Violence in Midwifery Part 2: Obstetric Violence

Posted by Katy Bones

Midwives deal with violence on a regular basis. Whether its violence experienced by the women we serve, violence within systems of health care, violence against women by providers, or violence within the community of midwives, violence should be looked at continuously in an attempt to understand it, cope with it, and curb it.

“Obstetric violence” is a legal term defined by the Venezuelan government that has been talked about a lot in the birth community since Dr. Perez D’Gregorio published an editorial describing the Venezuelan laws on obstetric violence in the Dec. 2010 issue of the International Journal of Gynecology and Obstetrics. There are several links to some wonderful blogs and articles at the end of this entry that describe the particulars of the legislation in Venezuela. These laws emphasize the role of individual providers in perpetuating and engaging in violence by holding individuals responsible for their actions. D’Gregorio also recognizes the importance of health care systems in contributing to or preventing violence. He notes the importance of training, specifically in regards to upright deliveries, in supporting the autonomy of women and in respecting the natural process of childbirth. Additionally, he recognizes the limitations of individual providers in resource-poor settings where “environmental” reasons necessitate separating the mother and baby shortly postpartum. In itself, the idea that laws can change violent practices points to the importance of system changes as well as individual changes in eliminating practices that undermine the ability of women to get both the best care and the care of their choosing.

As I begin the intrapartum clinicals in January, I feel grateful to have this opportunity to examine obstetric violence with clarity and intentionality before starting to guide women through labor and birth. The very specific acts delineated by the Venezuelan laws offer explicit components of care that must be handled with knowledge and deep respect for the woman. Specifically, I recognize the importance of learning to help women give birth vertically, a skill that I haven’t yet learned or been well familiarized with. I also intend to maintain consciousness of the ways that I am learning to be a midwife, to avoid violence and to gain trust in the process of childbirth that allows me to serve women in the best ways possible.

Salon.com on Obstetric Violence

Babble.com
The Unnecesarean

Orgasmicbirth.com on Obstetric Violence

Temptation

Posted by Tatiana

I'm in earshot of the siren call of the temptresses of number-bending.  Oh, the lure, the lure!  Not number bending, exactly, but we'll call it selective emphasis. I did a research project this fall about the experience of babies in labor and birth and it involved an online survey. I ended up with over 500 responses from all sorts of birth settings (I didn't only post it in natural birth cyber land, you know!) so I have this amazing spreadsheet of quantified experience. It makes me drool just thinking about it.

I can think of dozens of fascinating comparisons to make, and it's been a pleasure to get my hands dirty with collating data. I fully expected that all of that would the fruit of this experience, but I didn't anticipate that it would acquaint me with the temptation that I can now imagine faces many "real" researchers.  Sitting before a mound of numbers and running various comparisons, it is very easy to say "Hmm, that set of numbers doesn't make much of an impact, don't bother listing it." or "Gee, those numbers make a statement but if I alter the definition of such and such to include this and that it might show it even more strongly, let's see.."

It's very much my style to go about these things backwards (trying my hand at research without really knowing my nose from my elbow with it, and then embarking on getting the academic foundation for how it "should" be done.) I can't help it, I learn well this way.  And I totally disclosed that it was an informal survey, so don't yell at me! I know I'm not a real researcher. Just one little organism pushing my own boundaries and investigating curiosities with the tools on hand.

Violence in Midwifery Part I: Intimate Partner Violence

Posted by Katy

Midwives deal with violence on a regular basis. Whether its violence experienced by the women we serve, violence within systems of health care, violence against women by providers, or violence within the community of midwives, violence should be looked at continuously in an attempt to understand it, cope with it, and curb it.

I’ve been seeing a patient in antepartum clinic that has a very interesting story suggestive of intimate partner violence (IPV). IPV is both affected by pregnancy and affects the course and outcomes of pregnancy. While the statistics of prevalence are fairly unknown, about 14% of pregnant women in the US experience IPV. IPV in pregnancy is associated with low weight gain, substance abuse, premature labor and birth, persistent STIs, anemia, vaginal bleeding, and complications associated with physical trauma. IPV is an important and relevant topic for midwives to be familiar with in order to best care for women. Intimate partner violence is challenging to fit into the process of diagnosis and management which makes midwives (and all providers) shirk away from the issue rather than dealing with it appropriately. This case study served as an important opportunity for me to become more competent in screening for and supporting women experiencing IPV.

This woman, let’s call her Josefina, came to the inner city hospital clinic where I’m doing clinicals for prenatal care. The first time I saw her she had bruises on her face that she said were from play fighting with her partner. She had been testing positive for chlamydia since the beginning of her pregnancy and had already been treated once. She said that her partner had not been treated and that they were still having sex without condoms, despite previous counseling on the importance of using condoms or abstinence to prevent reinfection. She withdrew with questioning about her social situation or the sexual relationship with her partner, and would not answer questions.

Breastfeeding: It's not even a word

Posted by Tatiana

Reading articles and making annotations just now, I experienced the transition from semi-awareness to active annoyance at the fact that every time I type the word "breastfeed," be it in my PDF annotating software, my email, word processor or yes, right here in Blogger it is flagged red by the spellcheckers. Where I can, I add it to the dictionary, but that's not always possible and frankly I don't see why it needs to be done in the first place. The spellcheckers are fine with breasts and feeding, but put the two together and it's like consciousness of modern civilization rearing its head in proclamation, "Breasts are for sex, not for feeding!" I don't make a habit of freaking out at the failures of spellcheckers, but I just reached my saturation point with this one. What gives?

Midwifery education survey

Posted by Tatiana

Daphne Singingtree is conducting some research about the experience of student midwives and precepting midwives. Take a little time to take the appropriate survey.

2010 Clinical Education Survey - Students

2010 Clinical Education Survey - Midwives

Cheers!

Unnatural Causes - More about race and birth outcomes

Posted by Tatiana

Here are a couple of clips from the documentary series Unnatural Causes. Each is valuable in its own right and I can't decide which makes a more effective statement. With just a little bit of overlap they tell the story differently and use different sets of data. So here they both are.

I'm posting them because now and again when these conversations about race happen, someone actually is taken aback by information they didn't have before and reconsiders their preconceptions on this subject. And the more that happens, the better our chance at progress.

So let's keep shaking up our perceptions. Oh yeah, and pass it on.

How Racism Impacts Pregnancy Outcomes

UCLA obstetrician and gynecologist Dr. Michael Lu believes that for many women of color, racism over a life time, not just during the nine months of pregnancy, increases the risk of preterm delivery. To improve birth outcomes, Lu argues, we must address the conditions that impact women's health not just when they become pregnant but from childhood, adolescence and into adulthood.

