Hey, y'all. I'm going to be totally unsatisfying and leave my intended future posts dangling unfinished as I bow out from this endeavor which is much more like trying to perpetuate myself as a solo blogger than I was imagining, and that's not what I'm looking to do.
What I really want to do is collaborate. So I'll still be tripping around the blogosphere and perhaps occasionally offering a post in other settings (maybe even here if this blog stays around) and if you're working on stuff and are interested in bringing me on as a collaborator, hit me up by emailing me via the link on blogger.
Tuesday, September 20, 2011
Thursday, July 28, 2011
Will the NARMs new preceptor guidelines actually reduce the number of potential CPMs in the US?
My midwifery journey is not that different than many others. I birthed all four of my children with midwives, two CNM’s, a CPM and a traditional midwife. After completing all of my pre-nursing requirements, graduating with a Bachelors of Science degree in psychology, working as a Certified Nursing Assistant and working for five years as a doula and childbirth educator I began my apprenticeship with a traditional midwife. She had had a whirlwind apprenticeship that ended with her spending 5 weeks working at a birth center in the Philippines and returning home to a full practice as her preceptor moved out of the state while she was gone. About a year later I began my apprenticeship with her. She was a great preceptor. Matching my skill level where I was while continuing to stretch my thoughts and learning by working out situations both intellectually and hands on as they evolved in the births I attended with her. She encouraged my didactic education spending numerous hours studying and reviewing information, protocols, and reports written in my personal study. I quickly stepped into the primary under supervision role. We worked together like a well oiled machine. After about three years I had completed all of the required numbers in order to apply to sit for the NARM through the PEP process. I was surprised to discover that all of the forms and paperwork had changed since I had originally printed them in 2008. I was also surprised to find that they were putting restrictions on who would qualify as a preceptor.
Preceptor guidelines are as shown from the NARM.org website “ A preceptor for a NARM Entry-Level PEP applicant must be credentialed as a Certified Professional Midwife (CPM), Certified Nurse Midwife (CNM), or Licensed Midwife. Preceptors must also have an additional three years of experience or 50 births, including 10 continuity of care births beyond the primary birth experience requirements for CPM certification.
Preceptors who do not meet the above requirements must be approved by NARM before signatures will be accepted on CPM Applications. Exceptions will be considered only for midwives who meet the experience requirements but do not yet hold the required credentials.
No new preceptor exceptions will be accepted after January 1, 2012.”
My main preceptor applied for an exception as did another midwife that I occasionally attended births with. My main preceptor was denied as a NARM preceptor. She had met the experience requirements concerning the number of births but was about a year short of being on her own long enough and had no goal of acquiring the CPM credentials. My second preceptor, a midwife with 25 years of experience and an intention of applying for the CPM credential in the next year was approved. There is only one CPM with in a 200 mile radius of where I live and practice and she was a personal midwife of mine that ended in a very traumatic birth. Apprenticing with her was not an option for me. So where did that leave me on my personal journey?
When I contacted NARM about the denial they replied that “ACTUALLY, NARM HAS BEEN PLANNING TO REQUIRE THAT ALL NEW CPMs BE TRAINED BY CPMs SINCE THE BEGINNING OF THE CERTIFICATION PROCESS. IT IS FOR EDUCATIONAL QUALITY ASSURANCE. THIS IS THE FIRST STEP TOWARD THAT GOAL...THAT IS WHY THEY CREATED THE PRECEPTOR EXCEPTION. WE ENCOURAGE
EVERY MIDWIFE TO BECOME A CPM.”
They have a goal of only CPM’s being able to act as preceptors for students wishing to take the NARM? I was flabbergasted. What about areas such as my own where the CPM credential is not valued? What about areas where midwifery isn’t legal? Can they really put such restrictions on who can sit for the NARM exam? I thought the whole purpose was to increase the accessibility to midwives nation wide by having a national standard?
When I voiced my concerns about the limited access that traditionally trained midwives (who do not apprentice with CPM’s) will have in attempting to sit for the NARM I was encouraged to look at out of state options such as a high volume birth center in order to get “my numbers”. I then questioned NARM about the possible complications of taking midwifery training and experience away from the obvious need in my community to train as a birth center midwife when my goal was to work in the home setting. I also questioned my families needs not being met by me leaving them to “get numbers” at an out of state or country clinical setting.
This was the response I received “IT TAKES MANY MIDWIVES 3-5 YEARS OR LONGER, DEPENDING ON MANY LIFE INTERVENTIONS, TO COMPLETE THEIR EDUCATION. I ENCOURAGE YOU TO KEEP PLUGGING AWAY AT IT. IT ALSO SOUNDS LIKE YOU HAVE A FAMILY THAT NEEDS YOU, AND SOMETIMES THAT IS THE PRIORITY AND MIDWIFERY EDUCATION TAKES A LITTLE LONGER. I GUESS THE OLD ADAGE THAT "PATIENCE IS A VIRTUE" IS APPLICABLE, BUT MORE THAN THAT IT IS A CRITICAL LIFE LESSON FOR A MIDWIFETO LEARN.”
