MidwifeMom

One thing you can do is to have the mother try pushing on her side or on all fours if the facility will allow it. This opens up the pelvis and allows for a larger space for the baby to pass through. During labor encourage breathing and relaxation. Encourage the woman to empty her bladder frequently to give baby more room, and to change positions (walking, sitting, standing, leaning over the bed, etc). Changing positions will help the cervix dilate and baby move down. As for breastfeeding, encourage moms to breastfeed in the first hour while the baby is most awake. Then encourage breastfeeding ever 2-4 hours after. Even if baby doesn't initially get the hang of it, it is good practice. Mom's milk probably won't come in for a few days, but baby is still getting high antibody colostrum from the mother's breast. You can also try to encourage skin to skin with mom and baby immediately after delivery by placing the naked baby onto mom's bare chest or abdomen and then covering them with a warm blanket. Studies show that this helps the newborn regulate it's temperature. I know it's difficult to make changes when a hospital has such a strict routine, but encourage staff to make changes by showing them current research and by saying let's try this, etc. Good luck, volunteering is a wonderful thing.

I understand her point about not exploiting women in Kentucky due to the poverty. I would feel like I was exploiting a woman who was just volunteering because of financial issues. I also understand the need to perfect one's exam technique but I do not think that using students is the answer. Students are also in a vulnerable position and probably feel obligated to have exams performed on them. If Frontier says it is a personal choice than that is fine, but it is not ok to require it. In my opinion if you are require pelvic exams to pass than you are exploiting your students and we should be protecting ALL women. There are plenty of crappy residents who have never even picked up a speculum and are practicing on their first patient in a hospital or clinic. Most of us have been on the patient end of having a pelvic exam and we do not need to have it done again just so we can learn empathy. If you are not already empathetic towards others than you probably shouldn't be in midwife school!

I agree with you 100 percent. I think women need midwives in places where there are none because without midwives I think the philosophy of normal birth is lost and we begin to see more complications and interventions. On the other hand as you said, midwives can only do so much and women should be their own advocate first. I have seen many women who come to the hospital to have their babies who have no clue about labor and birth which makes them even more vulnerable than they already are. Others are not even open to midwives and trust only their doctor because they don't understand what research supports. Many ldr nurses even have no comprehension about what midwives are about. Atleast here in Kansas, everyone is so against midwives. Hmm according to the latest stats...the infant mortality rate is 11 per 100 and black infant mortality rate is 19 per 100. I wonder if maybe a lack of midwives is the reason? I think we need more education about the maternity care system before it gets any worse than it already is.

I have also heard these statements coming from other nurses. I think it is more from a lack of understanding about the midwifery profession. Research supports the midwifery model of care for birth. I have witnessed poor outcomes many times from ob/gyn practice and unneccessary intervention. More nurses need to support their profession and use evidenced based research in their practice. Women desperately need midwives to advocate for them and create a safer birth environment.

Selke thanks for your post. I am glad at least one person can understand my feelings. I just don't think it is acceptable for midwifery schools to require this. Sure we can all get through this, but it is really necessary. Gynecological Teaching Assistants seem so much more effective because these women are trained like you said to teach the skill effectively and critique students. I can't see how much could be learned on the opposite spectrum when both students practicing in front of an instructor are already embarressed and uncomfortable. It's not ok for Frontier not to use GTA's just because they don't want to spend the money. Students pay a lot for tuition. I will have to read the book you suggested. It seems very informative for those of us study to become midwives. Something like 1 in 3 women have suffered sexual abuse so this would be very helpful.

I don't think it is a question of maturity or not. I think it has to do with being the one in charge of your own body and not accepting less. I will not exploit my body for teaching purposes. I am actually shocked at how many women would just lay down and do this without any objections. I guess this just proves that women really are still considered the weaker sex and sexist practices are still being used. As i said before this would never be accepted in medical schools or schools with more men. Men would not agree to practice catheters or prostate exams on each other. If you can't speak up for yourself on issues like this then how can you ever advocate for your patients who are extremely vulnerable. How will you (as a midwife) ever sympathize with women like me who find pelvic exams to be humiliating and traumatic. Midwifery should be about empowering women not continuing to support the belief that the "norm" in our society should be passive, voiceless women.