Kim Anderson's Story

When Atlanta lawyer Kim Anderson was pregnant with her first child, she did everything right: she ate a healthy diet, exercised, and got the best prenatal care. But her baby was born almost three months premature. This excerpt from When the Bough Breaksexplores racism's impact on pregnancy outcomes.

A little laugh

Posted by Tatiana

I'm not posting these days, though I have some nice ones rattling around my mind.  Doubtlessly that is largely due to a little something that would be called PPD if I had the health coverage to actually see a professional. Somehow all those stories I've heard over the years about the stuff that's supposed to decrease the risk of PPD - you know, skin to skin baby time, breastfeeding, being hydrated, sleeping enough, community, good nutrition, eating placenta, staying in for a month, blah blah blah - translated in my mind to meaning PPD is for people who don't do those things.

Alarming, I know, but this like almost every other unconscious assumption turned out to be wrong. Nothin' like some good contrary experience. It's a consolation to know that more than likely this experience will prove invaluable sometime in the future, but in meanwhile it's been a bit of a bear.

Anyway, this comic made me giggle and reminded me of some of the other absurd attitudes we are faced with in this work, and think of you guys over here in this rather cobwebby corner of cyberspace enough to actually pipe up.  So here it is, and here I am.  And don't worry, I'll be getting what I need.

Freely shared thanks to open licensing.  From: xkcd

The exemplary midwife

Posted by LeAnna

A discussion assignment for one of my classes this week was to write about what I think defines an exemplary midwife and the essence of midwifery care. This seemed like a good place to share these thoughts as well.

An exemplary midwife is one who embodies the Midwives model of care in every interaction she has with her clients. In order to do this she truly gets to know all of her clients on a personal level in order to keep the lines of communication open and to create trust between herself and the client. This allows her to get honest information from the client to better monitor the pregnancy and to know how to provide individualized care. She arrives at births early enough to truly be able to provide continuous care and monitor the birth to make sure everything is going smoothly and watch for signs that things are about to deviate from normal. She knows what to do to prevent this deviation and when to get further assistance. By paying close attention and having a wide knowledge base the exemplary midwife can often prevent the need for technological intervention. She also knows when a woman needs help that is beyond the scope of her practice and ability and refers her to an appropriate care provider.

The exemplary midwife has an evidence based practice, she keeps up on research in order to have a wide knowledge base to be able to know all the options and with her client choose the best course of action. She strives to obtain truly informed consent and with the exception of emergent situations she takes time to confer with her client on what the client feels is the best course of action. She discusses possible emergent situations in advance in order to know how what course of action her client would prefer. If an emergent situations she uses her midwifery knowledge and knowledge of her client's preferences to chose the best course of action.

The definition of essence is “the basic, real, and invariable nature of a thing”. With that in mind I feel the essence of midwifery care is trust. The exemplary midwife trusts birth. She trusts her clients and has faith in them that they know their body and can make good decisions. She also trusts in her abilities and knowledge. She knows that birth is not a game and that if not properly managed and monitored things have the potential to go very wrong. Though she has this knowledge she does not allow it to cause her to fear the birth process. Her trust in birth and her client helps them to trust her, themselves, and the birth process as well.

Lack of Support for Birth Trauma in the United States

There is a huge misfortune occurring to women and babies in this society. Birth trauma is greatly misunderstood and rarely believed to be a problem. Other countries such as England and Australia have well organized groups to help combat and heal from this real problem. Too often women who have suffered a traumatic birth are told to "just move on", to "get over it" to "take accountability for their choices", that "they have a healthy baby so what is the big deal". This is demeaning to women and our culture as a whole. How a woman and baby experiences birth is trans formative for their family and society as a whole. I have no doubt that if more births were gentle and peaceful the family unit would be as well.

After my own traumatic birth(see http://completebeginnings.blogspot.com/2010/09/birth-of-my-third-everett-roger.html)it took so much work and healing to come to a place where I felt like I could parent and welcome another child (see http://completebeginnings.blogspot.com/2010/09/birth-of-my-fourth-scoot-october-24th.html).
My experiences were transformative. The healing was powerful. I feel the need to help other women come to a place of peace and healing regarding their own births.

I have several plans in motion and encourage my sisters in birth to consider taking similar strides in their communities and practice.
*I have started a local support group for birth trauma.

*I am attending a series of trainings over the next three years to become a practitioner of Somatic Experiencing (see www.healingtrauma.com) as a way to help even more women and other people dealing with trauma in their lives.

*I am also involved in the rebuilding of a internationally well known childbirth education organization to add a birth trauma prevention and healing component to their instructor training.

*I also make it my life goal to respect the women that I work with and if trauma does occur, because sometimes it does regardless of how careful we are, that their feelings will be taken seriously and resources provided for healing.

I encourage practitioners and those working on healing trauma to also visit www.solaceformothers.org and support this organization.

Birth survey

Posted by Tatiana

I'm conducting a survey for some research I'm doing about a baby's physiological and psychological experience of childbirth.  If you've vaginally birthed a full term baby, please take a few moments to take the survey. And even more importantly, whether you've birthed a babe or not, please pass this along where mamas might see it and participate.

I'm interested in as diverse a response as is possible (on the internet.)

Cheers!

Your Baby's Birth - A Short Survey

Midwifery and Public Health: A Sisterhood

Posted by Katy
There is an old fable told in the Public Health world that has been on my mind this week:

The villagers of Downstream lived peacefully by the river until one day, many years ago, a single man was found floating in the river. Good people, the villagers jumped to their feet, dragged the body from the river and were able to save the man. After the first bodies, many turned up in the river and quickly the rescuing mission became the primary work of many of the villagers. The villagers grew better at rescuing the bodies, swifter and wiser, and the village was very proud of their work. Despite their prowess at life saving, the number of people drowning in the river continued to increase until the villagers were not able to keep up and the numbers of dead bodies began to pile up. The villagers worked harder, learned more, trained more rescuers, put more resources into rescuing, but higher still the bodies piled. Until, one day the granddaughter of a wise old woman finally took the time to listen to her grandmother and began to hike upstream. The other villagers shook their heads at her and told her that people were dying while she chose not to help. It pained her to do nothing as the bodies floated by, but she was faithful to the wise woman and continued her journey until she reached the village of Upstream.