When I addressed that almost all of the midwives in my community didn’t find value in the CPM credential so my potential NARM approved preceptors were essentially non existent I was told that
“IT IS A PROBLEM THAT WE ARE AWARE OF. HOWEVER, IT REALLY IS A COMMUNITY PROBLEM AND NOT SOMETHING THAT NARM HAS ANY CONTROL OVER.”
Really? . Here I was trying to bring midwifery and the CPM credential to an area that found little value in it and they were trying to tell me I wasn’t being patient and that I needed to put my family first and work on my priorities. I had more than completed all of the requirements laid out by NARM for the PEP process but the new stipulations of only allowing CPM’s to act as preceptors changes the entire dynamic of the PEP process for the traditionally trained midwife. Also the lack or responsibility from NARM for the affect it has on communities was disheartening. So that leads to the ultimate question, will NARM’s new preceptor guidelines actually lead to fewer CPM’s? I believe the answer is YES, and I may just end up being one of them.
Preceptor guidelines are as shown from the NARM.org website “ A preceptor for a NARM Entry-Level PEP applicant must be credentialed as a Certified Professional Midwife (CPM), Certified Nurse Midwife (CNM), or Licensed Midwife. Preceptors must also have an additional three years of experience or 50 births, including 10 continuity of care births beyond the primary birth experience requirements for CPM certification.
Preceptors who do not meet the above requirements must be approved by NARM before signatures will be accepted on CPM Applications. Exceptions will be considered only for midwives who meet the experience requirements but do not yet hold the required credentials.
No new preceptor exceptions will be accepted after January 1, 2012.”
My main preceptor applied for an exception as did another midwife that I occasionally attended births with. My main preceptor was denied as a NARM preceptor. She had met the experience requirements concerning the number of births but was about a year short of being on her own long enough and had no goal of acquiring the CPM credentials. My second preceptor, a midwife with 25 years of experience and an intention of applying for the CPM credential in the next year was approved. There is only one CPM with in a 200 mile radius of where I live and practice and she was a personal midwife of mine that ended in a very traumatic birth. Apprenticing with her was not an option for me. So where did that leave me on my personal journey?
When I contacted NARM about the denial they replied that “ACTUALLY, NARM HAS BEEN PLANNING TO REQUIRE THAT ALL NEW CPMs BE TRAINED BY CPMs SINCE THE BEGINNING OF THE CERTIFICATION PROCESS. IT IS FOR EDUCATIONAL QUALITY ASSURANCE. THIS IS THE FIRST STEP TOWARD THAT GOAL...THAT IS WHY THEY CREATED THE PRECEPTOR EXCEPTION. WE ENCOURAGE
EVERY MIDWIFE TO BECOME A CPM.”
They have a goal of only CPM’s being able to act as preceptors for students wishing to take the NARM? I was flabbergasted. What about areas such as my own where the CPM credential is not valued? What about areas where midwifery isn’t legal? Can they really put such restrictions on who can sit for the NARM exam? I thought the whole purpose was to increase the accessibility to midwives nation wide by having a national standard?
When I voiced my concerns about the limited access that traditionally trained midwives (who do not apprentice with CPM’s) will have in attempting to sit for the NARM I was encouraged to look at out of state options such as a high volume birth center in order to get “my numbers”. I then questioned NARM about the possible complications of taking midwifery training and experience away from the obvious need in my community to train as a birth center midwife when my goal was to work in the home setting. I also questioned my families needs not being met by me leaving them to “get numbers” at an out of state or country clinical setting.
This was the response I received “IT TAKES MANY MIDWIVES 3-5 YEARS OR LONGER, DEPENDING ON MANY LIFE INTERVENTIONS, TO COMPLETE THEIR EDUCATION. I ENCOURAGE YOU TO KEEP PLUGGING AWAY AT IT. IT ALSO SOUNDS LIKE YOU HAVE A FAMILY THAT NEEDS YOU, AND SOMETIMES THAT IS THE PRIORITY AND MIDWIFERY EDUCATION TAKES A LITTLE LONGER. I GUESS THE OLD ADAGE THAT "PATIENCE IS A VIRTUE" IS APPLICABLE, BUT MORE THAN THAT IT IS A CRITICAL LIFE LESSON FOR A MIDWIFETO LEARN.”
