Ok folks....I'm already proving to be a bad blogger, but here's an update anyways. AND....since I had to write something up for one of my classes about the experience...that's all I'm doing. Here's a copy of what I had to write for the class. If you REALLY have more specific questions about my Farm experience, hit me up and I'll see what I can do.
3.7-13.10 The Farm, TN c Ina May Gaskin, CPM, Pamela Hunt, CPM, Stacie Hunt, CPM,
Carol Nelson, CPM, Joanne Santana, CPM
Ok, now on to The Farm. I flew from Arcata to Nashville and was picked up and driven the final hour ½ to The Farm. I was housed in one of the grand mansions of The Farm which used to house up to 50 people back in its hay day. In brief, The Farm is a community created in the 70’s by a group of people following the teachings of Steven Gaskin – a former professor at San Francisco State. In 1966 he started holding “Monday Night Class” which grew to crowds of over 1500 people each class. He decided to go on a speaking tour around the country and many people purchased busses and vans to follow Steven as he spoke. Naturally, with so many people following, babies were born on this caravan. Since Steven had served in Korea and knew a little medicine, he was considered the highest authority on medicine in their group and subsequently his wife Ina May began attending births as well. With her friends, Ina May and a few other women became midwives out of necessity, but then studied on to become some of the world’s most knowledgeable women about childbirth. When they settled down to create a permanent community in Tennessee, it just so happened that they were also situated near a large Amish community – with a long history of homebirth. They befriended a few doctors in the area and for the most part were able to deliver nearly all the babies at home on The Farm. People even traveled from far away to birth their babies on The Farm – in fact, people are STILL traveling from across the world to be in the hands of these midwives. They have multiple birthing houses set up to accommodate the mother, her family, or whoever needs to be there to make their birth a smooth, peaceful process. And since these midwives are still out there, people like me get to go utilize them as resources as well!
I attended a six day intensive Midwife Assistant Workshop. Basically it was an overview of all things relating to childbirth in a short amount of time. Most women in attendance were currently practicing as doulas, but there were other women who were simply getting their feet wet with the midwifery practice. I fell somewhere in the middle – coming from a nursing school background added extra information to the group and I had a few moments where I thought “aha! I really AM learning things in nursing school!” Hahaha (that’s a joke of course). Overall it was a great experience and simply being in the presence of Ina May and her colleagues was special and inspirational to my future nursing practice.
I will now attempt to answer the questions associated with this clinical rotation while also giving over what I feel that I learned from my experience on The Farm.
Classes I attended included:
• History of The Farm
• What is expected of a midwife assistant
• Sterile technique, packing instruments
• Introduction to midwifery assistant skills; BP, P, FHT
• Introduction to anatomy and physiology of female reproduction, labor, birth and postpartum
• Helping the breast-feeding mother; latch on problems and solutions for engorgement sore nipple
• Bloodborne pathogens
• Charting, record keeping, medical terminology
• Baby’s position, station, engagement, dilation checks
• Oxygen set up and use
• The midwife assistant’s role in postpartum care of the mother
• Midwife assistant’s postpartum care and assessment of the newborn
• Prenatal testing of iron and urine
1. How did you incorporate the five aims of intervention?
During this workshop I did not deal directly with any clients. We had one pregnant volunteer allow us to measure her fundus and palpate the position of her baby, but that was the only direct client contact. During our course on what is expected of a midwife assistant and throughout many other classes we discussed the importance of working with the laboring mother and her family to make the birth as easy as possible. Things like respecting the mother’s space, desired lighting, sounds, foods, beverages, and smells during labor mirrored many of Modeling and Role Modeling’s core philosophies regarding promoting client control and strengths, promoting positive orientation, and building trust between the client and care provider. In these circumstances setting mutual goals would most likely focus on what’s best for the health of the mother and child and whether or not transporting to a hospital was necessary.
2. What impact did you have on the client(s)/family?
Since I did not deal directly with clients during this workshop I can’t say that I had any impact on them or their families. We did lots of role playing in our classes which included breast feeding tip, post natal and cord care directly following deliver, and dilation and station checks (on models).