Female Circumscision

posted by Katy
 
During undergrad at Berkeley, I came across the topic of female circumcision (also called female genital cutting, female genital mutilation, FGC, or FGM) fairly frequently. The subject came up in Public Health classes, in Medical Anthropology, in Development Studies, and in classes my friends were taking about gender and race. It seemed to be everyone's favorite example of ways that culture and power effect health. I often got the strangest of looks if I pointed out the motifs of the Heart of Darkness story playing out as we discussed female circumcision, despite the fact that this was a very popular concept in other conversations. The key sources used in discussing female circumcision were white, American, faith-based organizations who were set to "save" African women from the horrors of female circumcision. Berkeley's much loved cultural relativity was not considered applicable to families, mostly women, who chose to have their daughters circumcised. The voice of women who were assumed rather than elicited. Needless to say, female circumcision did not seem like something I would ever experience in the US, it seemed like an "African Problem".

I was surprised to discover that the first patient I did a pelvic exam for was circumcised. She was not a meek woman who had no voice, the character suggested by Berkeley academics. She was strong and angry about pain during sex, which was the reason she had come to the clinic. The pain was not from circumcision however, but rather from an endometrial infection, presumably contracted from a colposcopy. She did not mention the circumcision and the midwife I was studying with also did not. The next day, though, I worked with a midwife who is currently doing ethnographic research on circumcised women in New York (this is one reason I love midwives!). We served another circumcised patient and the midwife responded in perfectly "I can see you've been cut, when was that done? Where? Have you had any problems with it? Do you have any questions or concerns?". She answered with validation and empowerment, opened the door for the woman to discuss the circumcision in a setting that was affirming and non-judgmental, or not as her choice may be. This was a moment where theory was biased while practice in the real world lived up to the opportunity to be honest, human, and completely present to serve a woman's needs.

People often ask me "Girl, what are you doing in New York?", often with about that much attitude-- usually I don't have an answer. "Its just the way the wind blew." Slowly though, I'm piecing together reasons and one of them is the diversity of patients. Having the opportunity to work with women who were circumcised is an opportunity to broaden my understanding of the experiences of womanhood and what it means to serve women. This is why I came to New York and why I chose a CNM program.

Dreaming

Posted by Tatiana

I had my first midwifery dream last night. I remember a fleeting feeling of being with a friend. And then being on the ready below her squatting body. I watched her swell and felt an impulse to apply counter pressure, but I held back and that baby came smoothly out with her pushes. I caught its slippery body in my nervous and elated hands. The whole dream was probably just one minute long, but what a delicious minute.

I hope I don't catch most of the babies I attend. That's a pleasure I'd like to leave for the mamas and the papas.

A nice little glimmer, too, that in my dream mind, at least, I could set aside the urge to intervene unnecessarily. That dream mama didn't need my hands pushing on her.

How Many Hours to Become a Midwife?

Posted by DyAnna

I came to my midwifery journey in a round about basis. I can't say that I always knew I would be a midwife but my life experiences have definitely helped bring me to this place. I looked into becoming a Certified Nurse Midwife briefly while on I was on the nursing track. After the birth of my second in 2005 I looked at different distance education options including Midwifery College of Utah and National College of Midwifery. My midwife for my second offered to be my preceptor if I went with a school she was familiar with. I also looked into finishing my nursing degree and then doing my CNM through Frontier School of Midwifery. In the end we moved away and I resolved myself not to do midwifery or other birth work. We moved to an area that had no CNM's or licensed midwives that did home births. I was very grossly misinformed regarding the education it took to become a traditional midwife and thought I would never want to train with any of the midwives locally.

I took a little over a year off. Few people even knew I had ever been involved with birth work and it was a much needed break. After the difficult birth of my third I knew that in order to be sure that quality midwifery care was offered in the area I would need to help by providing it myself so my midwifery journey began. I attended a few births of mutual friends with a local midwife I had been friends with for a few years. We hit it off and before I knew it I had transitioned from assistant to apprentice.

I still struggled (and still do) about whether or not I needed a more traditional school. In the end it came down to a few things. 1- I had already done the traditional college route and done it well graduating with and A- average and learned and retained very little compared to the amount of time spent. 2- Money. We already have so much student loan debt for my husbands law degree that the thought of spending more money on my school for a career that wasn't a huge money maker just wasn't possible for my family. 3- I wanted to be able to tailor what I learned and avoid the busy work. So far I think I am holding my own with a curriculum I established on my own and tailored to my needs.

So this is how it has broken down give or take. For the last 2 1/2 years of my life I have spent time studying individually, studying and discussing with my preceptor, teaching childbirth classes, attending doula birth, attending prenatals, births, and postpartum visits, doing skills classes, attending workshops. In the end of my apprenticeship assuming another 18 months the break down will likely look like this.

Time spent studying individually, reading, writting protocols etc.
8 hrs a week x 208 weeks =1664 hours

Time spent doing prenatals and postpartum visits
6 hrs a week x 208 = 1248 hours

Time spent in skills class (suturing practice, exams, etc.)
5 hrs a month x 48 months = 240 hours

Discussion, review and study with my preceptor
2 hrs a week x 208 = 416 hours

Birth attendance
2 births a month at an average of 8 hours per birth x 48 months = 768 hours

Additional workshops
24 hours total

Childbirth classes and doula births
3 series a year at 18 hours per series plus another 20 hours a year doing doula births x 4 years =296

Total: 4,656 hours of study and instruction

NARM the national midwifery association that provides the test for your Certified Professional Midwife required a minimum of 1350 hours.
I think I've got it covered.

Grandmother's at Birth

Posted by DyAnna
 
Having your mother attend your birth seems like a relatively benign thing. Wrong, really, really wrong. Your mother's influence at your birth is so powerful both for the good and the bad that can come from it. It seems like it would be a natural part of human nature. Years ago before we all lived in large cities most of us lived in extended family groups. Your mother would be at your birth as well and many other births in the family. It was a normal part of every day life. Fast forward many years when fear and women's rights meet with a vengeance. As women were requiring to be seen as full citizens of the USA, meaning we get the right to vote, we also rebel against Eve. Who was she to doom women of all time to painful child birth? Liberated women have a right to pain free childbirth. Enter anesthesia for childbirth. Mothers were removed from being at their daughters births in almost a single generation as their roles were taken by nurses, doctors, ether and stirrups. Fast forward a few more years. Woops we made a mistake and women still want their mothers at the births of their babies. Let's let them back in the room. Sounds like a perfect solution the joy of choice in childbirth, natural or medicated, with your mother by your side. Unfortunately it is more often than not like a train wreck. But it is not the grandmothers fault. For the past 80 years nothing but fear and distain has surrounded childbirth. So when you explain you want an unmedicated birth, to have your baby underwater and maybe even have your baby—gasp—at home what is a grandmother to do. Unfortunately most of the time it is panic. She was never encouraged to listen to her own instincts and intuition in her births or often even with her parenting. How can she be expected to support you while you do the same?
I most often see three different types of grandmothers when it comes to their daughters or daughters in law giving birth at home.