When I addressed that almost all of the midwives in my community didn’t find value in the CPM credential so my potential NARM approved preceptors were essentially non existent I was told that
“IT IS A PROBLEM THAT WE ARE AWARE OF. HOWEVER, IT REALLY IS A COMMUNITY PROBLEM AND NOT SOMETHING THAT NARM HAS ANY CONTROL OVER.”
Really? . Here I was trying to bring midwifery and the CPM credential to an area that found little value in it and they were trying to tell me I wasn’t being patient and that I needed to put my family first and work on my priorities. I had more than completed all of the requirements laid out by NARM for the PEP process but the new stipulations of only allowing CPM’s to act as preceptors changes the entire dynamic of the PEP process for the traditionally trained midwife. Also the lack or responsibility from NARM for the affect it has on communities was disheartening. So that leads to the ultimate question, will NARM’s new preceptor guidelines actually lead to fewer CPM’s? I believe the answer is YES, and I may just end up being one of them.
Saturday, July 23, 2011
Notes from a day-long lecture with Michel Odent - Part 1
Long promised notes from the lecture I attended with Michel Odent at the Midwifery Today conference in Eugene, Oregon back in April. Text that is offset are roughly paraphrased quotes, scrawled as I heard them spoken. The rest is a summarization in my words.
Make sure you turn on the French accent in your brain for full effect.
On becoming radical
On pitocin
Pitocin drips are the most common intrevention. Almost no births take place (in the Western world) without some amount of synthetic oxytocin. A birth is considered to be normal and natural despite a continuous drip of pitocin through the labor. You'll see it ignored as a factor in research, and certainly in the medical culture. We have no idea of the long term implications of giving synthetic oxytocin to, practically speaking, all birthing mothers.
Make sure you turn on the French accent in your brain for full effect.
On becoming radical
It is time to stop being politically correct and to talk about the situation as it is. Nice terms like "turning point" are not relevant. To accurately discuss what is happening in natural birth, we need words like "abyss" or "trap."He was really emphatic about this - that he was at a point in the discourse when trying to be appropriate or accessible was no longer important, that we can't look for shifts or movements, that we have to speak radically because the reality of birth today is radical. And he's talking about home and birth center settings, too.
On pitocin
Pitocin drips are the most common intrevention. Almost no births take place (in the Western world) without some amount of synthetic oxytocin. A birth is considered to be normal and natural despite a continuous drip of pitocin through the labor. You'll see it ignored as a factor in research, and certainly in the medical culture. We have no idea of the long term implications of giving synthetic oxytocin to, practically speaking, all birthing mothers.
The number women who birth without the hormone of love approaches zero.Coming soon: Part 2, On three recent studies questioning home birth safety, and why they're right.
Sunday, June 5, 2011
"Women are indispensable," and other nuggets from Cleverbot
So I just finished listening to the latest RadioLab episode about artificial intelligence, and decided to take Cleverbot (AI you can chat with) out for a spin on some of my favorite topics. It doesn't seem to process more than the immediate line of conversation to come up with a response, so they're sort of wonderful one-liners. Here are my favorite exchanges:
Me: How should women give birth?
Cleverbot: For every person, human or robot, the answer is different.
Me: What do you think about women who give birth at home?
Cleverbot: Women are indispensable.
Me: Do you think the rate of cesarean births is a problem?
Cleverbot: Only when I'm sober and you?
Me: Do you have a uterus?
Cleverbot: Yes.
Me: What do you do with your uterus?
Cleverbot: Talk, play, hang out.
Me: Should midwives be allowed to practice?
Cleverbot: You really should. You guys would be great for each other.
Me: How should women give birth?
Cleverbot: You should trust me.
(Typical technocrat..)
And finally...
Me: How can we address the disparities in access to midwifery care?
Cleverbot: Love bridges all gaps. We will find a way.
My only editing of the exchanges was to change "User" to "Me" so that it would be easier for our readers here to quickly track what's what, and to capitalize the "I" in "Only when I'm sober" because.. I just couldn't help myself.
Feel free to try your luck with Cleverbot and post any good ones in the comments!
Me: How should women give birth?
Cleverbot: For every person, human or robot, the answer is different.
Me: What do you think about women who give birth at home?
Cleverbot: Women are indispensable.
Me: Do you think the rate of cesarean births is a problem?
Cleverbot: Only when I'm sober and you?
Me: Do you have a uterus?
Cleverbot: Yes.
Me: What do you do with your uterus?
Cleverbot: Talk, play, hang out.
Cleverbot: You really should. You guys would be great for each other.
Me: How should women give birth?
Cleverbot: You should trust me.
(Typical technocrat..)
And finally...
Me: How can we address the disparities in access to midwifery care?
Cleverbot: Love bridges all gaps. We will find a way.