3. Interventions performed:
The only interventions performed directly on a client was to measure fundal height during pregnancy (our mother was about 32 weeks along), and to check the position of her fetus (baby’s head was down, but not engaged). During our classes we used models to simulate cleaning the mother prior to birth, checking dilation and station, baby’s position and engagement, different breastfeeding techniques, postpartum cord care, and postpartum assessment of the newborn. We also learned multiple techniques on how to sterilize instruments, how to set up and use oxygen for different circumstances, and how to do prenatal testing of iron and urine.
4. Discuss what you learned about yourself as a communicator and care provider as well as your role and functions in the agency.
Looking at this trip from a communication standpoint, I learned (or continued to learn) that I have a strong voice and I have the ability to affect change in whatever direction I set my work to. No matter the situation I tend to slip into a role of leadership and I’m learning that embracing this can be a good thing if my intentions are set right and on positive goals. The desire to advocate for womens issues feels inherent within me and meeting Ina May and hearing about her Safe Motherhood Quilt was completely inspiring. She has been speaking up about underreported maternal mortality cases in the US for years and recently there has been more attention shown on this subject than ever before. To me it’s inspiring to see one woman’s voice be heard at such a large level and, though I haven’t found my passion project, I feel that someday I too will help affect change at the level that Ina May has been able to.
As a care provider I learned that there are many routes to becoming a midwife. When these women started practicing none of them had licenses…and no one really seemed to care as long as the care they provided was high level. Eventually they became instrumental in creating the Certified Professional Midwife certificate – which has multiple routes to receiving it. People can attend an accredited program through a Midwifery Education Accreditation Council (MEAC) school, apply through a Portfolio Evaluation Practice (PEP) program, or become a Certified Nurse Midwife/Certified Midwife before applying for the CPM. Oh course, in addition to a skills exam and extensive clinical expectation prior to application, accreditation is different depending on which state you plan to practice in. Some states allow CPMs to practice, some states don’t allow homebirth at all, and some states allow CPMs and CNMs to practice. So it gave me a lot to think about as far as my future practice goes. In the end I think that I’m going to continue on the route to becoming a CNM since New York is one of the states that doesn’t allow CPMs to practice and that’s where I intend to go after here. I also feel that although it might be harder to start up a homebirth practice as a CNM, I am myself, and I will make it happen if that’s what I want to do. Additionally, if I end up practicing in a hospital as a midwife I feel that those women need good caring midwives too!
5. Describe the positive and challenging aspects of this experience. Upon reflection how might you have approached a treatment or client differently?
Positive aspects of this experience included being able to interact with world renowned yet down to earth midwives, having hands-on examples to work with, and the intimacy of the course (there were only 15 students). I was hoping to increase my knowledge base by attending this workshop and I certainly did. I brought home many handouts and other resources compiled by the midwives there that I feel I will use in the future as well.
Challenging aspects of this experience included the physical travel required to attend the workshop, but once there the experience was pleasant and it was relaxing to be in rural Tennessee. Since I did not provide much treatment while at The Farm it’s hard to reflect upon how I would do it differently, but in general I was happy to have made the journey and to have tried something different.
6. How has your worldview been affected by this experience?
Well, again, meeting and interacting with Ina May and Pamela Hunt and Stacie Hunt was a really special experience unto itself. They’re all still actively practicing midwifery and I was definitely inspired to continue on my chosen path into this profession as well. I always find it interesting to meet new people and hear them say that they can see me doing big things in my life, or that I seem very familiar, or that I remind them of someone very specific – which all happened there on The Farm. Maybe I am familiar to everyone and that’s how I will affect change on the world for the betterment of women’s health.
I feel inspired after attending this workshop and I know that I need to continue to speak up and become a stronger advocate for many of the things these women are advocating for because they won’t be around forever. I agree with them that birth has become too medicalized and that women have an inherent ability to birth their children because that’s what we’re biologically made for. Of course I understand that there is a place and a time for medical intervention, but I feel even more strongly the need to enter into this profession for the sake of the women who don’t want and don’t need medical interventions.
My goal of adding to my knowledge base was met and I look forward to applying this experience to my nursing practice and to my upcoming trip to Ghana this summer.
Hip-Hop for Haiti was a total success!!!!! Humbrews was rockin' and about 300 people showed up to support the cause. Music started round 10 with J the Sarge representing the One Wise Sound on the turntables...segued into VJ Itchy Fingaz playing some of the finest old school hip-hop jams (thanks for Mos Def Ms. Fat Booty!!)
so) and stepped it up!!! Flips, jumps, spins, coordinated routines....the works!!!