First- grandmothers who want nothing to do with the experience. They don't want to know or hear anything about birth. From the midwives approach these ones are easy to deal with unless the mother has a burning desire to have her mother there. Then it gets more difficult as the pregnant mom feels abandoned because her mother doesn't want to be involved in her life changing event.

Second- grandmothers who want to be there and are super supportive. These are often women who a- either had amazing empowering births that they can't wait to share with their families or b-had completely unfulfilling births and want to see and experience how different and normal birth can be. These women are often wonderful helpers to have at a birth IF and I do mean IF their daughters want them there and they can follow directions and respect boundaries. If they are not welcome and can't respect boundaries it is a recipe for disaster.

Third-grandmothers who want to be there because they want to protect their daughters. Unfortunately my mother falls into this category. She wants to help me and protect me from anything that could possibly go wrong with my birth. They often bring fear, distrust and belittlement into the birth experience. Not only making it frustrating and difficult for the mother to manage but potentially dangerous as well.

All of these situations have the potential for disaster or success. So much of it has to do with the pregnant woman talking to her mother about her wishes for her birth and her mother's role there, the pregnant woman discussing her mother's role at her birth with her midwife, and a hopefully uncomplicated labor. If any of these three things don't occur, aren't clear or go astray there is likely to be hurt and frustrated feelings.

As midwives we walk a fine line between support emotionally and support physically and with grandmothers it is easy for this line to get fuzzy. I highly encourage all pregnant mothers who are considering having their mothers at their birth to truly consider what both you and your mother have to gain from the experience. Now it may seem that I am calloused against grandmothers being in attendance and this is not entirely true. It can be a wonderful and bonding experience for the whole family, however often this is not the case. We are a different generation and we screwed up long ago removing our mothers and other support women from our places of birth and now we are reaping the consequences. It will take patience and careful navigating to mesh the natural and seamless beauty of a woman in labor supported by her mother with the thoughts of the world regarding normal birth.<

Are scholarships for non-white midwifery students anti-white racism?

Posted by Tatiana

I can't for the life of me figure out where to start, or where to stop. So much seems obvious to me, and I assumed it was obvious to other people. But that assumption crumbled when that discussion exploded on the MANA discussion group a few weeks ago.  It seemed a minor item, I didn't blink when I glanced through the email when it came through the first time. Scholarships for women of color to attend midwifery school. Uh huh, sure, woulda thought that was already happening. Next..

Then the torrent of response. You guessed it. "This is divisive, this is perpetuating racism, why shouldn't I have access to those scholarships, I don't see what I'm getting that women of color aren't getting..."

So here's the deal, we're talking about scholarships for midwifery students. We all have it tough, right? Midwifery is never going to pay well, the education is long and often unfunded by grants or scholarships, depending the route you go. You have to work for free for years to gain the experience you need. It sucks. And then, when you finally call yourself a midwife, you're treated like scum in the medical field and people are constantly lobbying to eliminate the profession. It's not a comfy road for any of us, so why should these "women of color" receive this freebie money when all of us are struggling? And isn't it racist to suggest that they need this special help?

I say yes, it is absolutely a difficult path for anyone who embarks on it. I don't suggest that we should, say, remove a limb from all white aspiring midwives to make it more difficult, or deny them enrollment in schools, or steal their books in the night. There's no threat to white folks here. (Why is that the way it is received?)

What I say is that white people have already been given scholarships the whole way through in the form of privilege.  Maybe the word privilege throws people off.  Maybe it sounds like affluence or power. I can imagine reading that, looking at my myriad of struggles and saying, "Ain't feeling the privilege here, folks!" I can see how that would be misleading, but it's worth taking a closer look.  Scrap the word privilege for a moment, and take a fairly neutral example from another setting:

"In one community, for example, there has been an effort to get jobs in school districts for more people of color. Superintendents were encouraged to assure equal access to employment by distributing job postings more widely in the community of color. In the past, jobs that became available were quickly known to the people working within the system, who were predominately white and tended to mostly socialize with other white people. Therefore, the job openings inadvertently were known about faster and easier in the white community. There was no intended racism, but this example shows that a form of historic racism in modem institutions continues to exist. To change these systemic and institutional forms of racism, temporary public policies to bring these subtleties to light are needed, as well as an approach to help individuals become aware of the daily harmful effects of their unconscious attitudes and actions." 
(From Diversity & Equity by Kathy Castania)

And now let's bring the word back with a less neutral example:

"White privilege is when you can claim that being mayor of a town smaller than most medium-sized colleges, and then Governor of a state with about the same number of people as the lower fifth of the island of Manhattan, makes you ready to potentially be president, and people don’t all piss on themselves with laughter, while being a black U.S. Senator, two-term state Senator, and constitutional law scholar, means you’re 'untested.'" 
(From This is Your Nation on White Privilege by Tim Wise)

We may not feel it, but us white folks have gotten that extra bonus all our lives. The "scholarship" that just says, "No matter what, you're the color of smart people who make important contributions, are trustworthy, fill history books and political offices and white coats, are virtuous, are beautiful, are capable.  I mean, you're basically the color of people." That kind of scholarship may not look like an installment for tuition from MANA, but it sure has made everything a hell of a lot easier for me. It doesn't mean I have a secret well of money under my house to fund my education, hire a nanny, and pay for expensive internships in faraway places.  It just means that I don't have to work against a societal structure that assumes I'm not quite human, or am up to no good, or am just a little less smart or reliable.

What's useful to me about thinking of white privilege as a scholarship is that it calls up some of the responses one has to a monetary scholarship. (Because the point isn't to recognize privilege and then cower in shame.) So as I might with a scholarship, I can ask myself: Am I using it well?  Am I leveraging this advantage in a way that will benefit people without this privilege? Am I idealistic now about serving marginalized people in my area, but when I actually get around to being a midwife am I just going to do what's comfortable?

The worst part about this is that it isn't like a scholarship "buys away" racism.  It goes a very small distance towards alleviating a tremendous body of counter forces that I've not done much justice to describe. A small, pitiful distance. I suspect that a small, pitiful distance is as far as we'll ever get.