My only editing of the exchanges was to change "User" to "Me" so that it would be easier for our readers here to quickly track what's what, and to capitalize the "I" in "Only when I'm sober" because.. I just couldn't help myself.
Feel free to try your luck with Cleverbot and post any good ones in the comments!
Thursday, June 2, 2011
Student midwives - Be heard!
The Future Midwives Coalition we heard about a few months ago has taken shape and also joined with MAMA's Student Section. They've created an anonymous and comprehensive survey for aspiring, student, new, seasoned and retired midwives of all ilks to share their experiences, opinions, and ideas. And on the whole gamut.. apprenticeships, education, inclusiveness, specific programs, etc.
"We specifically encourage people from marginalized communities to share their experiences so that we can create documents that serve all future midwives, in a truly inclusive way," they write.
The responses will be painstakingly used to draft a "Bill of Rights" which will hopefully help to shape a more sound, diverse, and feasible future for incoming midwives.
So go fill out the survey!
"We specifically encourage people from marginalized communities to share their experiences so that we can create documents that serve all future midwives, in a truly inclusive way," they write.
The responses will be painstakingly used to draft a "Bill of Rights" which will hopefully help to shape a more sound, diverse, and feasible future for incoming midwives.
So go fill out the survey!
Wednesday, June 1, 2011
Resources for dads
"...a unique father-to-father, community-based workshop that inspires and equips men of different economic levels, ages and cultures to become confidently engaged with their infants, support their mates and personally navigate their transformation into dads."
I put a "..." instead of the name of the thing, because the name just grates on my nerves. Seriously? But here it is, the above blurb is describing: Boot Camp for New Dads. And if you can get past the militaristic drumbeat in the background, the video on the main page is sweet in a confused-new-dads-sharing-their-feelings sort of way.
I was surprised that they even have BCND in my town. As much great mama-centered stuff as I've heard about, the most I've encountered for new dads is that some childbirth educators will set aside a portion of time for new-dad related conversation. But mostly its a flying blind thing, and it seems really valuable that new fathers have some extra support. Obviously same-sex partners and "unconventional" participants in burgeoning parenthood would have that same need. I've most appreciated the modeling of some midwives of bringing the partner (if there is one) on board during prenatal care and addressing their needs (articulated, or equally importantly, not articulated) with care and the benefit of much experience. Not all midwives tune into that.
It has also been intriguing to realize that postpartum depression is increasingly being recognized among men (not to mention the impact on them of PPD in their partners). For a little more on that check out Postpartum Dads Project. I think we'll all be wise to remember to check in with partners when serving moms and babies.
And for both of these great resources, a hat tip to MedEd PPD who have a wonderful series of free Postpartum Depression modules that I plan on going through this summer. Anyone want to join me and make it a study buddy party?
I'm in sprinting distance of having completed my first year back in college since I had kids, and look forward to cashing in on some of those promises I've made about posts to this blog once my end-of-term schoolwork wraps up.
I put a "..." instead of the name of the thing, because the name just grates on my nerves. Seriously? But here it is, the above blurb is describing: Boot Camp for New Dads. And if you can get past the militaristic drumbeat in the background, the video on the main page is sweet in a confused-new-dads-sharing-their-feelings sort of way.
I was surprised that they even have BCND in my town. As much great mama-centered stuff as I've heard about, the most I've encountered for new dads is that some childbirth educators will set aside a portion of time for new-dad related conversation. But mostly its a flying blind thing, and it seems really valuable that new fathers have some extra support. Obviously same-sex partners and "unconventional" participants in burgeoning parenthood would have that same need. I've most appreciated the modeling of some midwives of bringing the partner (if there is one) on board during prenatal care and addressing their needs (articulated, or equally importantly, not articulated) with care and the benefit of much experience. Not all midwives tune into that.
It has also been intriguing to realize that postpartum depression is increasingly being recognized among men (not to mention the impact on them of PPD in their partners). For a little more on that check out Postpartum Dads Project. I think we'll all be wise to remember to check in with partners when serving moms and babies.
And for both of these great resources, a hat tip to MedEd PPD who have a wonderful series of free Postpartum Depression modules that I plan on going through this summer. Anyone want to join me and make it a study buddy party?
I'm in sprinting distance of having completed my first year back in college since I had kids, and look forward to cashing in on some of those promises I've made about posts to this blog once my end-of-term schoolwork wraps up.
Sunday, May 22, 2011
The Baby Project on NPR
Putting it out there for those of you plugged in with a lot of pregnant mamas:
"This summer, NPR is looking for expectant mothers to be part of a special project where we document that final month leading to delivery.
If your due date is mid-July and you'd like to be considered for our Baby Project, please fill out the form below.
We're looking for the most compelling stories to feature, so please describe what makes your family, pregnancy or delivery plan interesting or unique."The Baby Project
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