CPMs can only work home or birth center settings (and only in some states). While I certainly hope to do home births one day, the option of working in a hospital is there for my choosing and that means steadier work, higher salary, benefits, financial stability, my life won’t be on call 24/7 because I’ll be able to share the load a little with other midwives. Many states are not CPM friendly, some even have specific laws against CPMs practicing, while CNMs can legally practice in all states. I’ll also be able to work within a larger scope of practicing as I’ll be providing well-women care to women throughout every stage of their life. I’ve even considered combining my Midwife major with that of Pediatric Nurse Practitioner so that I can provide well-care to the children I help birth as well their mothers. Thanks to better insurance coverages, more women will have access to my care. I think my nursing training will be invaluable and I’ll also have prescriptive authority (a benefit that I was thankful for with my own CNM as she was able to provide me with a prescription for my breast pump).

For me, the distribution of benefits between the route of CPM and CNM fell easily to that of CNM. I believe the time and money put forth for my schooling will be well worth what I get out of it.

(Sorry for the really intense rant.)

Blog Reading List

Here are some great childbirth, parenting, birth work, doula, midwife blogs that I read:

The Leaky Boob  Blogs about parenting, breastfeeding support, and labor/home birth. She live blogged her recent home birth! 

A Midwife’s Tale Blog of a CNM that works in an OB practice. Her archives also have her entries about work as a L&D nurse and her journey to becoming a CNM. 

The Unnecesarean Blogs about all kinds of birth related things. Pregnancy, parenting, childbirth, c-sections, natural childbirth etc. 

Birth of a Midwife Blog of a nurse chronicling her journey to becoming a CNM and then her work as a CNM. She hasn’t posted in quite a while, but the archives have lots of good reading. 

Anthro Doula a certified birth doula and aspiring medical anthropologist. 

At Your Cervix A L&D nurse who is in school to become a CNM. 

One Delicious Delivery Blog about midwifery

PhD Nurse To Be  Blog of a PhD nursing student

Stand and Deliver Blogs about all things childbirth, pregnancy, breastfeeding, and parenting related. She has got three great birth stories (including video)

With Women the First Year and Beyond CNM student

Navalgazing Midwife  CPM who is currently working as a doula. 

Radical Doula Great doula info and resources

Got any other blogs you love to read?