For more about why we need more midwives of color in this country in the first place:

Very Low Birthweight in African American Infants: The Role of Maternal Exposure to Interpersonal Racial Discrimination

Crisis in the Crib – Black Infant Mortality in the US

The Cost of Being Born at Home

Inspiration, too

Posted by Tatiana

I didn't realize I was short in inspiration until I got a little extra and found it to be like a quenching of a thirst I didn't even realize I've had.

I've been talking with naturopathic midwives this week, interviewing to follow up on the promised "next part" of my original post about that subset of midwifery.  They've been beautiful to talk with, and I have another interview scheduled so the follow up piece (or pieces) will still be forthcoming. Those I've spoken with have been thought provoking and moving.  Especially the woman in New Zealand who sat in the morning light, spilling forth sweet stories of home and hospital births. It was night for me, and I took her stories to bed and dreamed about that spirit of midwifery all night. It's rejuvenating sleep, that way.

The other source of inspiration for me has been beginning Mamma Primitiva's Traditional Midwifery Education program online this week.  There are women from all over the world enrolled, literally - Haiti, Bulgaria, Greece, Argentina, Australia. It's easy to get sucked into the technocratic approach when we're getting our Western educations. Even though I've been in self study mode I've still been steeped in that modern thought train. I want to have the most up-to-date research and evidence based information... but even though I fancy myself connected with the heart of womanhood and the old wisdom, it gets hazy in the shuffle of all that... This program (and community, really) is really giving me a dose of that good old wisdom. It's a bummer for me that it's coming at a time when I'm in school full time, since I'm so limited already, but the small bit of extra stress is very much worth keeping the spirit of the old wisdoms at the forefront as I process the rest of the information.

It will be fun to share with you what I've learned from the NDs, they gave me some great advice I want to pass along as well as some really interesting information about the profession.

And if you want a little piece of that traditional wisdom, too, it's not too late to join Mamma Primitiva.

Also, don't forget about the Midwifery & Racism blog carnival, tomorrow.

When Inspiration is Lagging

posted by Katy
 
I've been slacking off on my blogging. I have frequently sat down to write, its been on my to-do list, I've thought through a few blogs, but somehow the inspiration is lacking; not just the inspiration to blog, but the midwifery inspiration in general. So I decided to just sit and write a rambling blog in which I will find some inspiration.

Among the things that awe me about midwifery is its ancient history. I turn to the biblical story of Shiphrah and Puah the Hebrew midwives that maintained their integrity, doing what was right, despite the Pharaoh's command to kill all of the male Hebrew babies. The midwives stayed true to those they served, the oppressed, the powerless, in the face of the great power of the Pharaoh. Even in the very early days, midwives were spiritual, connected to God. Here's a lovely image that I shamelessly borrowed from this website.

Free learning resource on the New Ballard Score

posted by Tatiana
 
Just made another addition to the Free Resources for Midwifery Study post. The Ballard Score was new to me!

The New Ballard Score - walks you through the Ballard Score method of determining gestational age.

It even has stick figure babies.

Helloooooo elephant!

posted by Tatiana
 
Carnival!

Yes! Just the excuse I've been needing. A few weeks ago we had a rather hairy and alarming discussion going on the MANA students and new midwives yahoo group about race. Our student representative made a post listing the many student issues she's be discussing and advocating for at the upcoming MANA conference, and on the list was the mention of midwifery education scholarships for women of color. This precipitated a roar of response, much of it in opposition to the notion of limiting scholarships to women of color. The usual arguments to the tune of "I'm white and it's hard for me too, why shouldn't I have access to those scholarships?" and "How will we ever move on from racism if we keep creating divisive things like these anti-white scholarships?" Okay, so I might be ungraciously paraphrasing, the original points might have been made more tactfully, but those are the messages I walked away hearing.

It's no secret where I stand on this issue, (absolutely disgusted at the above arguments and very aware of the GLARING under-representation of minority women in the ranks of midwives and midwifery students, just in case it is a secret,) so my responses to what I was reading from fellow students have been festering in me for weeks.  I've just not found the words yet. But now, I have incentive:

Join the Midwifery & Racism blog carnival on September 30th to talk about this too. Talking about race is really uncomfortable, but most things worthwhile are. I'll be making a post on that day.

While we're at it:

minority midwife recently uploaded all her old posts about her journey as a black midwifery student.

And, if you want an invigorating read addressing racism in a different context check this out, and follow the links.

Free learning resource on PPD

posted by Tatiana
 
Just added to the Free Resources for Midwifery Study post:

Postpartum Depression Learning Modules from MedEdPPD.  You can pick and choose whichever modules interest you, or do them all and become eligible to be listed in the provider network.

One could clobber together an excellent education with all the free resources out there, plus the stack of books recommended by NARM, plus a study group and a high quality local apprenticeship.  There are definite advantages to a formal program that I don't want to minimize, but clearly formal education is still inaccessible to many.  With internet access becoming possible and sometimes common even in remote and impoverished corners of the earth, that accessibility issue is changing.  You could give yourself a great education, but you still have to come up with the bucks if you want an education that the wider public will regard as legitimate.

Purely anecdotally, there doesn't always seem to be a direct relationship between the depth of knowledge and understanding that a midwife had and how she (or he, I suppose) obtained her (or his) education.  I've heard tell of very scary midwives that excelled in formal programs and went on to practice recklessly, and also know a number of midwives who have taken on the responsibility of educating themselves completely and have earned the esteem of local hospitals with the quality of their knowledge and practice.

Anyway, I'm excited to have found another up-to date and research based set of educational modules available to anyone with web access and time.

Erik Erikson’s Stages of Development and Dy’s Midwifery Stages of Development

Posted by DyAnna

So this wild road we call midwifery education has gotten me thinking a lot about my more traditional education. I studied psychology for my undergraduate degree and I must say that it transfers very nicely into midwifery. One memory that kept coming to mind was Erikson's Stages of Personal Development and I couldn't help but see how similar they were to my personal midwifery journey. For those who are not familiar with Erickson here is a quick run down thanks to about.com and copy and paste so I don't have to write it all out in my own words. One of the main elements of Erikson's psychosocial stage theory is the development of ego identity. Ego identity is the conscious sense of self that we develop through social interaction. According to Erikson, our ego identity is constantly changing due to new experience and information we acquire in our daily interactions with others. In addition to ego identity, Erikson also believed that a sense of competence also motivates behaviors and actions. Each stage in Erikson's theory is concerned with becoming competent in an area of life. If the stage is handled well, the person will feel a sense of mastery, which he sometimes referred to as ego strength or ego quality. If the stage is managed poorly, the person will emerge with a sense of inadequacy.

