Tag: NARM

Reflection

jmacmidwife

In what ways do you think this experience might affect you as an individual?  I believe this experience is making me much more patient as I have to pace myself.  I am getting invaluable experience with time management and managing my time as well as my daughters’ time, but it has still been an adjustment to really focusing on getting in the habit of getting it done.  I am a procrastinator at heart, so this has been a hard habit to change, but one that needs to be eliminated. Being away from home has made me more forgiving of the little things my husband used to do that annoyed me, but strengthened me in that I know I can still not be physically with him, but make it work.  This experience is also giving me the opportunity to live in a different climate around different cultures.  This is verifying that I am adaptable as a person and can do anything for 2 years, even if that means living in an apartment.  Since I am not a journaling-type of person, this journal has been challenging.  So, although I prefer to talk things out, journaling has worked for me thus far.  Ask me this in a month and a half, though, when the thing is due.

In what ways do you think this experience is affecting you as a student midwife?  I love this experience. Even though I do not have a preceptor, I am in no hurry to jump into a full blown apprenticeship.  I do want to start, just because I know I need to apprentice for a year, at a minimum for NARM standards and I don’t really want to be in school forever.  But I am here to learn the books, read the books, and understand the books.  Yes, I love apprenticing, but having a good foundation of book-knowledge, I believe will help me with the challenges I will encounter in the field and enable me to at least have a jumping off point before going and researching more. 

Overall the combination of experiences I am receiving will not only affect me personally, but also professionally one day.  In my practice, I will employ all of these effects.  By having the opportunity to utilize them, it will hopefully make it easier to run my business.

Midwifery education on the bayou

jmacmidwife

The community college in Lafayette, Louisiana has been trying to get a direct entry midwifery program off the ground for years.  It finally looks like it will take flight this January.  How do I feel about this?  Well, it is unfortunate that I had to relocate my family 1,000 miles away from our home and separate my husband from me and the girls, but I do not regret it for a minute. 

I feel this way because I know some of the potential problems that the school is going to have—one of which is that there is not the volume of births for the students to attend because there aren’t enough midwives or clients.  Louisiana has a very small midwives association and no consumer support group.  Therefore, few consumers even know that midwives are still around. But this new program will definitely get eyes open, which is good for everyone!

My issue stems from the clinic component of the college—half of all births (assists or observations) need to be in a hospital setting and half of out of hospital births need to be in a clinical, birth center, or public health setting (I have no idea what that might be).  Finally, the remaining ¼ births will be in a home setting.  Now, don’t get me wrong, I am happy that more midwives will be made, but is this really the most effective mechanism—to require the majority of births be in a hospital setting? Seriously? I must be missing something. 

Plus, to make it all the worse, MANA and NARM apparently are supporting this curriculum.  HMMMMM. The last time I checked, MANA’s core competencies did not include hospital births.  And it isn’t like I think it would be invaluable AT ALL to be in the hospital. I was a doula for 5 years and gained incredible perspective and knowledge from attending births in hospitals; however, hospital births will not be the basis for my education and experience –besides—how will NARM even count these births on the NARM paperwork, unless they are making special concessions for this school? Currently, I believe NARM only allows for 2 hospital births to be part of its requirements.  So what are these students going to do with the other 18? And what about the transport rate? It isn’t like Louisiana doesn’t have a high surgical birth rate—oh yes, it is high, one of the highest in the country. Can these student midwives gain valuable experience from a c-section? Well, maybe the first one or two, but again, we are not training surgeons here! We are training home birth midwives!  So, why aren’t they training in that setting?  

And another bone of contention—a student cannot count more than 10% of total births from out-of-state experience.  So, even if that student was to get a rockin’ apprenticeship in Washington, she couldn’t take that experience and apply it to her educational component because that would be too practical, no wouldn’t it?  My understanding is that the NARM functions to provide a minimal standard in midwifery skills and competencies — towards creating a national standard.  How can a national standard have different qualifications? I feel that if the minimal standards are not being met that it will cheaper my degree and/or my CPM making this whole quest for standardization and respect for it null and void.