Sorry, let me clarify a little. I just feel like students with a history of an STD or sexual abuse should have the right to refuse just because the experience itself might be traumatizing for them emotionally. Frontier's handbook made it sound like it was a mandatory thing before begining clinicals. If it is strictly optional than I think that is fine and would be a great learning experience. My post was based strictly upon REQUIRED pelvic exams. I have heard some schools like Columbia require this. Here is the forum on allnurses that talks about male student going to the hospital and females being required to practice on each other. https://allnurses.com/forums/f223/columbia-university-etp-2008-a-257838-36.html There is also a documentary call At Your Cervix, that identifies this as an issue in colleges. The documentary also talks about medical students doing exams on anesthesized women which is completely unethical. http://www.atyourcervixmovie.com I just think that women should have the right to choose whether or not they participate in this experience and I wanted to get feedback on others who have done this while attending Clinical Bound. As far as male students, I was just stating that it wouldn't be fair to require female students to practice on each other, while male students go to the hospital, etc. Another point I was trying to make was that if it was required than I would reevaluate what schools I want to go to. Thanks for all the feedback. I am glad to hear that the process is voluntary.

I understand that the population of women will consist of women with stds or sexual abuse which are extremely vulnerable. I do not agree with causing these women more trauma then what they have already experienced. Making them go through a pelvic exam without the privacy of their trusted healthcare provider (not fellow students) when it is medically uneccessary is not acceptable to me. This causing more harm then good in my opinion. I also do not think it is fair to women (from a feminist standpoint) because men would never have to do these type of procedures on each other.

Have you heard anything about Frontier requiring pelvic exams on each other? I was considering Frontier, but I read in their handbook that students "will give and receive pelvic exams at clinical bound". I emailed Frontier to verify this, but haven't received a response yet. If Frontier insists on using real people for pelvic exams, we pay enough for gynecological teaching assistants.

I know Columbia does this for sure but was unsure about Frontier. Midwyf what do you mean students have to do one before they can start clinical? Does it have to be on a mannequin or another student? My main concern for this practice is student who have a history of sexual abuse or a sexually transmitted disease. I realize midwifery student are primarily women, but what about male students? I have also never heard of medical students or ob residents practicing on each other and I think this would be considered sexist if they "forced" female students to participate. I don't think the philosophy applies to this situation, because most women have had pelvic exams in the past and know what a pelvic feels like. (Same thing with shots, iv sticks, etc) That's what the Sim man is for. Let's not forget that these are still our bodies and we are practicing medical procedures that are medically uneccessary. I think most midwife students go through with this because they are too afraid to stand up for themselves. In my opinion this practice is outdated and completely unethical. We pay enough for school that they should be able to hire "models" or gynecological teaching assistants. If you don't go into midwifery with a compassionate attitude to begin with than you shouldn't be in the profession. No one can make you compassionate and caring to patients if you are not compassionate and caring:angryfire.

I am thinking about going to Frontier for nurse midwifery next year but am concerned about the clinical bound portion of the program. I read on Frontier's website that students give and receive pelvic exams. I am assuming that this means you will give and receive these during clinical bound. Can any Frontier students or previous graduates tell me your experience with this. It's not that I mind getting a pelvic exam, but it's a little unnerving around your peers. Thanks for any feedback

I am planning on trying to get into midwifery school in the fall of 2008. I live in Kansas and there are very few CNM or CM's here. In fact there is one nurse midwife in my area. I am considering the Frontier School of Midwifery or the University of Kansas program. I would really like to do the Frontier program since I have heard excellent things about it, but I am concerned about being able to find a CNM to be my preceptor.I am willing to drive if I have to but I don't want to be traveling all the time. Does anyone live here in Kansas or attended frontier and have any suggestions. If you have attended frontier how many hours per week are you usually in clinical? Do you feel like you were able to get enough experience with the opportunities that you had during school?

I am in Kona right now working at Kona Community Hospital. The condo is awesome right on the ocean. I am not to crazy about the hospital though, very out of date. Love Hawaii though!!