Where I am, How I got Here, and Where I am Going

My name is Dy. I have been a practicing doula and childbirth educator since 2002. I was always drawn to the wonder of birth and was able to witness my first miracle at the age of 11. I am the mother of four children born at a hospital and at home. All four attended by midwives. Their births have helped me to realize the potential of what I am capable and focus the importance of everything I believe.

While getting my Bachelors degree in Psychology I once again found myself drawn to the miracle of pregnancy and birth. I focused my study on issues of pregnancy and human and child development. After the birth of my first child I trained and Certified with Doulas of North America (DONA) as a birth doula. I soon became a Childbirth and Post Partum Association (CAPPA) and Bradley Method (AAHCC) certified childbirth educator. I have been honored to attend over 50 births as a doula and have taught dozens of couples. My experience includes home, birth center and hospital births, women who chose medicated and unmedicated births, as well as births attended by doctors and midwives.

In 2008 I was given the privilege of coming to train under a wonderful preceptor. In that period of time I have learned so much about the physical and emotional care of the family in the prenatal, birth, and postpartum time period. In addition to the hands on experience I get by attending prenatals, births and postpartum appointments I am actively perusing my midwifery education in many different ways including: a distance midwifery education outline of study material and projects, active participation and establishment of a local study group for midwifery apprentices, as well as hundreds of hours of individual studying, reading and discussions with Laura and other birth professionals. I plan to end my apprenticeship with serving at a high volume birth center where I can get even more experience with higher risk pregnancies and issues that are rarely dealt with for those who birth at home in our community such as suturing and deep suctioning of the newborn etc. I plan to sit for the NARM exam (the national certifying exam for midwives in the United States) within the next two years giving me the use of the title Certified Professional Midwife. I am to the point in my training that I am taking clients as a primary midwife under supervision. Meaning I provide all aspects of care with my preceptor there in a supervisory role. I get the benefit of learning what it is to truly have the responsibility of being a midwife while the clients have the benefit of a highly motivated and attentive midwife. We are a great team and we love what we do and the women we serve.

PHILOSOPHY

I believe that a woman has an innate ability to birth her baby. It is a normal physiological process not a medical event. Women are often astounded by the options around them when they are nearing their time of birth. I believe that when women are given all their options, they will choose what is right for the health of their baby. I believe those present should trust the woman to know what is best for her and her baby. This leads to a sense of satisfaction and responsibility which follows them through the rest of their life. I believe in the value of women in service of other women.

There are many factors that play into a woman's choice for her birth. Her emotional, physical, and psychological well being should be taken into account and her wishes supported. Not fear, but understanding and intuition should be the motivating factors for her choices. I believe all women have the right of loving support from her partner and if she desires a doula. This is not a change she must undergo alone.

Goals

My goal as a doula or educator is to provide women the skills and knowledge they need to have the birth they desire. I believe birth is an amazing normal and natural experience and the birthing mother should be treated that way as well.

My goal as a midwife is to protect the sanctity of the birth and post partum experience. It is such a fragile time in life. It should be enjoyed and supported by those who are in attendance. The attending midwife should respect the natural birth process and provide her clients with the emotional, physical, and clinical support they need. My believe is that a midwife is a life guard for the birth process only there in case they are needed with an deep understanding that birth is a normal event.

homebirth and no home

posted by damidwif 
 
Many years ago, I never thought about homebirth even though I wanted to be a midwife. I, like many, or most, Americans, thought homebirthing was back in the day. My grandmother proudly told me that she birthed all of her kids at home, in her bed. I thought it was cool...for her. Several Black persons that I have talked to, both men and women, tell of their grandmothers, great-grands and even mothers birthing at home. But everyone speaks as if this time existed during the slave trade or something.

Flashback to Ms. Celie giving birth at home. The Color purple was set in the early 1900s, I think.

Storytelling

Posted by Katy 

The first day of the year, at orientation, we each shared our journey to the room that day. Even though I already knew everyone in the room, taking the time to listen to and tell our stories was quite powerful. There were a few common threads that are worth mentioning. Many of the students expressed the challenge of getting to midwifery school. Many students came to the profession of midwifery through academic and intellectual pursuits, a path that may be more common to university training programs.

That pesky meta-analysis

Posted by Tatiana

I don't know about you, but that meta-analysis that has been all over the news has made me uneasy.  I hear the criticisms of it, but it still makes me uneasy.  If it is true that there is this large increase of neonatal mortality in home birth, would I really want to be a home birth midwife?  I kinda don't think so.  I want to think the study is just wrong, but it doesn't satisfy to say, "Oh well, people I respect have dismissed the study, so... that should be cool."  I want to be a bit more clear than that.  If a client or, say, a policy maker happens to ask me "What about that study published in 2010 about the threefold increased risk to babies in home birth?" I'd like to answer coherently, and in a way that's grounded in real science.  Not convenience science.

I've alluded before that I really want a stronger understanding of how studies are conducted so that I can be a better judge of their quality, and I'm not there yet.  (Pan camera across floor riddled with toys and clothes to baby cheerfully pinching my arm and erupting with a river of spit-up.)  In time.  In the meanwhile, I've read a bunch of articles about this study over the last few weeks, and I came accross this reponse today which does well with specifics and left me curious to see what better studies in the future would show:

Planned home birth and neonatal death: Who do we believe? - posted by Amy Romano of Science and Sensiblity

I look forward to the results of the de Jonge and Buitendijk analysis she mentions.

Online traditional midwifery education

Posted by Tatiana

Seems a little conflicted, doesn't it? Traditional midwifery education - online.  But perhaps it isn't so outlandish.  Why not utilize this crazy virtual platform to bring together women from anywhere with internet access to learn lessons about traditional midwifery that have stood the test of time?

Quoting Clare Loprinzi from the Mamma Primativa's website:

"I am a traditional midwife and have never used ultrasound or drugs... as Onnie Lee Logan, a southern granny midwife said, 'What I know about deliverin babies came from motherwit, common sense.' 

...I realize that few will be traditional midwives but most of this knowledge will still become incorporated into your life and help you on this journey of empowering yourself and other women to birth with respect and grace."  

Opening at the end of September is Mamma Primitiva, an online traditional midwifery education program started by Clare Loprinzi.  Clare is a traditional midwife who lives and practices in Hawaii, and is called "mammana" - the name for midwife of her Sicilian ancestors. She is also on the board of directors and the medical advisory board of Mother Health International and has chosen to funnel the funds from the school in direct support of MHI's efforts.

