Hello folks! I am pre-CNM and will *try* to get a L&D position to gain some much needed experience before trying to find a CNM position...
I was wondering how those of you who are working in L&D are coping with the different model of care as you are (mostly, I assume) working under OB/GYNs in the hospital setting? As I read through the different posts (ie: lichotomy positions, enemas etc.) I keep imagining how hard that would be to have to perform as RN who might not believe in all the interventions...
Is this something that actually crosses your minds, or are you really too busy to think about it? What advice can you give to someone who is worried about having to administer so many routine procedures that totally go against what they're working toward?
And I'm sure you know about Mary Breckenridge, who brought the English style of educated midwifery to the USA in the 1920s, helping form the nurse-midwifery profession. She lived and practiced in Appalacian Kentucky, and founded the Frontier Nursing Service.
The post has evolved into something even more beautiful, LOL.
I, too, know a thing or two about the history...I am going to be a third generation midwife. Women in my family were "lay" midwives in rural Arkansas...
I've been given so of the weirdest looks as I explain that I am going to graduate school to become a midwife! LOL
How similar we are. Same dilemma for me, last year. I finally decided to put in time in a hospital with high risk births as well as a birth center. The birth center was the reason I took the job.
How has that been going for me? In the L&D area, horrible. If you must take this path, I suggest avoiding a teaching hospital. The residents will teach you what NOT to do, but too much of that can be damaging to your psyche. The only reason why you would put yourself through a conveyor belt mentality in hospital birthing practices, is to learn from good people.
But working with the midwives has been great. Furthermore, when I finally go on my own, I get to rotate in the birth center as much as I want to (because the other nurses, for some reason or other, really hate b/c assignments). Being able to give myself and to support mothers/families during labor, makes me feel right at home.
Someone has mentioned that a lot of midwives practice in hospital settings, and that's true. But that's not the kind of midwife I eventually want to be. I believe there are many women out there who would want midwife care dictated by skill and experience rather than hospital protocols.
Only time will tell if I made the right decision. I feel right now, I might come out of this a little scathed by the bad experiences, but hopefully they will serve to make me a better practitioner. Good luck with your decision, and please keep me posted.
Try a freestanding birthcenter.It is wonderful for the right candidate, they usually do not pay as well as the the hospital because they are ususally self supporting. By the way we are usually reimbursed by the insurance company at less than half the rate of a hospital delivery. 99%of our moms breastfeed,use the jacuzzi for comfort measure and for tub birth. A wonderful book to read of birth stories is spiritual midwifery by Ina Mae Gaskin whom actually still practices on the FARM with a group of midwives with wonderful statistics. They also have teaching clinics at different times of the year. Our one midwife says that just because they hang wallpaper and add a plant at the hospital does not make it a birthcenter. One last thing, our midwives join our clients when they go into labor at the hosp or bc and stay with them until delivery, they dont jusxt popin to catch at the last minute.[unless they come in that way!!] Hope this helps. :)
Lpn, I think a birthing center would be ideal for me, but the problem is that there aren't enough them to go around! I have read Ina May's work and it's great. I liked Peggy Vincent more though!
Epiphany, I know what you mean! I am trying to mentally prepare myself for the institution...I have shadowed my community midiwves in different settings and I must agree that the teaching hospital was the worse. It was very sad to me...the clinic was the best though! (We don't have freestanding birth centers)
I will do a lot of hospital care simply because I have to keep in my mind my ultimate goals of earning a PhD for reasearch and teaching, and I think I will need to do a lot of institutional networking!
I am about to start my senior preceptorship in L&D in two weeks and I'm having a lot of the same thoughts, but we'll see.
I sort of think of it as a lot of the other posters have mentioned, plus I may be able to expose my patients to better or different viewpoints/care than they might otherwise get... in other words I won't be preaching to those that are already converted (not that I would literally preach my views to anyone, I realize that people make their own choices & respect that, but you know what I mean). I have found that often people are more open to change and new ideas if you get closer to their viewpoint/habits and plant one tiny seed at a time.
I know that there are a lot of things happening at the hospital that I'm going to that aren't ideal, but I can do my best for whatever bit I'm involved in. I think it's the nurses who make or break a delivery experience anyway... everyone remembers their L&D nurse! :)
By the way, I have an OB friend that has worked with midwives and she's basically like "bring 'em on" ... let them deliver the normal deliveries and call me for the problems!!" She makes beaucoup money and wouldn't feel threatened at all, but I know they aren't all like that... as a matter of fact our medical board has essentially blackballed midwives from practicing in our town (if one were to come here (which they wouldn't anyway with these policies), they couldn't deliver without an MD present, and they coudn't round... so what would be the point? Anyway, no mw's in my town... at least for now... which is a shame in our very underserved area...).
Anyway, we'll see how it goes in L&D... my ideals about me being ok with it may go out the window and I may end up working in endoscopy! LOL
I've been an L/D nurse for 14 years. I started out on Mother/Baby and soon after went to L/D. I have always wanted to be a midwife so I started back to school a few years ago, and I'll be getting my BSN this summer. My plans are to go to the Fronteir School of Midwifery. I've heard it's a great school, most of the work is online. Except for the clinicals of course. The one thing the school did have to say about doing my clinicals was that I wouldn't be able to do them in the place I'm employed. They suggested that I could transfer out of the L/D unit while I did my clinicals, for example, transfer to NICU until my clinicals are over then transfer back to L/D, however, I simply will do my clinicals at the other hospital in town. I didn't want to transfer out of L/D. Good luck with getting into L/D, I'm sure you'll enjoy it.
I had taken enemas out of my birth classes and thought it was looong gone. last week a charge nurse told me "Dr so and so want's all his pt's to have enemas" Knock me over!! guess i'll have to put that back in. grr. In So. CA no less.
That's my plan too, first LVN then work my way up- I'm sure it will take forever but i'm pretty determined ever since I had a CNM home birth for my second dd :)
I've been an L/D nurse for 14 years. I started out on Mother/Baby and soon after went to L/D. I have always wanted to be a midwife so I started back to school a few years ago, and I'll be getting my BSN this summer. My plans are to go to the Fronteir School of Midwifery. I've heard it's a great school, most of the work is online. Except for the clinicals of course. The one thing the school did have to say about doing my clinicals was that I wouldn't be able to do them in the place I'm employed. They suggested that I could transfer out of the L/D unit while I did my clinicals, for example, transfer to NICU until my clinicals are over then transfer back to L/D, however, I simply will do my clinicals at the other hospital in town. I didn't want to transfer out of L/D. Good luck with getting into L/D, I'm sure you'll enjoy it.
I want to be a nurse in L/D and am wondering what the best route is for me to take as far as schooling goes. Would you mind telling me how you got to where you are now? Did you get your LPN first or just go straight to your RN? Did you go to a vo-tech school or a college? Did you have to wait a long time to get into L/D? Do you have any suggestions for me based on your experiences as to what would be the quickest way to get to where you are now if you could do it all again?
I was a pre-health intern at a hospital L&D unit for 4 months as well as a birth partner for teenage mothers having county hospital deliveries. I had my own 3 children with a midwife, the first at her free-standing birth center and the last 2 at home. I am SO glad I made that decision esp. after what I observed in the hospital. We need more truly educated midwives who have a real understanding about the birth process! I feel so passionate about this that I just may have to become one myself! I think good midwives have to have been exposed to a lot of "unremarkable", baby-centered and parent-centered births and experienced (not necessarily personally!) the dynamic and powerful process of totally supported home births. It is a given that one will learn complications and high risk situations but if one never experiences the latter, a huge chunk will be missing. Seek and you shall find!
Selke
543 Posts
Here's more on African American midwives, many of whom practiced in the south:
http://www.kaisernetwork.org/daily_reports/rep_index.cfm?DR_ID=34416
Anacostia Museum in the Washington DC area has an exhibit on AA midwives until August 6th, "Reclaiming Midwives: Pillars of Community Support"
http://anacostia.si.edu/exhibits/exhibits.htm
And I'm sure you know about Mary Breckenridge, who brought the English style of educated midwifery to the USA in the 1920s, helping form the nurse-midwifery profession. She lived and practiced in Appalacian Kentucky, and founded the Frontier Nursing Service.
http://www.midwives.org/whoweare/fnshistory.shtm