I am traveling right now in Hawaii with my Husband and two girls 5 & 3. The main thing is just getting your agency to work with you as far as a two bedroom. I am sure your kids will have a blast exploring new things and seeing the world. You can always enroll them wherever you go or just homeschool. I've even thought about doing longer assigments (26weeks) just to enroll the kids in school, but homeschool works fine as well. Good luck

Hello all, I am currently a traveler on the Big Island, Kona side. Make sure to apply for your license well in advance. I applied May 11th and just now got a license June 18th. (after much time spent on the phone with the Hawaii board). Apparently this is the worst time to apply for a license in Hawaii because July 1st every nurse is reapplying for a new license and they are extremely busy. I was told that to be licensed by June 18th, I would have to pay 135.00 for initial licensure that would expire July 1st of this year. (yeah a total of two weeks). I needed to pay an additional 180.00 to be licensed from July 1st, 2007-2009. What a mess. As far as the Big Island goes, it is extremely expensive. Groceries are outrageous ($7.00 for a gallon of milk) Of course I am from Kansas too. :-) Kona side is nice, lots of beautiful beaches within driving distance and plenty of places to snorkel. The scenery is very different, from lava fields that look deserted to white, gold, green, & black sand beaches. Volcano National park is an excellent place to visit, and the Hilo side is greener and more lush with plants and waterfalls. Good luck in July! If you have any more questions just pm me. Jamie

Kona Community Hopsital, 500/month for ground transportation, Health insurance is free, and guarenteed pay. Did you like Kona? How was housing? Is the area pretty safe? Thanks for any info

Are there any specific benefits that I should ask for in Hawaii? I am going to the big island in June and have never been. These are the benefits they are giving my so far: Free private housing Utilities travel reimbursement ground transportation reimbursement Anything else I should ask for? Thanks

I was offered a position at CHOMP for 29.00 an hour. How much are you going to be making because 29.00/hr seems way too low considering new grads make about 35.00/hour in northern california.

Yeah it would be at CHOMP if I accept. Thanks for your reply, I thought that sounded too low.

I am new to travel nursing and was offered 29.00 an hour for a L&D assignment in Monterey. This sounds low to me but I am not really sure what the starting salary is in this area. Can anyone give me an idea what the normal starting salary for Northern California is. I only have a year of experience. Also if this seems too low can you recommend another good agency for Northern California. Are there any particulars that I should ask for in California? Thanks

Thanks so much to everyone who is helping by signing the petition and writing letters to ksbn & the governor. We still have a lot of signatures to get so keep them coming. Thanks again Jamie

Here is a petition to sign for ksbn to change their decision. Pass it on to anyone willing to help. Please sign the petition to change Kansas Board of Nursing's decision regarding licensure of Excelsior students. http://www.petitionspot.com/petitions/changeksbndecision Thanks Jamie

Please sign the petition to change Kansas Board of Nursing's decision regarding licensure of Excelsior students. The board is meeting March 16th so it is critical that we get a lot of signatures. http://www.petitionspot.com/petitions/changeksbndecision Thanks Jamie

Please help recent Excelsior graduates to get the ksbn decision changed. If their decision does not change we must repeat the year over or be forced into another profession. Write to the governor, & ksbn board members expressing your opinion why they should change their decision. Unfortunately this affects us all, because Kansas is trying to make Excelsior degrees worthless, and with the nursing shortages already, this will decrease the amount of new grads. As nurses we know that distance education is the way of the future and Excelsior college is the beginning of it all. Here are there emails: Here is the emails of the governor & ksbn members if anyone is willing to write: http://www.ksgovernor.org/comment.html (Just fill in the comment form) [email protected], [email protected], [email protected], [email protected], [email protected], [email protected], [email protected], [email protected], [email protected], [email protected], [email protected],wall...n.s tate.ks.us, (These are all the board members for Kansas Board of Nursing, I just sent one email to all of them, copy & paste their names into your email) Thanks to anyone who is willing to help. Jamie

Please help recent Excelsior graduates to get the ksbn decision changed. If their decision does not change we must repeat the year over or be forced into another profession. Write to the governor, & ksbn board members expressing your opinion why they should change their decision. Unfortunately this affects us all, because Kansas is trying to make Excelsior degrees worthless, and with the nursing shortages already, this will decrease the amount of new grads. As nurses we know that distance education is the way of the future and Excelsior college is the beginning of it all. Here are there emails: Here is the emails of the governor & ksbn members if anyone is willing to write: http://www.ksgovernor.org/comment.html (Just fill in the comment form) [email protected], [email protected], [email protected], [email protected], [email protected], [email protected], [email protected], [email protected], [email protected], [email protected], [email protected],wall...n.s tate.ks.us, (These are all the board members for Kansas Board of Nursing, I just sent one email to all of them, copy & paste their names into your email) Thanks to anyone who is willing to help. Jamie