MHI birth clinic in Jacmel, Haiti.  Mamma Primativa tuition directly funds MHI.

Photo reposted with permission - © 2010, Mother Health International

I learned of the program because I've been following MHI as the midwife for my April babe has been involved in starting their clinic in Haiti. They caught their 100th baby at the end of July (they've been operating since January.) They're building a more permanent structure for the clinic, but this dome is where they're working for now.  (I think dome birthing can catch on!)  I also suggest you check out the MHI blog, it features beautifully written birth stories written by volunteer midwives.

Back to the school; Mamma Primativa is beginning its first session September 27, 2010.  The program runs for three years and new sessions start every six months.

Mamma Primativa welcomes both students seeking a primary midwifery education, as well as people who want to complement a different educational choice. You can throw yourself in full force, or "listen to the lessons, read the questions and look at the answers."

The tuition is a sliding scale donation of $35-50 per month going directly to Mother Health International.

Clare Loprinzi, CPM with Dr. Jade Patti McGaff, MD (OB/GYN)
Both teaching staff at Mamma Primativa, pictured here in Clare's garden.

Photo reposted with permission - © 2010, Mamma Primitiva

Their teaching staff features an obstetritian, an emergency MD, a naturopathic doctor, two midwives, and a cultural practitioner.

The class format is four weeks of the month:

Week 1: Audio, video, or written lesson
Week 2: Birth story demonstrating the previous lesson
Week 3: Questions relating to the lesson
Week 4: Student discussion

I'm always excited when I see people setting up infrastructures that will be in the reach of many.  I'm more than a little tempted with this program myself!

Check out their website: Mamma Primativa - Traditional Midwifery Education.

More free learning resources

Posted by Tatiana

Just made two new additions to the Free Resources for Midwifery Study post:

Midwife's Abdominal Examination in the Antenatal Period from The University of Nottingham.  Interactive lesson from the UK nurse midwifery angle.

Free online learning resources for midwifery from WikiEducator.  A long list of learning resources including midwifery specific biology, suturing, breastfeeding and featuring stuff like pharmacology for the more medically inclined.

Enjoy!

"Selfish" moms and I liked it better when they didn't say vagina on tv. *warning I use anatomically correct terms in this post*

Posted by Le

I read an article from a fb link for midwifery today about how home birth moms are reckless and selfish. I am used to the hype about women who just want a spa like birth experience at home even though it increases the risks for their baby. So most of this article was the normal stuff I just ignore until I got to this part.  "The other selfish aspect of a home birth is that it requires a fully-trained midwife to leave the hospital and give one woman her undivided attention for the duration of her labour, which can be 24 hours or even much longer. Websites supporting home births, including the National Childbirth Trust, strongly encourage women to 'stand your ground' if a local authority declines a request for a home birth. There is no mention of all the other women in hospital who might need the midwife's care during that time. Thought is given only to the right of the woman to choose to give birth wherever she likes."

That really really bothered me and made me sad. It also showed that the author doesn't understand some of the fundamental differences between ob/gyns and midwives. While she is in England and things work a bit differently over there I would guess that home birth midwives there, like home birth midwives here, tend to have less clients due at the same so they can accommodate for spending a whole 24 hours (or more) with just one client. I think it is sad that she doesn't think she (or anyone else) is important enough to request special attention when giving birth. I for one think all women are special enough to have the complete attention of a midwife (plus whoever else comes with her) at their birth. That is part of why I want to be a midwife - to give women the attention and support that they need and deserve.

And on a different note I like it better when they didn't say vagina on tv because I can't stand it when people use the word improperly. I saw a clip on tv last night where a guy was complaining that a girl's vagina was showing. She was blurred but apparently the woman was naked and she was standing up with her legs together. If her vagina was actually showing then she needs to be rushed to an emergency room because there is a serious problem! I guess I should be happy they are attempting to use anatomically correct words but I'd be more impressed if they could add a few like labia or vulva because that is what they actually mean 99% of the time when they say vagina...

Birth Stories in India

Posted by Katy
August means a much needed vacation from school and the toil of New York City. I'm spending the month with my boyfriend in the Himachal Pradesh region of India (that is very north). I decided to let this be a true vacation and not do any nursing or midwifery work, but I still have run across some interesting stories:

Mountaineering Mama- We went to the mountain institute outside of Manali for trekking information and met the nicest woman who gave us a map, directions, and advice. She is a mountaineer, guide, and teacher at the institute and was clearly incredibly knowledgeable about mountains. She asked what I did and when I explained midwifery she launched into her birth story (it seems to be a cross-cultural response)! She explained that she had a c-section for her first baby because the cord was wrapped around his neck. She tried to have a natural birth with the second baby, but when the labor pains started, they were so painful that she requested another c-section.

Disappearing midwifery students

Posted by Tatiana

Did we all get sucked into our studies?  Just to liven things up, I'm making a more casual post.

A few lessons my childbearing and childrearing is giving me to take along into midwifery work:

• When a mother says she'd like to throw her baby out the window and nervously giggles, don't assume she's joking.
• Same mama can have pain free and ecstatic birth, and a bitterly disappointing and painful birth in the same set of (controllable) conditions.  Lesson: Avoid drawing conclusions about a woman based on the way you see her birthing!
• If I can remember that adults are like overgrown children and practice NVC and other presence-based communication with them half as willingly as I do with my kids, things are a lot more clear.
• If I feel the well of my patience is absolutely dry and life presents me with yet another challenge, I must be wrong about that well being dry.
• Vaginal exams during labor can be flippin' painful.
• A birthing woman can pull back her own swollen cervical lip, thank you very much.
• When giving nutritional counseling to a woman who already has children or is otherwise excessively busy, be very creative about how she can meet the nutritional needs of herself and her baby with minimal money and minimal time.

And just in case you also need a little extra oxytocin...

And yes, this baby came out of my vagina.

Standing on the Precipice...

Posted by D

This is it. The last big hurdle, outside of taking the NARM exam next year. This is what I have been waiting for and wanting, for many many months. I feel like I am standing on the precipice, waiting to jump off and either land on my face, or find out I can fly. Sure, I have 6 more weeks at Casa, but Casa right now feels easy and familiar, and much like a vacation to me now.

So, what is it that I am referring to with such trepidation? Last week the midwife I have been hoping to apprentice with called me and asked me if i was interested in working for her doing postpartums and birth assisting as a paid "nurse." Apparently, her most recent nurse quit after 2 months. She was hired when the previous nurse quit after 3 months, and she was hired when the previous quit after... Yes, I've heard stories. Stories about being yelled at, stories about how wonderful she is, stories from doctors about the "crazy" things this midwife does. And it all intrigued me until recently. Until she asked me to come work for her until she is able to hire a "real" nurse. So, today I went and met her and spoke at length with her one long term nurse. We talked aboutthe schedule and expectations and we also talked about the practical side of surviving working with this midwife. I've been warned. It will be rough. She will yell. But...she is also a great teacher and I will learn a lot.

Aside from the anxiety of workign with this midwife, I also have questions in my mind as to how this will actually work since I will actually be working with TWO midwives. This new one and the one who I've been going with for the last two months. I've logged a good 30 births in the last two months with the other one. She's VERY laid back and is so easy to get along with. She trusts me (for as much as she knows me) and she is very open to a student finding their way and figuring out what works for them. In other words, she's easy and comfortable for me now.

So, we worked on the schedule, which will be four days with one and probably two to 3 days with the other. There is some flexiblity in that, but it will be a lot of time on call. And though I remind myself that it is temporary, it is pretty clear that for the next year, or at least a good six months, my entire life will revolve around birth. It basically has been for some time, but it hasn't been with the commitment that it comes with now. Scheduled=paid=commitment.

The other thing that gives me pause is the fact that this population (Plain- Amish and Mennonite) is so different from the typical homebirth population that I would generally plan on serving. The general population is basically healthy, well-educated about health and hygeine, and they have doctors and the Internet readily at their fingertips. They take a huge responsibility to know their options and exercise choices in decision making. Many people (myself included) refer to these families as higher maintenance with their birth plans and ideas for the perfect experience. but at the same time the level of responsiblity they take on themselves is freeing to their care provider. The Plain population is easy in terms of birthing and choices, but they also rely on their midwives for information and care outside of the general scope of practice of a midwife. For example, this new midwife typically gives the MMR vaccine to the babies. Already I have seen families call the midwife when the baby is in the car seat and is pushed off the woodstove (cold woodstove) by the older sibling. Or a 2 year old who falls 8 ft from a barn ledge and hits her head, fracturing her skull. They call the midwife (who tells them to go to the ER). And I know of midwives who suture children after accidents that require repair. All of this makes me so nervous. In this practice that sees 18-20 babies a month...so much can and WILL happen. And will I miss something that I should have found. Will I miss a blood clot or a heart murmur? Genetic anomalies are common...will I miss a clue to a lethal something that could have been prevented. I've already been told that they typically attend 2 to 3 funerals a year. WHAT??? That definitely is not your typical homebirth population. And just as I had to rephrase my assumption that babies will choose breathing over eating , I am going to have to remember that much of the assumptions that we take for granted aobut birth being safe, really need to be balanced with the idea that things can and sometimes will go wrong.

For the time being, I am holding my anxiety in check. I know thiat this journey has been anything but boring to this point, and that there is a reason for everything. I'm confident that I can come out of this experience a better midwife and a better person, even if parts of it may be quite painful,

Dorky new additions to the free resource list

Posted by Tatiana

I've added the following free learning opportunities to the Free Resources for Midwifery Study post:

Pelvic Floor Muscle Trauma from Medscape.  You need to join the site (free) to access this one, and there's a free CEU for completing it.

Examination of the Newborn from the University of Oslo in Norway.

The Little Handbook of Statistical Practice from Gerard E. Dallal of Tufts University in Boston.  It is my opinion that with the amount of "studies show..." spouting that midwives do, we better well be equipped to coherently interpret studies.

The first two were posted to discussion groups by other folks, the last one I unearthed myself because I kept bumping up against "I really don't know enough about statistics to interpret studies."  I wish I didn't need to be reading for the doula training I'm doing next week so I could just read through that statistics handbook.  It's absolutely delicious because it answers so many questions I've had about statistics, plus it's math and that's just a good time on a Friday night as far as I'm concerned.  I really think that I need the ability to critically analyze research as a midwife, and doing that when I'm not even sure what p= actually means is problematic. 

Inspiration to be a Nurse Midwife

Posted by Laurel

If men flee the female, we will survive, but if women themselves treat femaleness as a disease we are lost indeed. ~Germaine Greer

10 thoughts on why I am inspired to be a nurse midwife...
1. Women are not socialized to celebrate their bodies, let alone live in them and own their power... I want to help bring in generations of beings that celebrate women and the female body. I love my body!
2. No matter where a woman is at in her life cycle, I believe that she deserves the option and opportunity for midwifery are. Whether a woman wants to have children, is pregnant, is pregnant and does not want to be, is unable to have children for one reason or another or choses not to... they can benefit from a midwifery philosophy of care. No matter age, sexual orientation, race, religion, ethnicity, SES, marital status, class, motherhood status, education, nationality, able-bodiedment - the option of midwifery care should be available.

I.am.exhausted.

Posted by D

I'm trying to figure out whether my exhaustion is a result of something with my health, or just my general state of circumstances at the moment. Several nights of disrupted sleep from a few births and also a 3 year old who is waking up at 3 Am and insisting that he wants to go play with his friend outside, does nothing to improve my sense of well-being.

It was an interesting week of births. Only 4...although I guess to some that sounds comical. Only? Four births with 3 different midwives. It both exhilarates me and exhausts me just thinking about it. I came away from all four births with lessons learned.

In Celebration of Nursing

Posted by Katy
I just passed the NCLEX, which is the nursing licensure exam! It took me a humbling first attempt and much more confident successful attempt but now I am officially a New York RN! Som with that really good, relieving news I want to take some time to share some of the things I've enjoyed in this year of nursing school, several of which are quite surprising!

(1) I have enjoyed meeting all of the wonderful people with diverse backgrounds who completed the program with me. I learned so much meeting people from all over the country with interest and expertises including transgender health, dance, massage, art, and community organizing! I gained an enourmous amount of knowledge from and respect for my peers, they enriched the learning environment.

Naturopathic midwifery - Part 1

Posted by Tatiana

Naturopathic midwives make up a small minority among midwives. They are naturopathic doctors who practice midwifery either in conjunction with a larger practice, or as their primary practice. I was introduced to the existence of this subset of midwives recently and personally vacillate between being compelled by the notion and turned off by the notion. I want to know more. I'm investigating it further by interviewing some ND midwives, but I want to first provoke questions I haven't considered from the rest of you.  

Here's a breakdown of my current understanding and opinions of naturopathic midwifery: